4471 Clover Lane
4
Use BLUE or BLACK Ink
For Office Use I
U
Permit#: ~Q
City of Ea
EaI PermitFee:
I I
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 1' J / L 1 G 1,3,
Tenant: _ >i5) L21I Lr. ,'CA„ds,0, SuiteM
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: lalc&
Construction Cost:01`~0 0 Multi-Family, Building: (Yes / No )
CONTRACTOR Name: Q. License
Address: cl S! C„~,g~ City: n Ct e,
State: Zip: g7 S-/9 Phone: Co S % - ::z S'"? - V3
,
cc(( J
Contact: Email:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.cjoi)herstateonecall.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 approv I of plans.
x cam- J~ x IL, - , ~ ziaua
Applicant's Printed Name Ap" is is Signat e
Page 1 of 2
LH -71 QWC-(~- Ln'
DO NOT WRITE BELOW THIS LINE
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 ,3CYw Occupancy T ge, -1 MCES System
Plan Review Code Edition `,ZM -2 SAC Units
(25%_ 100%_I/) Zoning ID City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length- Fire Sprinklers
Type of Construction Width0
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) _-Y4 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
Base Fee
Surcharge
Plan Review JT-2
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 2
i s
"1(tG~L ~✓1 a ~SC~(l 3-5 37
ROBE ' CONSULTING ENaINEEAS
ENGINEERINGI PLANNERS and LAND iURVEYOAS
COMPRNY, INC.
.1000 EAST 1461h STREET,; BURNSVILLE, MINNESOTA 53337 PH 4323000
c4ff
z 'z ctac_,_, ~ `dux-3c u '4q:-i
LOTS 9, /o, ll, AND J,2, BLOCK / J ' E'DCA) AOL717-10,t,1
DAK07-4 COU"TY, MIAIM550TA
C~-P% DENOTE5 E)(15771!16 ELCVf17-1QN
(920.0) DENOTE5 PROP05--D E'LEVAT/on/
W DI CATS 5 Ul KECT1o/cl OF SvRFACE 09A/NA6
920.5 = IN/SHED C.~iRAGE FLOOR ELEVAT/otv
.00
IV aRT H EAC At'
d
R
SCALE: 30
NS DIVISION
X10 'q
g fj
SIC
C
Ri S9 T
a ~ 9,80 del,
A,
red)
at pi"t
\ 9/7
A)ZI .00-
O E3 a
• 00 v Q`
Irv
X03 8 nAi ~'sj `9j [r'fv),-~~'.`"
~ ~9_` ~ yam, o ~ I O P a O p
b
I hersby certify that this is a true and c"ct'representation f a tract of
land as shown' and described hereon.. As prepared by, me on this 33M,r day of
' Minn. log. No.
Mike,
Jeff has several building permit applications for deck replacements in Eden Addition. Eden Addition is
quad homes, zoned PD, dating to 1980. There was no provision for reduced setbacks in the PD
Agreement.
Some of the permits are for decks are in front yards, facing public streets. The buildings are already at
the 30' setback, and it appears existing decks are 8' deep. I gave the go-ahead to replace decks the
same size as existing, which appears to be 8'x 10'. Two are proposed to be 8 x 20'. Are you
comfortable with larger decks, provided they do not go any closer to the front lot line than the existing
8'?
.
Please let me know.
Pam
Thu 7/22/2010 3:34 PM
Yes, as long as the 8' encroachment isn't increased.
Thanks,
Mike
J
" CITY OF EAGAN NO 18763
3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55121 ? f
' PHONE: 454-8100
BUILDING PERMIT Receipt # ?
To be used for g?gx' h?-pAjg esc Vaiue ??0, OCO Date MAR 5 , 1g 91
Site Address 4473-.A ,C.I.p\g= LN _
Lot i l- Block 1. Sec/Sub.
Parcel No.
w Name?ITIKh',,.OSTF.i.E
? Address 4413=A CLOU,Ek LN
Citv EAGAN Phone
o Name _ADVANCE COMPANIES INC
gQ Address FW00,Etd,'Fp?A?i?,.gkELNE
i- Cjty ?FRIDLEY Phone 572-2000,
r
ww Name
?'a Address
aW Cdy Phone
I hereby acknowlege ihat I have r ad this app' ation and state that ihe
inlormauon is correc _and-agree mply witb II pplicable State ot
Minnesota Statut? a?ntl Ciry o g?n O dinarices. '
SignaNre of Permnee ?- ?-`
A Bwlding Permit is issued to: ADVANG?_ CO 4P I-
on the ezpress condition that all work shall be done in accordance wifh all
applicable State ot Minnesota Statules and Qty J of Eagan Ordinances.
BmltlingOlfiaal 1N14 .Oif.?-1411i
OFFICE USE ONLY
Occupancy R-3 M=1 FEES
2oninq -
(ACtual) Const _ Bltlg. Permit ?07 - On
(Allowable) - Surcharge 10 • 00
F of stories -
lengih _ Plan Review
Depih - SAQ City
S.F. Total - SAC, MCWCC
S.F. Footpnnls -
On Site Sewage - Water Conn
On Site Well - Water Meter
MWCCSystem _
Ciry Water _ Acct Deposrt
PRV Required _ S/W Permil
Boosler Pump - SNJ Surcharge
Trealmenl PI
APPROVALS qoad Umt
Planner - park Ded
Cauncil
BIdg.Ofl _ CoPies
Vanance - TOTAL 217.00
~ - CITY OF EAGAN
' Np 18769
3830 Pilot Knob Road, P.O. Box 21- 199, Eagan, MN 55121
PHONE: 454-81 00
BUILDING PERMIT Receipt # T
Tobeusedfor FIRE REPAIR EscValue $60,000 Date MAR 6 ,?g 91
Site Address 4473-B CLOVER LN
Lot 12 Block 1 SeclSub. EDEN OFFICE USE ONLV
Parcel No.
Occupancy R-3 M=1
FEES
Zoning -
s Name RICHARD ENDERS (ACtual)Const - BIdg.Permit 460.00
w
o
AddrBSS 4473-B CLOVER LN
(Allowable) -
Surcharge 30.00
Clt EAGAN PhOne
Y A" of Stones _
299
.0
0
Plan Rewew
_
Length
o Name ADVANCE COMPANIES INC Depth - SAGCtly
4
0 Addr2sS 6400 CENTRAL AVE NE S.F.Total -
,
IE
City FRIDLEY phone 572-2000
S.F.FOOtprints _ SAC.MCWCC
Water Conn
On Sne Sewage _
?
ww
Name
On SileWell -
WaterMeter
?i
X
AddfBSS MWCCS lem
? -
?
a W
Ciry Phone
ary water - pcq. Deposit
mil
S/W Pe
PRV RequirBd _ r
I here6y acknowlege tha[ I have read this application and state thal ihe Booster Pump - SMJ Surcharge
inbrmation is corract a io co p witp all applicable State of
Mmnesota Statute -dnc Cit a ag Or inan es, Treatment PI
SignaWre of Pertnit APPqOVALS Road Unit
ADvANCE COMP $ IT]C
A Butlding Permit is issued to:
Planner -
park Ded.
on the ezpress condition that all work shall be done in accordance with all Council --
applicahle State of Minnesota StaWtes and City of Eagan Ordinances. Bldg. Ofl _ Copies
BmltlingOBiaal noi(q 4,aid,j V Vanance - TOTAL 759-00
(TOWNHOUSE)
BUILDING PERMiT
CITY OF EAGAN N°_ 11221
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
r PHONE:454-8100
Recerpt $
4_ PLEX Esr. Value $60, 000 Date NOVEMBER 719 85
sttepddress 4473B CLOVER LN
Lot 12 elock 1 Sec/Sub. EDEN ADDITION
Parcel No.
W Neme GOOD VALUE HOMES INC
? Address 1460 93RD LN NE
City BLAINE phone 780-5510
? Name SAME
i
Address
City Phone
rc
F W Name
?-Z, Address
<uZi City Phone
"
I hereby ackrqwledge that I hava reod this applicotion ond stote thof
fhe inlormotion is correct d agree fo comply with oll applicobte
$tata of Minnesoto $tatut s nd Gry o4 Eagon Ordin ces.
Sipnafure of Permitte
A Building Pemi s i d to: GOOD VALUE HOME ]
all work ahall ne in acmrdance with o^ll ap,{pF/imbla Storop{}-Jp?n-
Buildinp Offlciol / 11L?.e ? / \-?S
Erect [R Occupancy R3
Remodel ? 2oning Pil
Repair ? Type of Const, V
Adddion ? No. Stories
Move ? Length 44
Demolish ? Depth 24
Int Impr. ? gq, Ft.
Install ?
Approrals Fees
Assessmenf Permit +S 31-3.00
Woter 8 Sew. Suroharge 30 . 00
Police PlenAeview 156.50
Fire SAC 525.O0
En0• WaterConn. 500,00
Plonner WaterMeter 63 _ 00
Council Road Unit 280 _ 00
81dg. Off. 11 4$?j Tr. PI. 132. OO
APC Parks
Var. Date
? Copies
rotal 51.999.50
C on the axpresf conditlon thoi
soto $tatutes ond City of Eogan Ordinancea.
(TOWNHOUSE)
,. CITY OF EAGAN N2 11222
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127
PHONE: 454-8100
BUILDING PERMIT tieceipt #
Te M wed !er 1 OF 4 PLEX Esr. Vol,e $ 6 0, 000 p„tp NOVEMBER 7 Ia 85
SiteAddresc 4473 CLOVER LN
Lot 11 elock 1 Sec/sub. EDEN ADDITION
Parcel No.
d Name GOOD VALUE HOMES INC
?
„
; Address 1460 93RD LN NE
U City BLAINE phone 780-5510
? Name SAMF.
0? Address
? City Phone
w Name
?
?? Address
16 City Phone
I hereby ackrrowledge that I have read this opplicahon and store that
the iniormofion is correcf rid ogree to comply wifh all applicable
State of Minnesota Statufe and Cily of Eaqo rdinances.
Sipnofure of P . ee
A Bulld?ng Ve it Is iuu to; GOOD VALUE HOMES IT
all wark sholl do n attordance with oll appliypble Stote of
Erect p(1 Occupancy HS
fiemodel ? Zoning PD
Repair ? Type of Const, V
Addition ? No. Storias
Move ? Length 44
Demolish ? Depth 24
Int Impr. ? Sq, Ft.
Install ?
Approrab Fees
Azsessment
Woter & Sew.
Police
fire
Enp.
Vlonner
Council
Bldg. Off. I 1/4/$ 5
APC
te
on
Statutes ond Ciry ol
Permit +:? 313 . V U
surcnarge 30.00
P1en qg?ievi 15 6. 5 0
SAG 525.00
Water Conn. 500.00
waterMeter 63.00
aoaeunit 280.00
rr. Pi. 132.00
Parks
Copies
Totel $1 ,999.50
the express conditlon that
Ea9on Ordinoncas.
Buildinp Offkiol
( TOWNHOUSE ) CITY OF EAGAN
. , N° 11224
3830 Pilot Kirob Road, P.O. Box 21•199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100
Receipf #
To M wad /er 1 OF 4 PLEX Eo,Value $60,000 Da1e NOVEMBER 7 1 q 85
Sitenddreu 4471B CLOVER LN erect %7 OccuPancy R3
Lot 9 Block 1 Sec/Sub. EDEN ADDI TTW Remodel ? Zoning PD
Parcel No Repflir ? Type of Const. V
. Adtlition ? No. Stories
GOOD VALUE HOMES INC Move ? Length 44
5 Name
l
h ?
Z 1460 93RD LN NE Damo
is
Dapth 2¢
9 Address
BLAINE
780-5 1 Int lmpr. ? Sq. Ft.
City phone Install ?
o Name SAME
Address
? City Phone
G
W Name
Q Address
U
?w City Phone
Asseument -
Water 8 Sew.
Police _
Fira
Enp.
Planner _
Council _
I hereby ockrwwledge thot I hove read fhis opDlication ond state thaf Bldg. Off. 11 4$S
the inlormotion is torrett aS d agree fo ComDtY with all oppliceble AP?
Stote of Minnewto Statut94 JOnd Citv of Eooan Ordir?oncez.
Sipnature of Perminea _
A eultding Pe ?s 'e ?ed to: GOOD VALUE HOMES INC
oll work yvdone in ocmrdance wifh oll aoolicnble Statc of Mln ew
Fees
Parmit S 513. UU
Surcherge 30.00
Plan Review 1 5 Ei _ rj Q
SAC 525.00
Water Conn. 500.00
Watar Meter 63.00
iioad Unit 280 _ 00
Tr.PI. 132_0 0
Parks
I COPIes
Totel $1,999.50
_ on tM expren condition thoi
ond Ciry of Eapan Ordinanus.
Buildfny Official
(TOWNHOUSE)
CITY OF EAGAN N°_ 1 12 2 3
3830 Pilot Knrob Road, P.O. Box 21-199, Eagen, MN 55121
BUILDING PERMIT PHONE: 454-8100 2eceipt
# ??1
ZZ
Te he good for 1 OF 4 PLEX Est yalUe $60, 000 Do1e NOVEMBER 7 ?y 85
SiteAddress 4471 CLOVER LN erect 91 occupancy R3
Lot 10 Block 1 Sec/SubEDEN ADDITION Remodel ?
. Zoninq PD
Parcel No Repair ? 7ype of Const. V
. Adtlition ? No.Stories
Name GOOD VALUE HOMES INC Move ? Lenqth 44
?
1460
93RD LN NE Demolish ?
Depth ZQ
nddress Int?mpc ?
Ft'
BLAINE
City 780-5510
Phone Insiall ?
SAME Approvols Fees
O Name
Addreu Assessment Permlt $ 313.00
City Phone Water & Sew. Suroharpe 30.00
156
50
p Police .
PlanReview
F„
W, Name Firo SAC 525.00
?? Address Enp. WaterConn. 63.00
ZW City Phone Planner WeterMeter 280.00
CounNl Road Unit 132.00
1 hereby ocknowledge ihat I Mve read ihis opDlicotion ond state that Bldg. Off. 11 4$$
fhe inlormotion is correct?d ogree to wmply with oll opplicnble AP?
SMta M Minnewro Statut and Ciry o?n Or?nuncez.
Tr. PI._
Parks
Sipnafure of Pe I Copies
A Buildinq Pe ?e ssued ro: GOOD VALUE HOMES INC on tha atxl $1, 999.50
preu conditlon ?Mi
all wrork shall done in xcordonee with oll o I' ble Stme??(_yy??}{?nesota Statutes ond Ciry of Eogan Ordinonces.
Bulldinp OtfiNol ?-- ?!T.?t?-?L r
? CITY OF EAGAN
. : ?;. b.. .
!P
dUILDING PERMIT
.
Site Addre
Lot
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-$100
Receipt #
- Esf_ Velue • - '-/ 4 ?• IL,?a ,4.: I: _C .,_ lo
Name q Address
?- City Phone _
?W
Name
?? Address
?W City Phone-
1 hereby ocknowlodge that 1 hove reod rhi:
the intormution is correct and ogree to
Stale oi Minnesoto Stotute4 and Citv of
,ued to:
in occo?donte wifh
and state thot
oll opplicoble
Ocxupancy
2oni ng
Type of Const.
No. Storiea
Length .i
Depth
Sq. Ft.
/lssessment Permit )0
Woter & Sew. Surcharge . i10
Police Plan Review - 50
Fi?. snc - W
Eng. wace? conn. • 0 0
Planner Water Meter ? ? • U 0 ?
Council Road Unit 2 .00
Bldg. Off. Tr. PL '. } .' ,. ? 0
APC Parlcs
: . :) TNC
Stote of Minnesota
Coples
Totel , ` 1 t. . G
on the •xprcss condition ihai
ond City of Eogon Ordirances.
napeir u
Percel No. AddRion ?
Move O
W Name Demolish ?
Z ?
? Address Int Imp?. ?
PMmh No. Permk Holder Daa Telophone #
Plumbinq ? U ?
H.VA.C.
? ?05? J + ?a/ - goo
EhmWc p, S q o ni ,??. aA 8?.
soft«».
In"etion Dats Insp. Other
Footin9s 1
Footinps II
FoundaUon
Framiny
Il)
</
Rooflny Ad,
Rough Plbg.
ROU9h Htg. 1e ?-IZ S'TA CNL
InsuL
Flnplaca
Flnal Hty.
Final Plbp. ?L
Flnsl
Cort/Occ. ? b'6 ld B
W?K DKeribe Lotation:
W11
Sewer
Pr. Disp.
e
?
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
QUILDING PERMIT
Te ie wud fe.
;.a A.1./--
Peroel No.
W Nxne "
? Address ^. ,
"""' 11223
Receipt #
' Dcte _
Erect ?
Remodel ?
' Repeir ?
- Addition ?
? Move ?
- Demolish ?
- Int tmpc ?
3I Name
o? Addreu
u
? r.i*„ Phnno
Name
I hereby ocknowledpe thot I
the informotion is correct o
State of Minnesoto Stotutes
Sipnoture of Per?nittee '
A Buildiny Pen+iit is issued ro:
oll work shall be done in acoo
Buildinp Officfol
how read this
nd ogree to c
ond City of i
Hsxssment
Wcter a Sew.
Po! ice
Firo
Eny.
Planner
CourKil
Bidg. Off.
APC
with olt opplicoble 5tote of
Occupancy
Zoni ng
Type of Const.
No. Stories
Length ?
Depth
Sq. Ft.
Permit
Surcharqe )
Plan Review SAC : 5 .UO?
Water Conn. _:s 00
Water Meter . J 0
Road Unit
. Tr. PL
Perke
Copies
Total on the axpross CondiNon Iha+ ?
and City of Eapon Ordinances.
• Pamit No. Pwmit Holder Da" TeIephons #
Plumbinq
H.VA.C. -(p?QS
ehictric q S44 5 u Ne- iSe 7. 42?
soft.n..
InWaet{on Da" Insp. Other
FooUnys l
Footinys 11
Fo
undatlon
Framing
Roofinq F
Rouph Plbp. -/2 - 4 ? / '? ?
Rouph Hty.
inwl. ?
Firoplacs
FInN Htg.
Final Plbp.
Final
Cert/Occ.
WatN Dsscribe Location:
w.u
Sewsr
Pr. Disp.
Receipt PLUMBING PERMIT
CITY OF EAGAN
Parmit Na.
Fee ?
fill in nm»bered spaces S/C ?
TYpe or Print legibly
Tot.
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
b. Contractor Phone
6.
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New ? Add 11 Alter O Repair ?
10. Descri6e
11.
Na, Fixtures
Water Closet No. Fixtures
Cess
ool/Dr
infield
Bath tubs p
a
Se
tic Tank
Lavatory p
$
ft
Shower o
ner
Well
Kitchen Sink
Urinal/Bidet Oth
Laundry Tray er
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this tYpe af work.
Signed :
for
Rough F inal
,.... ?___
' CITY OF EAGAN
r 3830 Pilot Kno6 Rosd, P.O. Box 21-199, Eagsn, MN 55121 J
PH ON E: 454-8100 QUILDING PERMIT Reuipr
TO w w"d fa Est. Volue Dote
Site Address Erect ? Occupancy
Lot Block SecJSub. j! Aemodel ? 2oning
Parcel No. Repair ? Type of Const.
Addition ? No. Stories
Move ? Length
Z N&^e Demolish ? Depth
? Address Int Impr. ? Sq. Ft.
City Phone ' Install ?
Aoprovab Fees
Name
/l
?? Address sstssmenf Permit
? City Phone Wcter b Sew. Surcherqe
Police Plan Review •
?W Name Fira SAC
?? Add?ess Eny. Water Conn. j
t W C ity Phone Plannn Water Meter j
Council Road Un{t :. c`:'
I heroby ocknowledye thot I have reod this opplicotion ond stote thot gldg. Off. Tc PL
fhe informotion is correct ond ogree to comply with oll opplicable APC
Stota of Minnesota 5tatutes and City of Ea9an Ordinonces. Parks
VaF. Oate Copies ?
Sipnaturc of Permittee
Totel
A Building Pennit is issued to: on the exprcss conditia+ thot
oll work sholl be done in accordonce wlth oll opplicoble Stote of Minnesoto Statutes ond Ciry of EoQon Ordirances,
Buildinp Ofliciol
. Pamit No. PNmit Holda DoN Telephone it
Plumbinp
H.VA.C. ?p? ? J ?J
?
?.
Ebct?ic
r U I1? 2 { S?
Softsn?r
Irapection Date Insp. Other
Footirtgs 1 (,J
Footings 11
Foundstlon ? ? ?,4 B
Framing ?
Rooflng
Rouyh Plbq. -j-f6 of, a, / `
Rouyh Htq. _ ewl
Insul. `
Firoplace
Final Ht9• 3?z7
Finel Plby. d - $L ' ?3GC
? o 9
Final
Cert/Occ. 2 ?
WatH Dftcribe Location:
WNI
Sewsr
Pr. Olsp.
t ?
_ .
.??....? . - ...._ ....:.
:
. ..,.:-, . . ,
,- . ??
-? . CITY OF EAGAN iJ? 18763 :
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
'
G; PHONE: 454-8100 j
BUILDIjV
PERMIT Receipt #
-nt& ??vp
T D
t 19 91
o be used for
Est. Va lue
a
e
Site A pss
OFFICE
?
USE ONLY
Lot Block Sec/Sub. R-3 U- ?
Parcel No. ? Occuaa"cv - FEES ?
?
$499, Zoning 00 k
W Name ?? ?? (Actual) Const - Bidg. Permit '
7W ?
? Address (Allowable) - surcharge .
City EJWIM Phone
r ot stories _ ?
Length Plan Review
o Name -
? ? ?
*W
' Cpw
p
kt DePth - SAC, City
?
l
?? Address ?i
_ S.F. Total - SAC, MCWCC
~ Clty PhOf12 S.F. Footprints -
On Sife Sewage _ Water Conn r
?u¢+ Name
? On Site We11 - Water Meter ?
?
z
?? Address MWCC System
?
a W City Phone Ciry water _. Acct. Deposit ?
PRV Required _ S!W Permil ,
I hereby acknowlege that I have read this appiiCation
and state that the Booster Pump -
S/w Surcharge 1
a
information is correct and agree.tG comply with all e
Minnesota Statutes and Ci!?_015agan Ordinanoes. pplicable State of
Treatment PI
Sgnature of Permitee APPROVALS
Hoad Unit
?
A Building Permit is issued to: Planner
- Park Ded.
on the express condition that all work shall be done in accordance with all Council ^ •
applicable 5tate of Minnesota Statutes and City of Eagan Ordinances. gldg, pff, _ Copies
-
Building Official
Variance -
TOTAL
.
.
-
-
Parmit No. Permn Holder Date Tekphone #
WATER
SEWER
PIUMBING
H.VA.C.
ELECTRIC ?y /
Inspeetion Date Insp. Comments
Faotings I
Faxndetion
F?am-tng 3 -,f -? /
Roofing
Rough Pm9•
Ra?h HD9.
lsul. cs ? G.? - s ti."%2
Fireplace ?- /%;,.? IC?a?'7 c•?:3 i?l
Final Htg.
Final Plbg.
Cpst. Meter Plbg. Inspector - NoG(y Plumber
Engr.lPlan
Bldg. final
Deck Ftg.
Deck Final
Well
P?. asp.
CITY OF EAGAN v4L+ 1$769
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
?
i
BUILDING PERMIT PHONE: 454-8100
t #
R
i /' .
1 . ?! '
ece
p
FIRZ R"AIR ?60,000
? MAR 6 91
To be used for
Est. Date
Value , 19
Site A liess R LM
&DEN
OFFICE USE ONIY
?
Lot Block Sec/Sub. R-3 M-1 a
P8fC81 N0. Occupancy - FEES
RZCHM ziumm Zoning - ??.oo
?t
N8t11B
(Actual) Const -
Bldg. Permit ?
Address (Allawable) -
S
cha
e 30.00
0
City PhOne
# ol Stories
_
ur
rg ?
Z".pp
Plan Review
no?vurc8 caMruNIa irc ??h
U -
o Name DePth - SAC, ccy
0?
< Address S.F. Total -
o
LrKlu
LEI SAC, MCWCC
? City
Phone S.F. Foolprints -
Water Conn
On Site Sewage _ ?
?
W W
Name
On Site Well -
Water Meter
W
AddfASS MWCCSystem -
' Acct.De t
?
<W Phone
City ' Water
C'
?' -
SlW Permit
PRV Required _
I hereby acknowlege Ihat I have read this applicati
"
' on and state Ihat the Boaster Pump - 5IW Surchazge
inlormalion is correct and ag
rAi to comply with
a ll applicable State of
Minnesota Statutes and City of Eagan Ordinances.
-
Treatment PI ?
.
Si
nature ol Permitee -}-?
" APPRQVALS Road Unil
g
A Building Permit is issued to: ADYI1IiCE 8 I11C Planner - Park Ded.
on the express condition that all work shall be done in accordance with ali C.ouncil _
applicable State ol Minnesota Statutes and City of E agan Ordinances. gWy. pff. _ CoP'es --?-?
•
Building OffiCial `' j' '
Variance -
TOTAI ?
Permk No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBING , 3
H.vAC. ? ?. r' . 10,119
ELECTRIC
InlPecttion Date Insp. Comments
Footings I
Foundation
Framing .S
Roofirg
P-Ou9h PIb9•
Rou9A FIt9
is,i. 5 9- S L? S ir{slb N-? c tj?ef
Fireptace
Fnal Htg.
Final Plbg. -? -
Const. Meter Plbg. Inspeclor - Notity Plumber
Ergr./Plan
Bldg. Final
oeak Ftg. F%.,Af- ?-
Dedc Final
Well
Pr. Disp.
• r f CITY OF EAGAN
3830 Pilot Knob Rosd, P.O. Box 21-199, Esgan, MN 55121
BUILDING PERMIT PHONE: 454-8100 tteceipt
Site Address -
Lot Blc
Percel No. -
W Name
? Address
City Phone
Est. Vclue Date _
Erect ?
Remodel ?
Repair ?
Addition ?
Move ?
Demolish ?
_ Int Impr. ?
!' . /? ;?t 1
Occupancy
Zoning
Type of Const.
No. Stories
Length
Depth
Sq. FL
..po.v.a.s r?as
? Name "
tv A?? /lssesunent Permit (1
u?
F City Phone Water 3 Sew. SurCharge
Polite Plan Review 1 5 fi _? Q
Fin SAC • ? - ' (?
Eny. Water Conn
Plonner Water Meter
Council Road Unit
3nd state that Bldg. Off. Tr. PL
oll applicoble APC
Parks
onces.
Var
Date
` C?ies
Total
on the express condition 1hol
e State of Minnewta Statutes ond Ciry of Eopon Ordinonces.
Name _
Address
fhat I hove reud fhis opplica
rrect ond ogree fo comply i
tatutes and Citv of Eaaon 1
sued to:
in accordonce with oll appl
Bufldlnp Officfal
' PKmk No. Pwmit Holder Dirw Telsphone #
?urnbing
H.vrA.c. 411 J/ -
Ekmtr;c
Sottener
InWeetion Dats Insp. Qther
Footinys I
Footings II
Foundatlon
Framing . 3 - -?
Roofiny , 4
Rouyh Plbg.
Rou9h Mtg.
Insul.
Finpiace
Finel Ht9•
Final Plbg. 10-1
Final
Cnt/Occ. ?
W??r Detcri6o Location:
Wsll
Sewor
Pr. Dlsp.
CITY OF EAGAN Remarks
Addition Fclen Addi ti on Lot 10 Blk 1 Parcel #10 22750 100 01
owner_ ?JScreet 4471 Clover Lane State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 050 1982 504.70 100.94 5
STREET RESTOR.
GRADING (p D 182 232.99 46.60 5
SAN SEW TRUNK ' 1974 62.93 4.20 15
1F SEWER LATERAL 8 6 46 3T9.29 5
WATERMAIN
1F WATER LATERAL 1 82
WATER AREA ? 1977 62.93 4.20 15
* Services 1982
STORM SEW TRK 1982 2 6. Qo 1.20 5
f STORM SEW LAT 1982 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
Rnad Unit $280.00 572/4 11/5
WATER CONN. 500.00
BUILOING PER. 1221-11224
sAC 525,00
PARK
CITY OF EAGAN Remarks
Additio--.Eden Addition Lot 9 sik 1 Parcei #10 22750 090 01
Owner Street 4471 B Clover ` Lane State Eagan NIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ?5 1982 504.70 100.94 5
STREET RESTOR.
GRADING 1982 232.99 46.6d
SAN 3EW TRUNK al,? 1974 62.93 4.20 15
!F SEWER LATERAL (p?j4? 1982 1896.46 319,29
WATERMAIN
• WATER LATERAL 1982
WATER AREA jg']'] 62.93 4.20 j5
• Ber-yices 82'
STORM SEW TRK ? 1982 2 C).OO 1.20
iF STORM SEW LAT 182
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. u n
BUII.DiNG PER. 21-11,224
sac 525.00
PARK
CITY OF EAGAN Remarks
Addition Eden Addition Lot 11 _sik 1 Parcel #10 22750 110 01
Owner Street 4473 Clover Lane State Eagan MW 55122
' Improvement Date Amouni Annual Years Payment Receipt Date
STREET SURF. & 19$2 504.70 100.94 rJ
STREET RESTOR.
GRADING c.( 1982 232.99 46.6o _
SAN SEW TRUNK dl/
? SEWER LATERAL 7j' 1$Q 18 6 46 379.29 .5
--
WATERMAIN
f WATER LATERAL ], S2
WATER AREA .3
* Services 1982
STORM SEW TRK ? 1982 256. oo 51.20 -
STORM SEW LAT 1982 S
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. no-on „ n
BUILDING PER. -1122
sAC 525.00
PARK
CITY OF EAGAN
Addition __._Eden Addition Lot 12 sik 1 Parcei #10 22750 120 O1
Owner Street 4473B Clover Lane state Eagan, hA1 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1982 504.70 100.94
STREET RESTOR.
GRADING 4'4 1982 232.99 46•6o '
SAN SEW TRUNK
# SEWER LATERAL (? 3 1826.46 ? .
WATERMAIN
• WATER LATERAL 1982
WATER AREA 1977 62-91 20
4
* Services 1982 .
STORM SEW TRK 1982 256.00 1.20
* STORM SEW LAT 1 ?
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER ?CNO NN.
9UILDING PER. 11221Z11224
sAC 525.00
PARK
Raosipt PLUMBING PERMIT Psrmit No.
CITY OF EAGAN
FN p
Filf in numbered speces S/C
Type ar Print /egib/y Tot.
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract ?
4. Owner ?
5. Contractor Phone ?
?
6. Address ?
i
7. City State tip ?
8. Building Type: Residential D Commercial ? Institutional O
9. Work Description: New O Add O Alter ? Repair O
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures ?
Cesspool/Drainfielci
Bath tubs Septic Tank
l.avetOry Soffner
Shower W e I I
Kitchen Sink
Urinal/Bidet ptner
Laundry Tray
Floor Drains
Drinking Ftn.
Stop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rouqh Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
?
PLUMBING PERMIT Pormit No.
CITY OF EAGAN
Fea
?- I
Fill rn numbered spaces S/C ?
Type or Piint /egiWy Tot. " i
1. Date 2. Installation Cost ?
3. Job Address Lot Blk. Tract ?
4. Owner
Phone
6. Addreu
7. CitY State Zip
8. Building Type: Residential ?
9. Work Description: New 0
10. Describe
11.
Commercial ? Institutional ?
Add O Alter El Repair ?
No. Fixtures
Water Closet No. Fixtures
l/D
fi
C
i
l
Bath tubs esspoo
ra
n
e
d
S
ti
k
T
Lavatory ep
c
an
S
f
Shower tner
o
Kitchen Sink Wel I
Urinal/Bidet O
Laundry Tray ther
Floor Drains
Drinking Ftn.
S
lop Sink
Gas Piping Outlets•
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rouph f inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Reoeipt ' MECHANICAL PERMIT Permit No. CITY OF EAGAN ." ?
Fes -
fill in numberied spacm " S/C
Type or Print legiWy Tot.
1. Date 2. Installation Cost
3. Job Addreu • Lot Bik. Tract
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
? 9. Work Description: New ? Add C) Alter O Repair ?
{ 10. Describe Fusl Type
I
f 11.
No. Equip,¢epi 9TU - M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codel qoverning this type of work.
Signed : , for
Rough Final
Inspections: Date Insp. Date InsR•
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Raceipt PLUMBING PERMIT Permit No.
C17Y OF EAGAN , `-
Fee
..,_ Fill in numbered spacea S/C ?
' TYPe or Print legib/y Tot +
1. Date ' 2. Installation Cost ;
- ?
3. Job Address ' Lot Blk: Tract j
i
?
4. Owner 1i
i
5. Contractor Phone ?
6. Address
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional O
9. Work Description: New fl Add ? Alter ? Repair ?
10. Describe
1 11.
No. Fixtures
Water Cfoset No. Fixtures
Ce
i
fi
!/Q
ld
Bath tubs sspoo
ra
e
n
Se
ti
T
k
LavatOry p
c
an
Sottner
Shower W e I f
Kitchen Sink
Urinal/Bidet O
h
Laundry Tray er
t
Floor Drains
?- Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby ceriify that the above information is true and correct, and I agree to
Compty with all ordinances and codes governing this type of work.
Signed : for
Rough Final
(nspections: Date Insp. Dafe Insp.
This is Your permit when numbered and apqroved.
Approved CITY OF EAGAN 454-8100
INSPECTI4N RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, MinnesQta 55122-1897 Date Issued: ?•? •? ?? .? I
(651) 681-4675 '
SITE ADDRESS: '' APPUCANT:
4 4 71 r,lOVf=R t AlIE
F Iaf N - i t F? l;' 1 F4t7R %:'??!
PERMIT SUBTYPE:
TYPE OF INORK:
' l I'AIR
??? .t ;r ? i ?, r??; I4I 1'I-ACE '+Itll'Nfi
?
J
Permit Holder Date Telephone #
SEWER/
WATER
PLUMBING
HVAC
Inspection Dete Insp. Comments
fOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLAC£
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
coNOUCTwirr
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
IN5PECTION RECURD
CITY OF EAGAN PERMIT TYPE: AI! 1 fff Nri
3830 Pilot Knob Road Permit Number: ?.i a 184
Eagan, Minnesota 55122-1897 Date Issued: o I/0k 19"
(651) 681-4675
4 l 1 E? 1. 1._ 1
I?F M
! PERMIT SUBTYPE:
?
1 fJtk',,- IIN11
F
L
" 10 - ` z7sA-H90 f': - APPLICANT:
!1?'T T y HLOf'e ?
i ANf
TYPE OF WORK:
. „ , i i . r 1,+!
r.0 H1, i
hFi•'H]fd
I?Ff'i Ai:I= ?; [I.)TNG
?
?
.?r
Permit Holder Date Telephone #
SEWER/
WATER
PLUMBING
HVAC
Inspection Data Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDFOSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
?
. . . ? ? ?? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE:
? 3830 Pilot Knob Road Permit Number:
? Ea an, Minnesota 55122-1897
9 Date issued:
(651) 681-4675
( SITE ADDRESS: ' 1 tio "' APPLICANT:
? ?? ? i t i?1 c?r.y .
i i?vEfk ?. R?wr- i .,? ii, i ?,;t, i t , c!„
+ ' N i?k:'1 ti•?kt?{?N
' PERMIT SUBTYPE:
?
I
TYPE OF WORK:
IiE'':KftlPllf.iN
1411 t 111 tNli
41.iAI't}ih
HI IOa r()q
FPpIR
FV1 Ac,E. <;I(??N(-i
?? 1\'??DD
?
?
?
Permk Holdsr Date Telephone N
SEWER/
WATER
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLAGE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
coNOUCriviTv
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
I -
? INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675
SITE ADDRESS:.
1 0 1 ;
(1Wr< t Arit'
N
PERMIT SUBTYPE:
. i, .,
lt++ i I Dr N+
014 -4 Hti
61 1 / 4! hi / q'
iR APPLICANT:
i 3 :: ???• i:
TYPE OF WORK:
?;, . ;, i „ .
ir i' 1' 11 I 1,1
kF I'I A"f -- flilh#C
I [NAI
?
F
L
?
J
??
PertnR Holder Date TNephone •
SEWER/
WATER
PLUMBING
HVAC
Inspection Date Insp. CommeMs
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUI
GYP BDARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONOUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pflot Knoh Road
P. O. Bdx 21199 PERMI7 NO.:
Eapn, MN 551.;J DATE:
`
L
C=
:`?
Zoninp: _
No. of Units:
oo<: ? a ue
Ownsr:
/4ddross:
51» Addroas: s _. ,. over ane _,i Lc en
Plunber. '-?ic?e •_,,nt? P u i•,
hAsfer No.: aOfge'
Siu: ?HINNOt' _?.00 n a
0
T-_
Rsod.r No.:
't ?:
? 11). 0
F
. ?
u
I N? h oo?rol?r wi1A elw c¦ rpe: ' ` P
?
or&mmm? REQUfRED W- t4vW p
Totol: 63.00pd meter
ey Dor. Pnid:
Dnft of Insp.: Irop.:
CITY OF EAGAN . SEWER SERVICE PERMR
3830 Pilot Knob Rosf!
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55W DATE:
Zonirq: No. of Units: '? Aie;•.
Ownsr:
?
Addrass:
S 4;
Plumber.
1 Mrw te wwRly wM6 tiwJClhr of `iowa
"MmaM.
ay
Dote of Insp.:
100.OG
ca??+?ctia, aar,.: A z s. 010 nu
AcaouM Deposit: 1 tJt?- _
P1Tmit FN:
Surtharfls:
Misc. Chorpm
Totol:
Doh Poid:
? CITY OF EAGAN
? WATER SERVICE PERMR
, 3830 Pilot Krtiob Rosd
? P. O. Bax 21159 PERMIT NO.: _
; Eagan,lNN 551??1 DATE:
~ t?
Zoniny; . ,oo a ue No. of Units:
r.
rrss:
???: 44/3 . over .ane Lil u , s: en 7 :n.
??r *?ic elson P u-i n^
WAN ?; 5dtl QOpd
r No.• 3? 7 SG D
?D?lT'p.?_
_°' •?
Vulul
?t: 10.00
r?.: D/ N S ???F(Q,C3l UIIIItieS p
.p+.. eo eomph? M?o Ir. Ctp LSiJ?NM?ci Q - f,AS Fts, • P
' REQU1i%SP°? 132.00pd Ta
.°..' . ? 6?, . o opa °?
Dati Pbid:
of Insp.: Irnp.:
3-/Y- J(-
CITY OF EAGAN SEVVER SERVICE PERMIT
3830 Pilot Knoh Road
P. O. Box 21599 PERMIT NO.:
Esgan, MN 55121 DATE:
Zoninp: f I;{ ,
No. of Units: ,
!;oed 17a_ue
Owrwr.
Address:
`{`?, 3 Cldvex Lsne ! :?
k Sia Addross:
??` ickeZ son P u?:l; w
nber:
-- '?
w h?? wMU !W G1?r oi ?ps ConrNCtian Charps:
AooouM Depodh
Pem,it F..:
-
t SY1'C?10fQl: ,
MFsc. CMrpn:
of iru
: Total:
p.
: :
ns Dote Poid:
p
?.18- Q j, FEQUEST FOR ELECTRICAL IIYSPECTION Ee-00001.04
9 0 ?See instructions for completirq thia lorm on baek o( yellow copy.
"X" Below Work Covered by This Request
I AAd Rep. Type o} Buildrng Aoolianeea Wirwd Eauinmwnt Wi....i
k Fe Service Entrance Size !! Fee Feeders/Subfeeders # Fee Cfrcuits
0 to200Am s 0 to30Am s Oto 30Am s
Above 200 Am ps 31 to 100 Arnps 31 to 100 A s
Swinunin Pool Above 100- Am s Above 100_Am 5
Transformers Irrigation Booms Partial- Othe
apeciai inspection ?
eerks TOTAL EE
?L 7 _ad
` I, the Ele ica
, ?.sDector, hereby
certify that the abova
Final DAte in
spection has been
? meda.
This request void ? „ l?7r.&Ib
firnoriths trom
095908 41o, B /,
Fde n Aru_
`J 9 g 3 z
9-4! 7_ m,
Request Date
? Fire No. Rou h-in Inspection
Req ired? , v
C]Ready Nuw Will Noufv. Inspec-
Yas ? N. or When Ready
U ucensed Electncai Contractor I hereby request inspection of above
? Owner electrical wwk installed et:
Stree Address, Boz or R t .
- I IF vt 1
l?.J?.JVL l Cit?
'
ection o. Township ame or No. ange o. ounty
Occu ant (PRINT)
? Phone No.
l.-?
ower Su p
i Address
El,pWrical Contracior lCompa amel
? Comractor's Licanse No.
.
-? 9 7,-? - -4-
Mailinp Ad ress (Co?ractor or Owne? M
?;J C7 ?
1 c J aking Installation)
A ized Si?nature (Con ?ac or Owner Making Installation) ['7hoj?ne umberw+?nrvcsprq S7ATE BOARD OF ELECTRICITY lr+is IrvSPECTION REQUEST riILL NOT
Gripga-Midwey BId9• - Room N-181 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Peul, MN 56704 UNLESS PNOPER INSPECTION FEE IS
Phone (612) 297_2111 ENClOSED.
CITY OF EAGAN WATER SERVICE PERIIAIT
3830 Pild( Knob Road P. O. Box 21199 PERMIT NO.: 74 Eagan, MN 551,2,1 DATE: Zoninp: . No. of Units: '
. ,..
OWI'1lr:
Address: ;-lifIR C over ane i .. _ n.
Site Address:
- - - -- - --- - -
Plunber.
Meftr
i 1 q?w eo esM??11 M?ti'i?? 1
BY
Date of Insp.:
.'p,ynnection Charye: '
J?unt Deposit: L ' . , p
it i Fee: - • . L'
`fl" pci
L . .
Misc. Chorgm ..,,
Total_ 6-3 . 0Ond meter
Dats Paid:
Intp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilat Knob Road pERM1T NO.:
P. O. Box 21199 , Eagan, MN 551?1 ?TE:
,...
Zoninp: ' No. of Units: r
Owrnr.
Address:
, _
, iJar?.e s n , Aeen
Site /lddress: . :,i?;?,_! •. -
Plumber. 100. 0D6
I asm !,. ea.yy w11! eW Ciw of dN• Connection C]+orye: 4 2?. C?U?u
x S . 0???
OrJiu?eas. Aco°?mt DtPait. f 0 p a
Prnnk F«:
?
Surchwme:
BY Misc. CFaroes:
Doft of InsD•: Total:
Imp.: DoN Pofd:
i CITY OUAGAN WATER SERVICE PERMIT
? 3830 Pibt Knob Road • ^ ?
' P. d. Box 21199 PERMIT NO.: , i- `. -;_ •;
? Ea9sn, MN 55W DATE: . ,
Zoniny: No. of Unlts:
n.....i lla uP
( OWfIlr:
Acld`om 4 71 over ane ? ?. en .<-r- -
Slh Addmff: ., . , _ I n 1 .....h 4 n n
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Date Paid:
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Dote of Irup.: I^sp.:
CITY OF EAGAN SEWER SERV
P
ICE
ERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 551
11 pATE; '
.
Zanirp: Na. of Units: : x
Ow?rr. !'ilo d Va.Lue
Address: ?Ond mater
S3
? .
Sit* Address;
Plumber: -
bddn_
1 pree ro oomm* wilU 1M Cily oi gqpmm
Ordleanon.
By
Dote of Irap.:
-:':) . o ,"1,c's
Carxtiectton 0oepe; 425. 0fl j:-?
Aooow+t 0.posit:
Pem+it Fw: Surcharpe:
Mise. Qwrges;
Totof:
Oate Paid:
REQUEST FOR ELECTRICAL INSPECTION ??yy'??yap Ea-oooot.cu
? See instructions tor mmnlwtmn tAi. L..m .... 6en4 ..1 ..eu...., .? WnGW l-f. ? ..
ou 5909 '"X" Below Work Covered by This Request maw '-;, I aZ)"l'
f.dd flep. 'fype oi BuiltllnB Aapliancea Wired Equipment Wired
Home Runge Temporary Service
Duplex Water Heater Lightiny Rztures
Apt. Building Dryer Etectnc HeaLn
Commerc,al Bldg. Fumace Silo Unloader
Industnal BIAg. Av Conditioner Bulk Milk Tank
Farm ihe.r peo v ther ISnec?fyl
t er Sur:ruY Other Other
l.V//IU(l(C I/15DBGLlOq f?P ffP/OW
M Fe 'ServiceEntrencaSize b Fee Faetlers/5ubteetlers p Fee Cvcmts
0to 200 qm s 0 to 30 qm s 0. ) O 0 to 30 Am ps
20
A6ove 0 Amps 31 to 100 Amps 31 to 100 qm s
Swimmf
ng Pool Above 100_Ain s Above 100_Am s
Transiormers Irrigatfon Booms Partial-'Other Fee
Signs $pecial Inspection G
$^
Remarks
-'? J
1 TOT FEE
.
? O
Pooeh-in ? ?nw
I. xh c
'zM?j?fJ
ll Inspector, herebV
Rnal
D??
e cerlify that the nbove
? .
i p msoeetwn has been
i??7 mada.
rnierequestvamitlmonmeirom ? v• - - • ' ? -
This requast voitl
18 months from " r /' I? ?a
Reqpest Date Fire No, flauph-in Insyectmn L '
'e9iredI ?ReaAyNOw??/?'illNOUiVInsPec-
X- Ves ?Nu y`or When Ready
? Licensed Electncai Convacwr I hereby raquest inspection ol above
? Owner electncal work installatl et
Sve i Atldress, eox oryHOUte ryo.
?1?1 l ?7 L C I
ection o. Township NamF or No. Range No.
Occu ant VPflINTI Phone No.
Fawer $upp ier
c4a
Atldress
Li
Elec[ncal Convactor (COmyany Name) ? Contrar.tor?s ?L7ice se No.
?
M21mq
/ A Jr\5 ICOnVacmrlor Owngr MakingInstallavon)
U
J
?TJ Me[¢ed Smnauure (COmra todOwnxr M2kmg Installabon) Phone Number l.
LG
MIPIPoESOTA STATE BOAflO Of ELECTNICITY THIS INSPECTION qEQUEST WILL NOT
Griggs-i gldg. - Room N-091 BE ACCEPTED eV THE STATE BOAHD
1821 UniversitY Ave., 51. Paul, MN 65104 UNLE55 PflOPEH INSPECTIpN iEE IS
Phane (672) 297-2111 ENCLOSED.
a/i.a /a.
,, ga-, „
a 13961 iaa 4409
,a
fiepueet Daid ire No Ro?9Mn In
speceon
uned9 ? ReaEY Now CVill Notity Inspeclor
? Ves ? No When Reatlyl
I licensed contractor p owner hereby request inspection ot above electrical woik at:
J NGdress (Streeq Box or Ro e No ) Cm,
Seclion No. Township Name a W. parye
?
Occ eM (PFINTI Plqne No.
KIC O ?
7
2
P
o r upplier .
Atltlrpss
Elenr al onvai (COmpany Nartre/)-
? ConVacbr9 4cense No.
- ? 039u_
Minhng AEpress ICOmrocro. or Ownyr IA?ping Installafiory
, " Il
? )
W
L
e
I '1'Ylt?
()
_
Author¢ed Sgn (COnlractonOwner Maki Nallat n) Nur!ber
MINNESOTp STATE BDARO OF ELECTRICITY
GrIppHlldray BIEy. - pppm S1T! THIS INSPECTION HEOUEST WILL NOT
1821 Unlverslty Ave., St. Peul, MN 55100
?OM (b?Z) WZ-0BW BE ACCEPTED BYTHE STATE BOARD
UNLESS PROPEF INSPECTION FEE IS
ENCIOSED
REOUEST FOR ELECTRICAL INSPECTION EB-0000
?
Sae msimclions tor complelmg Ihis form on back of yellow copy
/Oo 342
?
P
'X" Below Work Covered by This Aequest
"
ew Add Rep 7ypeof8mlding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Elec[nc Heating
Apt. Bwldmg Dryer Other (Specify)
Comm./Industrial Furnace
Farm pir Conditioner
Other(specAy) Contractor's Ramarks
Compute Inspection Fee Belaw:
k Other Fee # ervi EmranceSrze Fee # Circmts/Feeders Fee
Swimming Pool
Transformers 0 to 200 AmpS
Above 200 _ Amps 0 to 100 Amps
Above 100 _ Amps
S,gns Inspeclors use onry TOT
Irngation Booms
i
S ?
pec
al Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
1, the Electrical Inspector, hereby
certify ihat ihe above inspection has
, been made. Rou9n-,n r. oere2 /?
?
OFFICE USE ONLY
TpiS repuest voitl 18 mOnOis irom .
J.
This request voiC ?,? /
78 months from ?t
m 0 5906 i, 6), fo/en
S?' fi'3a
Rrpuest Date Fve No. RouPh-in Inspecbnn
? ?^ C!
fl? red?
J
oFeady Now W?II No1rtY ??spec-
?
d ?es ?No or When Ready
? Licensed Eleuncal Cmrtrac[or i hereby raquast ins0ecfion ot above
? Owner r elecfricel work mstalled at:
Street Address, B
oa or qaute No. C??Y
^
?+ ? ? 3
,
ecLOn o. Township Name or No. qange o. Cnunry
?
OccupantIP NT?/ P ne No.
Power ulier Atltlress
Elec ?cal Cnnvactor (Company Na Contrecmr' s license No.
Mailinq AdJress ICOntractm or Owner Makinq Insiailauon)
Authorize a[uro (COnh todOwn¢r Making InstallaUOn) phone Number
66 - '?60
MINl STATE BOAND Of ELECTBICITY
Griggs-Mitlway Bltlg. - Room N-181
7821 University Ava., 5[. Peul, MN 55104
Phona (612) 297.2111
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BV THE STqTE BpqRD
l1NLESS PNOPER INSPECTION FEE IS
ENCLOSED.
,2? REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
Sea instructions for com0leti
^
0 9 5 9 0 ne this form on beck of yel low copy.
""X"" Below Work Covered by 7his Request ?43
?-
^ ql
^ ql Rep. • Type of Bwlding Appliancea Wrtetl Equipment Wved
Home Range Temporery Service
Duplex Water Heater Ligh6nG Fixtures
Apt. Bwlding Dryer Electnc Heatin
Commercial Bldg. Fumace Silo Unloader
Industnal Bldg. Av Condrtioner Bulk Milk Tank
Farm Other pem y ihe? l5panfy)
[ IP.f $VnGIfY
?thC! ?-
O1hL'r
nspection Fee Below
k Pee ServweEntranceSize en enersSUbfeeAers N iee
Grcus
rt
0 to 200 qm s r 0 to 30 Am s G .G` 0 t. 30 An! s
A6ove 200 qm)s 31 to 100 Ainps UO 31 to 100 A
Swinming Pool Above 100_Am s A6ove 100_Am s
Transformers Irrigabon Boorc?s Partial-`Other Pee
Signs Special Inspection
S
flemarks - '] N-(?
/ TOT EE
?
RouBh-in
2 Date
''r?
? ?wiC?
•?
I, tM1B ICAI
Insoecior, he.eby
Final
? 1
? cerlifv that the above
s
pecLon has been
mede.
Thle repuast voi01B monllre from
2 4 5- 5 91 51 OFFICIE USE NLY This reqven.oid 18 montha from .olidaeon dote pnnMd in fhrs box
- ?a.?I9(a
PLEASE PRINT OR TYpE UI / pLG.r?-- ??O ?
Requast Dok4 poogh-in mspenion reqwred2 ? Yes
(Yo
?
ll th Na Inspenian 01her ihan Rovgh.lnReady Now ? Will Coll
u m. s
co
e inspedor whm ready) Do1e Ready
1,96censed conirocior ? owner hereby request mspeciion of fhe above eleciriml work of.
Jo6 Pddress (Skaet, Bm, or RooM ?
µ 7 tl
;
L pM Z.o Code
-
-
r
DUt
Ci/l e? 5s
Id0
?
$eciion N. Township Name or Na_ Range N. Fire No
C
L
Occvpont
r .
Phone No
ail
Power Suppiier
Address
Eleclnco ntractor (Compa y Nome) `
- Confrocror Lianse N. Mosler Lic. Nn (Planl Elen Only)
??.,
?IG _{-
L./I''il 00
MadLag Md v (Co hoclor or Own ? Performinp Installonon) 'Ai
G ? ?
Aulhonzx{$iaoaNr ontrudororOwMrPer/ormerglnstollaM1On)
/ I PMneNo
? 61?+ oiwitli CaW-SEEINSTRUCTIONSONBACKOPYELLOWCOPY
IIIIIIIII Ilyllllll REQUEST FOR ELECTRICAL INSPECTION 5,50:ilit
MmnesoW State Board W ElectricRy
II 1821 University Ave., Rm? $-128, St. Paul, MN 55
0 104
? 2 4 5 5 9 1 3?t Phone (612) 642-0800! /??/Oi_ ?•???
Home
Duplex
Apt. Bldg. ?... ? y
Other: -
Commeraal Indusfnal Form
Air Cand. Hfg. Equip. Woter Hir. Load Mgmt. Other:
D er Ran e Elec. Hea} Tem . Service 7
"X" above the work covered by fhis reques? Enter remorks m fhis spoce and on the back ol the w
,,ly.
Colwlate Inspecfion Fee - This Inspection Request will not be occepted wdhout ihe mrtect fee:
Olher Fee $ $ervice Enirnnce Size Fee /F Circuils/Feeders Fee
Mobile Fiome Park $fall 0 to 200 Amps 0}0 100 Amps
$freet L}g./Tro{fic Sig. Above 200_Amps 6ove 100 Amps
Tronsformer/Generator INS PECTONSUSEONLY TOTAL
Sign/Oudine Lig. Ximr.
Al
/R
arm
emofe Confrol
Swimming Paol
Irriga}ion Boom I hereb oeni tha1l tn: tha elecmcu insmllafion dvmbed hemin on ?ha dote. slated
Rwgh-In
Speciol Inspedion Doie
Investigofive Fee F'"°l Da _
THIS INSTALLATION MAY BE ORDEReo rncrnuuc n
...... «??.. vnnm iomvnI na. I
0 08
?.
-1 3 9 6 4G ?
e
Haquest Oate Flre o. Fough-in InspecLOn ?
?
Repuire0? ?
? Fleatly N.
pill Notiy Inspeclor
? a ? No hVhen Readyi
I licensed contrector O owner hereby request mspection of above electrical work at
JoD AEdress (SVwt, Bmt o-FOWe No ) cryy
E
Secuon No Township Name or No Range No. yJ A
9ccu nt PRINTI
NoL7
. ?N P ro No.
- C?
P r SuOPlier Pdtlreu
f
I ro I Convanor (Cwnpany Neme) Conhacmr's 4cense No.
?T/l6- G
Meih q M ress Comra or Owner Ma
king Installat
y
`
AuthonieE S onVadorlOwror Making Instal i Phone `Number
'f L
MNlNESOTA STATE BOAHp OF ELECTRICRY ? THIS INSPECTION qEOUEST WILL NOT
GrIp9rMi0way BIEg. - Foom St]3 BE ACCEPTED BV THE STATE 6DARD
1821 Universlly Ave., St. Pwl, MN 55100 UNLESS PROPER INSPECTION FEE IS
Pli (812) 642-01110(l ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION a,1L " N ei? es.oooo,aa
? See insvuaions for compleeng mis torm on back of yellow copy ?b
sY *
? 13964 X" Below"Work Covered by This Request ??? /OO6
e AHd Re Type of Butltling AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Elechic Heating
Apt Bmldmg Dryer Other (Specify)
Comm /Industnal ' Furnace
Farm Air Contlihoner
Other(speciy) ConVacWr§ Remarks ? I
Campute lnspechan Fee Below:
# Other Pee # Service Entrance Size Fee # Circutls/Feeders Fee
Swimming Pool 0 to 200 Amps 0 m 100 Amps
Transtormers Above 200 _ Amps A 00 _ Amps
Slgns Inspecror§ Use Only TOTAI
IrngationBooms
Special Inspection
AlarmlCommunication THIS INSTALLATION MAV BE OROERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONTHS.
I, the Electncal Inspecior, hereby
certif
that the abov
in
ti
h pouyn-in t o?/ G
<
y
e
spec
on
as
, been made. oeie
/
OFFICE USE ONIY
•
This request voq 16 months fmm
rn,z .ea.ast yale nths (rom ';? _ / p r
NA 095907 Z-,ajB;, ?fdP,)
1? 3?
?? U "Py7 4?
Reques ate Fve No. Rough-in Inspecuon
(/
^
g R qu• ed, ?FeadY Nnw WiII Nntrtv Inspec-
Q
e;x Ves ?No ?nr When FeadY
U Licensed Electncal ConVactor (
I hereby requast inspec[mn of above
? Owner e lactnca I work vwta I led at
Street Atldres
s, Boxor/ Foute No. City
?
? / ? J /'??LJ ?iL??2? ? Gp-'C?ti?
ecv n o. Towrehip Name or No. qange No. Cou
Occu I PRINT one No.
wer SuDO
?
Atldress
E l actr al Contrec
tor (Gompany Nem Contracmr's Lwensa No.
?..?1.°C'_-c?
Q
Maitmg Address (COnVacmr or ner Making Ingtailation)
Author
mre (Co a
dO
wne
r M
aking Installation) Phone N
omb
er
?
/
-
/
,
f?? /
'
Ej C? " C1 b? Oo
I
MINNESp STqTE BOAHD OF EI.ECTfliCITV
GriB9s- itlwey Bldg. - Hoom N•191
7821 Umvatsity Ave., St Paul, MN 55106
Phone (812) 287-2111
THIS INSPECTION pEQUEST WILL NOT
BE ACCEPTED 8Y THE STqTE BDARD
UNLE55 PNOPER INSPECTION FEE IS
ENCLOSED.
REQUESTFORELECTRICALINSPECTION 0*02111 Ea-ooooi-oa
See InstlUCtlons (ar campleting this 7ofT on EaCk 07 Vellow coPY-c?/? ?
D . .,PwaQ nti ¦ n "Y" Ra/nw Wnrk Cnvered bV Thrs Request ?
na?oa Aoot?ancea wiree Equipmen[ Wired
Ratige Temp orary Service
Water Heater Lightiny Rxtures
inc? uryer Electric Heatin
l 61dg.
N Fumace
BIAg- Atr Conditioner Bulk Milk Tank
Pec?iV Othei ISper,ifyl
fy
ffv
Ot er
Oiher
r
(:ompu[e inspecuun ree oefuw -
r Faw . ServiceEntrenceSiza tl Fea Fanders?Subfeeders p Fee Cvowts
O 0 to 200 Amps 0 to :1U Am s
on?P 90? 31 ta 100 Amps ?._ S_oC 31 to 100 Ainps
FF Swimming Pool Abave 100_Hmps a+oove ????-•°•
Transiormers IrngBbon Booms Pamal.'Other Fee
Signs Spec?al Inspection ? TOTAL E
Femarks ? //2
-? s
Rough-in,
_ I
D"::te '
y
LI y?
I, the EI ical
Inspectoq heraby
° ? efIHy that the above-
Fnal pection has been
? .
Thi91BQYe5t v014 10 momns mnu
?i?N? p?? tirrT- pa,4 -G c4y" ru?-
?073 0/1 2006 RESIDENTIAL BUILDING PERMIT APPLICAITON ??????/
.-rr tt?? City OfEagan
? 3830 Pilot knob Road, Eagan MN 55122
'1'elephone # 651-675-5675 FAX # 651-675-5694
New Consiruction Reuwremonts
3 registered sde surveye showng ,q fl ofloi, sq fl of house, and all roofeU areas
209G ma?miirti lof corerage eL'cwdJ
2 copies oPplan showng beam ?I wmdow s¢es, poured found tlesigq elc
1 sel of Enecgy Cnbmahcns
3 copies ofTree F'reservalion Plan if lot plali=d aAer 711,93
Pom Joist Delad Opiioos selechon sneet (hwldmgs wdh 3 or less unds)
Minnegasco tidechanical acnhla[ion form
RemodPliRemir Rzawrem>nis
2 copies of pian shovnng foo5ngs, beams, joists
1 set aiFnergy Cebula6ons fur heated ndddions
I sile survey for adtldions & decks
AddiNon - indroale ,f cnvde s?ptr system
A NEW BUILDING
Date CS l? i?
Construction Cosf ?,? ,S ?
_
Site Address y? i
UniUSte
Description of Work
Mulri-Family Bldg Jz ?Y _ N Fireplace(s) _ 0 _ 1 _ 2
Proper[S Owner 7'elephone #(6?1)
Contractor PELLA WINDOWS and DOORS
- 15300 - 25th Ave N., #100
Address _ Plymouth, MN 55447 Ciry
9tate (763) 745-1400
LICENSE: #20165884 Tele hone#( )
p
COMPLETE THIS AREA ONLY IF
Energy Code Categwy - Minnesota Rules i 6?0 Cateeorv 1
• Residential Ventdation Category 1 Worksheet
(d submission type) Submitted
• Energy Envelope Calculations Submitted
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
In the last 12 months, has the City of Eagan issued a permit fa a simikn plan based on a master plan?
_ Y __ N If yes, date and address of master plan: _
Licensed Plumber
Mechanical Contractor
SewerlWater Contractor
Telephone # (
Telephone # f
OUce Use Onlv
Cedo(SurveyRecd _Y _N
Tree Pres Plan Reca 1' N
Tree Pres Reqmred Y N
On-sdzSep6cSystem _Y _N
Telephone # ( J
I hereby apply for a Residential Building Pernut and acknowledge that the infoixnation is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes, I understand this is not a permit, but only an application for a pernut, and work is not to start without a
permit; that the work will Ue in accordance with the approved plan in the case of work which requires a review and
approval of plans.
1- -?-k-??-?? - ? ?`• .
AnAli.,?nNo Printnd hTomP An?lirent?n Ci.rno` 1.ra
ePermits
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Permit yVindows/Doors
Number:
EA073611 4471 Clover Lane B
Required Inspections:
Windows/DOOrs Final
Comments:
If altering the opening size, a framing inspectlon is required. Smoke detectors
are required in all sleeping rooms prior to final inspection. When wall studs or
ceiling joists are exposed, hard-wired detectors are required. Battery operated
types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be
removed to install a smoke detector.
Total Fee:
It is the permit holder's responsibility to call and schedule inspections. Please call City of Eac
675-5675 to setup the inspection times and dates.
Privacv Statement
https://epermits.logis.org/ePermitsWebPublic/CheckoutComplete.aspx?orderID=130 6/2/2006
%
RESIDENTIAL BUILDING
p,,p Permit Application 7 6 ?
W?? 1( City Of Eagao
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Conshuction Reauirements RemodeVFteoair Reauiremenfs Oft Use OnN
3 registered site surveys showing sq. R. of bt sq, ft ot house; and all roofed arm 2 copies of plan Cert of Survey Recd _ Y_ N
(200k maximum lot wverege allowed) 7 set ot Energy Calculations tor heated additions Tree Pres Plan Recd Y N
2 copies of plan showing beam 8 window sizes; poured fountl desgn, etc. 1 site survey for addNOns & decks Tree Pres Reqd Y N
1 set of Eneqy Calculatlons Add'Mon - indkate ilonsde sepBc system On-srte Septic System _ Y_ N
3 wpies of Tree Preservatlon Plan if lot platted after 711/93
Rim Jast Defail OpWns selectlon sheet (bidgs with 3 or less unils
Date tJ ./?) / 03 Coostruction Cost
Site Address L (l{-11 b (? u) v? ;?, (A) UniUSte #
L m
Description of Work
il
Bl X
y
Muiti-Fam
dg -Y _ N Fireplace(s) _ 0 _1 _ 2
Property Owner Telephone # ((o---1 ) (?90-0s SO
Contractor
Address 30-4;1) 1,.1. f-lw`7 13 City 3uqWS?LI,l.(S'
State WL?/ Zip Telephone#(94?1) Fi`33-05D -X/lIz{.15A
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy CAde Category . Residentlal Vantilation Category 1 Worksheet ? • New Energy Code Worksheet
(d su6mission type) Submitted Su6mit[etl
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Confractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of NIN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of wo which requires a review and
approval of plans.
?
. ??,? N 9? YI?llO c
Applicant's Printed Name Applic 's Signature
1985 BUILDING PERHIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS NUST BE LICENSED pITH THE CITY OF EAG9N
C014MERCIAL
SINGLE FAMILY DWEGLINGS
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
I cp 4 ".o,ooo
To Be Used For:,% Valuation: -?-e-? Date: ?
f 1
Site Address //v7? C?„eT ?N
Lot /0 Block ?
Parcel/Sub
Owner <??l ?l?p L?uf?s ?-
Address /46o 93d4? NL
City/Zip Code /3R,Ae o'1,) 5143 Y/
Phone ?,?z1 s?-YO
Contractor - 49;7? iL
Address
City/Zip Code
Phone
Arch./Engr. f, = E-
Address
City/Zip Code
Erect X
Remodel ?
Repair ,
Addition
Move T
Demolish '-
Int.Impr. ?
Install '
APPROVALS
Occupancy
Zoning
Type of Const
# 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//-¢.¢JS Treatment Pl
APC Parks
Variance Copies
TOT6L
Phone #
. / ?DIV
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTEACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
COMRfERCIAL
SINGLE FAMILY DNELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIF'ICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF t SET OF ENERGY CALCULATIDNS
ENERGY CALCULATIONS' '
$2,000 LANDSCAPE BOND
I bF 4/ cao,ooo
To Be Used For: 7?sdx.(I ,;,' Valuation: ? Date: f-?/3d
Site Address !Z/?-71 '?j C/ux V.- 4 1-)r?OFFICE USE ONLY
Lot 2 Block ?
Parcel/Sub
Owner?'(
Address /4160 2?44LJ A)
?
City/Zip Code
Phone 7ffv SJ2 O
Contractor sL
Address l
City/Zip Code
?
Phone
Arch./Engr.
Address ?-
?
Cfty/Zip Code
Phone #
/
Erect X Occupancy
Remodel 2oning
A
Repair
? Type of Const
Addition # of Stories
Move Length
Demolish ? Depth
Int.Impr. Sq Ft
Install
APP@OVALS FEES
Assessments Permit
Water/Sewer ? Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Offj?g•?gS Treatment Pl
APC Parks
Variance Copies
TOTAL
U
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED ifITH THE CITY OF EAGAN
C014MERCIAL
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTZFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF t SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
i oF 4 caO,aoo
To Be Used For: au16; Valuation: ffnC-6-=
Site Address
Lot ? lock ?
Parcel/Sub
Owner ??? ???., C ??c S .?•?
Address /"a
City/Zip Code 'D /a,N e ?H?u 33--467
Phone `?Fo S"J / J
Contra
Addres
City/Z
Phone
Arch./
Addres
City/Z
Phone
Date:
Erect ;K,
Remodel ?
Repair ,
Addition
Move ^
Demolish
Int.Impr. ?
Install ,
APPROVALS
Occupancy
Zoning
Type of Const
S 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 0ff11:4R5 'h-eatment Pl
APC Parks
Variance Copies
TOTAL
i
V ? • • / /?? /
1985 BUILDING PERMIT APPLICATION - CI1R OF EAGAN
NOTE: ALL CONTRACTORS NUS'f BE LICENSED iIITH THE CITY OF EAGAN
C0141ERCIAL
SINGLE FAMILY DIiELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRl3CTURAL PLANS, 1 SET OF 3 CERTIF'ICATES OF SURVEY
SPECIFICATIONS AND 1'SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
I o F q-
To Be Used For: Valuation: Date:
Site Address OFFZCE USE ONLY
Lot ? Block ?
Parcel/Sub 3.1?9
Owner ?c-/ Y05jUe- 6= 'i 27Je-
Address /j6CJ lJ3"'a ), N q) L
City/Zip CodePy4k.A) c?(/p/J Sj4D/-
Phone 2 eO $-r/ 0
Contractor 6W?
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone If
Erect X
Remodel ?
Repair ?
Addition
Move
Demolish T
Int.Impr• ?
Install ?
Occupancy
Zoning
Type of Const
# 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 Treatment P1
APC Parks
Variance Copies
TOT6L
so
V ? 1991 BII 1ILDING q9
q PERM?A ZCATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
14fTLTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE tTNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CNANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERM2T IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT NAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For, t ?i 2 Valuation: Date:
Site Address 3-8 OFFICE USE ONLY
Lot Block ?
Occupancy R 3 M-1
f Zoning
Parcel/Sub Actual Const
Allowable
Owner # of stories
?f
Address 7?? l??OIJ????9,LYE, Length
Depth
S.F. To[aI
City/Zip Code
i Footprint S.F.
Phone On site sewage_
On site well _
Contractor qt-?g MWCC System _
? r ??' ?
lE City water
E
.
Address A =
PRV
- Booster Pump _
City/Zip Code T
2 x__U I
/
Phone l9l Z^??? Z' z-?? APPROVALS
Planner _
Council
Arch./Engr. Bldg. Off.
Variance
Address
City/Zip Code
FEES
Bldg, Permit 46t).00
Surcharge (D(D
Plan Review
0
299,0
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
TraiZ Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL . C (
?
Yhone #
agrees that all work shall be done in accordance with
(Signature o ontra r)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
1PERMIT AP??
1991 BUI NG PLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: r t
Site Address
Lot 11 91ock _I
Parcel/Sub
dValuation: OC.YO Date: Z?-s- -I (
Owner M,KF 0STLtE
Address 3?b3r7 ??p?/E.e LANc
City/Zip Code
T'
Phone -'-
Contrac tor ACSV A A-P£i'_t? vvi?u IE< ? ZiJC
Address (04co t,)E
City/Zip CodeFe:xka?a * ?`{3Z
-?_
Phone Co I Z-?? Z- Zoc7O
Arch./Engr.
Address
City/Zip Code
Phone #
OFFICE USE ONLY
Occupancy R-3 M-I
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off. SS-q/61S
Variance
FEES
Bldg. Permit c207,00
Surcharge 10.00
Plan Review -
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL 21 4? ?.`IV /O 1 2uS5e5, S
,E(ZFG`17°i(saC.) f
agrees that all work shall be done in accordance with
(Signature o Contra tor)
i2oG K ) f cU?.cu4T?! 2?.1.?
cJ/?c.t- r? t?Ca2 ?a7'i oNC?
ali applicable State of Minnesota Statutes and City of Eagan Ordinances.
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road
,
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMIT TYPE: s u } L D J N G
Permit Number: 034386
Date Issued: ml /+'03/49
SITE ADDRESS:
4473E CI OVHR L,9PdF_
LOT: 12 CiLOCK: 1
[DEN
P.Z.N.a 10-22760-120-01
DESCRIPTION:
RFPI.ACE SIDSNG
Buildinq-..Permit 'I'vpe S7DRM DAI+iAGE
aui.ldina W&rk Type REPFlIR
i CensuS Code ?•? A34 ALT. RESSDF.N7IAL
i
/
i ?
i'
i
\ i
i
i ? V';, . . . . _ . . , . .
REMARKS:
UNIT B.
FEE SUMMARY:
CONTRACTOR: - A ppLic,nr. -- sr. i.TC. OWNER:
CUSTOM CUNCEPTS CONST 18987290 201.42417 SWANSON JOLEEiV
16540 KE14ftTCK LOOP/STE 8 q4738 CLOVER LANE
IAf:EY'ILLI: MN 5500.4 EAG.jIV 1+7h! 551.:2
(512) 858-7296
i hereby aclcnowledve thaY I have read thi,, epplication and stote thnt tifie
intormation is ccrr'Gcc and aqree to ccmol.v w9th ali apoJicable St:eTe ui Mn.
StatutLle and Gitv ot Eaqan t7rdS.ndnces.
I
APPLICANT/PERMITEE SIGNATURE
UEDB??R?
I
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
:. J. ' 3830 PILOT - 55122 q?
??-1-3 (651) ? `
New Construcnon ReQUirements RemodellRepair ReQUirements
? 3 registered site surveys
? 2 copies of plans (inUude beam 8 window sizes; poured fnd, tlesi9n; etc.)
? 1 energy calculations
? 3 wpies of tree preservation plan if bt platted after 711l93
required: _ Yes _ No
DATE:
DESCRIPTION OF Wt
STREET ADDRESS:
? 2 copies of plan
? 1 sde surveys (exterior additions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST; c'f ?1 S D ?
LOT: I-?- BLOCK: SUBD./P.I.D. #: c? V`
Nante:__?wcAn5Ql'1__ Phone t#:
PROPERTY I-"'
ObbNliR
tiheet
City
.
coi„i:
CONTl2:ACl'OR
Street
G[y
ARCHITECT/
E V GINEER
Compazy:
N.unc:
Strce[ Adc
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 applicable
State of Minnesota Statutes and City of Eagan Ordinances. /
J
Signature of Appticant:
OFFICE USE ONLY
Certifcates of Survey Received _ Yes
No
Tree Preservation Plan Received - Yes _ No _ Not Required
State: ------------- Zip:
- - -C?-----
?ess:? License # ljQ oiZ 141L.1p. _-
--?
-
?L ? -------------------- State: ------ L'p: _ y
Yhoiic #: -------
_ Registr.ition #:
-- - - ----- - - ----
Statc: ------ -------- - "/_ip:
??_ .
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
PERMITTYPE: ButLotNs
Permit Number: 034385
Date Issued: 01!08 j S 9
SITE ADDRESS:
4473 ci.uvER LArae
t.vT. 11 si_Oct<e 1
FoEr•i
10-22750-110-411
DESCRIPTION:
REF'1_NCF
Bu.'4 Ldinq'_Nermi t 'fyr.,,?
?
Uu,..Ldinq WdCk 'rYPe
-Ceuqua eoac, ?
/ .
, .
?s
SIIJING
STOHN DFlMHuE
REPRIR
434 AL7". RESSDL'NT.IWL
? ??• G' .._ .: __?; ..
REMARKS:
FEE SUMMARY:
CONTRACTOR: - ElPplicant: - s T. i_:i c. OWNER:
CUSTOM CONCEPTS COPlST 18387290 20142417 ANSARI KHALED
96540 KLNft;CCK LOUP/S'(L= fi 4473 CLOVF_n I.ANE
LFlKFVILI.E MN 55044 EA(SAN MN 65122
(612) 298-7290
?
I nareby nel,nowledqa chat i have read 'chls applicatiion and scvtH Lhat the
LntorrnaT.ion is correct and iqrAe to comply wiLh a11 aoplicable 5t'ate oY 1+7n.
Statut<rs and City o`i -1-aoan Orc'in&rlce-.
APPLICANTlPERMITEE SIGNATURE
1 ,l
ISSU BY: SIGNATURE
I
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
J??g S 3830 P(60T ) 80 4RD - 55122
New Cons[mction Requirements
? 3 registered srte surveys
? 2 copies of plans (include beam & window sizes; poured fnd. design; elc.)
? 1 energy calculations
? 3 copies of tree preservation plan if lot platted after 7!1/93
required: _ Yes _ No
DATE: 1- 1 -Kckq
DESCRIPTION OF WORK:
Remodel/Reoair Reauirements
? 2 copies of plan
? 1 site surveys (exterior additions & decks)
? 1 energy calcuiations for heated addifion5
- C7 /
q ?-7 S-Dc
CONSTRUCTION COST;
z?p?
STREET ADDRESS: u `y]J 1.?h71)QJ?' l C It-9
LOT: BLOCK: SUBD./P.I.D. #: ? ?'?--
/ ,
?\.mie:_?Gl (_ 1-----?*-"`?? ! ----?---- Yhone H:
PROPERTY Last First
O'VD?V1:R
SucctAddress:_- --------- ----------- ------------------
City
S[ate:
Zip:
C:ouipazry:-L??al?'----C VC-? % J --- Plionc?: --
CONT12r1C1'012 ????^'n ?? ? ?- ^
Street Adelress: Iacense # aOf N 21?-1 ZE?p. __
C'ity --K-"?-- ------- ------ - State: ,y?? --- Lip: :sJ_?? F----
ARCHITECT/
EvGPIEER
Yhone k:
Registraliou #:
Stmct
CIIV '----------------- __ 541[B: ------- _'---- 71p:
Sewer & water licensed plumber (new construction only): _
change and lot change is requested once permit is issued.
Penalty applies when address
1 hereby acknowfedge 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.
Signature of Applicant
? ?I,!7
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 551 22-7 897
(F51) 681?-4675
PERMITTYPE: ?u??ozivs
Permit Numher: m 3 4 3 S 4
Date Issued: P 1/ N 8! 9 9
SITE ADDRESS:
44718 r,LovER i_AraE
LOT: 9 C3LUCK: 1
EOEra
P.z,N, e 10--22750-090-01
DESCRIPTION:
_ _ RcF LFlCr_
P,aildinqLpErmit: l"ype
kl.?i.tdit7w 4?Ti?i,?k Type
rtensu% Code ?
L.
?
i
\ J
? w
1>
`?•-
?
+ ll?,
l?
slnzraG
&'1`S5RM C1AMfiCiE
FEP61.T.R
434 ALT. RESIDEINT:CHL
!% ?''_ ;-' j-'.` _ _''" ?`+_. . _ ... '. `?r?? 1 • -._ ? ,.
REMARKS:
uP,lTT ra.
FEE SUMMARY:
CONTRACTOR: - Applicanr - s7`. LTc. OWNER:
CUSTUhi CONCEPTS CqNS'i' 1.8987290 2014?_417 F'FVL?pA JAPlE
15540 Kf_NRICK LOOF'/STE F, 4471E3 Llt]VER LRIVE
IHKEVILLE MA! 55009 tl4RfiiV hIN 55122
(612) 89$-72947 ,
I
I FierQby acknnwlodqe tVtat T haue read this apolicafi;i,an ancl state that the
iniarmation ,i.s e:orrect and agree ;tca cnmW1v wa,th all applir.abia Sta#e nf Mri.
SLatuE;es and City aE Ea4aa} Clr^ri3.riances. I
APPLICANTlPERMITEE SIGNATURE
)-? A A m I UED BV SIGNATURE'
-
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
?y CITY OF EAGAN
3830 PI' Sl) 680 4RD - 55122
Nzw Cons[ruction Reouirements Remodel(Reoair Requirements
? 3 registered s"ite surveys
? 2 copies of plans (include beam & window s¢es; poured fnd. design: etc.)
? 1 energy calculations
? 3 copies of tree preservation plan if lot platted after 711193
required: _ Yes _ Na
DATE: I ') " ICl
? 2 copies of plan
• 1 site surveys (extenor additions & decks)
? i enerqy calculations for heated additions
CONSTRUCTION COST; q _? I 5-(X)
DESCRIPTION OF WORK:
r 3 u
STREET ADDRESS: L{ f?
?-I rJ ? 1? ?Y nl'19 A 1cl_6n n
LOT. q BLOCK: I SUBD./P.I.D. #: 21tk?L?
Vaine:_ 60.r\ (L ---- Phoue k:
PROPERTY F"st
OWNI R
Strect Address:---------------------- ---------
City
State:
"Lip: 10 Comp,uiy:_C _-yj 74! ?_ C?C`l{9 ?r'?? -- Pliouc k: ?1?
CON"1'ftAC'1'Olt +r ??
??$"Y??--- License # xI ?I? ?I ? L:xp.
Stree[ Address:? _?.??' /
?
CIl4 _----- 4__1V -- ------ ---------- - $LaLC: 71P•
ARCHITECT/
L-NGINEER Coinp:ury:------- ---- Plioue d: -------------- --------
Rc;,risltation 4:
Street Address:------- --------- ----------------
Citv .... --........... - ----------- State: ------- --- Zip:
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 applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ? R F
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
,.
Tree Preservation Plan Received _ Yes - No - Not Required
PE?RMIT
CITY OF EAGAN
3€330 Pil7it Knob Road
Eagan, Minnesota 55122-7897
(651) 681-4675
PERMITTYPE: Bur_Lozroc
Permrt Number: 034383
Date Issued: 01108199
SITE ADDRESS:
4471 cL ovE '? L A riE
1_0 r: ie cH_ucK: c.
E 0 r_N
z=.l.iu.e 1 0 -:2 7 5 0 -10 e-0 .i.
DESCRIPTION:
REMARKS:
sI oTN G
STURP9 OA1+1RGE
rtrP A ztt
434 AI'f. RFS7i7ZNTIAL
Fl, ?P 1- nce.
Bplld3nq:..Ferrn3L ly;pe
?raaldina intc`ri°IS Type
./Cansus Cade,
J
- ,
/F
?..
t'
FEE SUMMARY:
CONTRACTOR: - aipplicant - s'r, i.ice OWNER:
C115TOhl CGhlCEVl`S CQNST 18987290 20142417 ROSENOL,I LAp0Y4uR
15540 KENRCCK 1_OQP /57E B t1471 CLOtIER LANE
LAKEVTLLt IqNI 560A4 EAGAN MN 55127
(612) 898-,7290
?
I heYebY acknaw]edqe thar I have road this appliaation and sL'ate that T.he
S.ntnrmatiari is cor rect aiid agraa to complv wi Cli a1.t applicable Stete nfi Mn.
Statut:es and Citv uY Eaaan Qrdi,nances<
APPLICANTlPERMITEE SI6NATURE
? 1? l-se
UED BV. SIGNATU E
I
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PI` 51) 83O4? - 55122 I-?` a q
New Construction Requirements
? 3 regislered site surveys
? 2 copies of plans (include beam & window sizes; poured fnd. design: etc.)
? 1 energy calculafions
? 3 copies of tree preservation plan rf lot platced after 711/93
required: _ Yes _ No
DATE: I -1- 91
RemodellReoair Requirements
? 2 copies of plan
? 1 sile surveys (exterior additions & decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST;
DESCRIPTION OF WORK:
?
q3l5. 00
STREET ADDRESS:
LOT: I D BLOCK: SUBD./P.I.D. ??-
N:une:,?S dY?? Phone ---------
------------
PI20PERTY
O"'ul:lt
Street Adclress------- ------- ----------- ------------- ----------
Ci[y ----- Sta[e: ---- ------ --- %tp:
D/?y] 9 ?y?/ /// 9/
?:c)Itl[>?111?':?d?L?' Pllone#: fQ/?XLSl_--Jr--L_---
coN"TizA(:rox '7 r
Street Address:?`?'?? 1-icense # )Ul ` L I Lp.
_ ---
cit, ----L ? _ sL,Lc: ?? ---- r;p: ----
ARCFIITECT!
GNGINEER Company: -------- ---------------------- --- Phoue #: ---- ------ -----------------
Reonstntion #:
Slrcct Address:---- ------------------- ------------ ------------
Citv ...... --........ ------- ------ Stare: ------ Zip:
Sewer & water licensed plumber (new construction only):,
change and lot change is requested once permit is issued.
Penalty appiies 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.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
--, -.?-- -, ?
Tree Preservation Plan Received _ Yes _ No - Not Required
L / CITY USE ONLY
? BL ?
RECEIPT #: 44A50 /
SUBD. _ ?? DATE?
1995 MECHANICAL PERMIT (RESIDENTIAL ?/a g/9S
CITY OF EAGAN ?7
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dweliings
? townhomes and condos when permits are required for each unit
New construction Add-nn furnace
_4z?ldd-cr, sir cc^di:;oning ?dd-on air exchanger, i.e. Vanee system, etc.
Date:
? Minimum Fee: Add-on/Remodel (existing residence
? HVAC: 0-100 M BTU
Additionai 50 M BTU
? Gas Outlets (minimum of 1 required Q$3.00 each)
? State 5urcharge
TOTAL
FEES
only 20.00
24.0
6.00
S .50
SITE ADDRESS: Yy7/
OWNER NAME: 'j U,?t•? PHONE #:
??60co WV- 667 - 0.7Z4
INSTALLER NAME:
STREET ADDRESS: 1,0frU xo? •
CITY: _ ??? STATE:? ZIP:
PHONE #: )
CITY USE ONLY
L I? BL _L RECEIPT#:?i4?'9d
SUBD. ?? DATE: "Q
t°.P. 1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construation Add-on furnace
? Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: ti - I -? lo
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)
? 5tate Surcharge C.50___1
TOTA` "
SITE ADDRESS: 4`1 ?? CL'wn 1^-
OWNER NAME: ILln u J ft?,wtj a 11n.an.r . PHONE #: 1`3?q53j
INSTALLER NAME:
YM+IFAPOLIS. YN 6610B-29i8
STREET ADDRESS: e1zaz44sss
CITY:
STATE:
ZIP:
PHONE #: ( ) ? ??? s
/
PLIKIVIlTrEt:
??
qsn? i?Gl? I e4tW rCITY OF EAGAN FOR CITY USE ONLY
3830 PILOT RNOB ROAD
F:eaGAN, MN 55122 PERMIT
PHONE: (612) 454-8100 RECEIPT # O O
"C?,I'?I?A?,;DATE: S /
4P n. . .. .. . .n.n.n...
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNAOMES/CONDOS WFtEN PERMZTS ARE REQDIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST _
ADD ON
REPAIR
n 1
OWNER NAME:
SITE ADDRESS:
LOT:_? &LOCK SUBD.
INSTALLER: 4v/-,G
ADDRESS: DR-
CITY: A) ZIP: Q /
r
PHONE #: I¢Z2 ?7 ?E '?7Z5
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL: $°1j?7 zo
STATE SURCHARGE: .50
TOTAL: Sd ?S?c7
SIGNATURE OF PE TEE
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDIISTRIAL BUILDINGS,
' APARTMENT BUILDINGS, AND MULTI-FAMILY BUIJ.llINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
^` QO
PF.30cS3cD PIFItiG - ?c?
$25.00 MINTMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
$
CITY OF EAGAN
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
9"Br7*;AY'??C.?
FOR CITY DSE ONLY
PERMIT #
RECEIPT # • ? 3( J
DATE: ?/
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMZLY DWELLINGS &
TOWNHOMES/CONDOS WIiEN PERMITS ARE REQUIRED FOR EACH IINIT.
WORK DESCRIPTION
NEW CONST _
ADD ON ?
REPAIR
OWNER NAME: ,? ??C L' n? CY R?' S
SITE ADDRESS: /_3 ?G?Ur.e L")
LOT:_/21 BIACK ? SUBD.
INSTALLER: ?/- -F R P-1- /'z?
ADDRESS : 9 9'? S /? ,. T.. ? .? Zcl9! O?
CITY: G ?llq S' eiA ZIP: ?i yi /6Q
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
o?L SHOWER 3.00 !a
? WATER CLOSET 3.00 _e_
? BATH TUB 3.00 3
? LAVATORY 3.00 61_
? KITCHEN SINK 3.00 3
? LAUNDRY TRAY 3.00 3
HOT TUB/SPA 3.00
? WATER HEATER 3.00 '?
? FIAOR DRAIN 3.00 -3
GAS PIPING OUT.
? (MINIMUM - 1) 3.00 3
ROUGH OPENINGS 1.50
OTHER
P WATER SOFTENER 5.00 5
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL S h/,q
ST. SURCHARGE .50
TOTAL: S ?{2 y?
bqT&IAIIi PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
------------ ____________------ ________
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: SLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
CITY OF EAGAN
FEES
ZIP: ,
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
$
$
( S IGNATITRE )
s i ? •?? ? • i o• • • u r. ?• •?.
•01• a •o• i • •?? ? • •• r•?• ? ? ? ?? ? ? ?
ff-A u
CITY OF EAGAN
APPLICATION FOR PII2MIT SEWII2 AAID/OR UL4TER CONNECTION
1) PROPII2TY ADDRESS: 4/1,,r1 _
r•Fr:ar• DESCRIPTION:
k LOt/t3lock/SUbcLtvi5lon or Tax Parcel I.D. Nu
IF EXISTING STRL'CTLRE, DATE OF ORIGINAL BL'ILDING PERNffT ISSL'ANCE:
(Nbn Year)
PRESENT ZONING/PROPOSID LSE: R-1 SINC',LE FANLiLY
R-2 DL'PLEX (ZGro L'nits)
R-3 'NWDII-IOC'SE (Three + Units) ( Lnits)
R-4 APARTMENT/CODIDOMINICM ( L'nits)
CONAIERCIAL/RETAIL/OFFICE
IDIDCSTRIAL
INST IT['TIONAL/GOVERPA'IENT
2> ?
NAME: /Y/'C 1-E 1,9,11 Art /,71 P/VC"•
ADDRESS :
CITY, STATE, ZIP:
PHONE :
3) ? i:?•
NAME:
ADDRFSS: Sd?-6yi e.-
CITY, STATE, ZIP:
PHONE:
MASTER LICENSE #0o!&f2- h7 ?'i
For City L'se
Plumbers Licens:
CI Apt' ve
Recorc
4) • r " ' • ?• /'
NAME: ?oc? [/ Fl?Lt E /?a mE$_
AonxESS: 1C1,60 CITY, STATE, ZIP:
PHONE:
MIGN&
• a• ??
)ELCONNECTION TO CITY SEWER O$"CONNECTION 'Ib CITY WATII2
Q OTfiEEt (Please Describe)
6) u • • i
[3 PLEASE HOLD APPROVID PERhffT FOR PICK-L'P BY ONE OF ABOVE
01 PLEASE MAIL APPROVID PII2MIT 7C] 1,(D2 3, 4, ABOVE
(Circle one)
7) ? ??? ? l/z? ??
F O R
PERMIT °- ISSUED
C I T Y U S E O N L Y
FrES: $ ?'(?-.? ?
$
$ G= 3??.
S
$
UC-
$
$
$
$
$
? - 3{, ? V
$
$
$ X/
,
nrR1qTT (I`ICL't;iE SURC^?aGc)
WATER PEIU1IT (INCLiIDE SliRCHA2Gn')
WAT:R METER/COPPERHORN/OUTSID° REi,DER
WATrR TAP (INCLUDE CORPORATION STOP)
SE:-iE4 T??
AC.^.OtiVT DEPOSIT - WATER
W?.C
SAC
TRuNK NAT°R ASSESS2?E.:T
TBi;:7K S?:iER aSSESSME^iT
LATE3.,L BE:IEFIT/TRUAIK SE:,T--F
L`n:c.RAL BENF.FIT/TR[7NK WATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
T0;',aL
r1MOL'NT PAID/qECEIPT
DOES UTILITY CON.IECTION REQUIRE EXCAVATION IN PUBLIC RIGiiT OF WAY?
? YES IF YES, THEN n"PERb9IT FOR *r10RK WITHIN
PUBLIC ROe\DWAY" MUST BE ISSUED BY THE
? NO ENGZNEERING DIVISION. LIST AS A CONDI-
TION.
SUEJECT TO THE FOLL0WING CONDITIONS:
APPROVED BY:
TITLE:
DATE : ???? )?
• ' I ? • ' • ? • I • ' ? 171' I? /• ?1• • ?1•
• 7?' ? ' D• • ? ? • /• • ` 7? ? M "H7+? • 1 1 1 01 • • ;
CITY OF EAGAN
APPLICATION FOR PERMIT SbWER ADID/OR WATIIt CONNFCTION
1) PROPII2TY ADDRFSS:
LEGAL DFSCRIPTION:
or
IF EXISTING STR[:CZL'RE, DATE OF ORIGINAL B[7ILDING PERMIT ISSCANCE:
(NFnth Year)
PR£SENP ZONING/PROPOSID USE
R-1 SINGLE FArffLY
R-2 DCPLEX (?t,o Cnits)
R-3 TOWDIIHO[:SE (Three + L'nits)
R-4 APARTMENT/CONIDOMINI[:M
C0MA'1EE2CIAL/RE.TAIL/OFFICE
IPIDCSTRIAL
INS72'I['TIO[Vr1L/GOVII2I=
( Onits)
( Lnits)
2) ?
NAME: / /'
/v/
C6?So T
C-
'v
c.
ADDRESS : PjQ x- 129
CITY, STATE, ZIP: 5g?ya/lr,, 5-2?-J 73
PHONE: 413 3 S/ 71/
3) r?• For City L'se
NAME' Plumbers Licenst
ADDRESS: 59•9 /r?c? A ive
CITY, STATE, ZIP:
ired
PHONE: MASTIIt LICINSE #
/JO%??/ZJyi t
Recor(
tial
4) ? • i?• / '
NAME : 61n 6 4-,( E ya rn E S'
ADDRESS:
CITY, STATE, ZIP:
?HODE: '7 ?f'G - S S/ D
5) n « ?• • a? ??
IIW CONNECTION TO CITY SEWER ACONNECTION TO CITY MTII2
Q OTHER (Please Describe)
6) n • i
? PLEASE HOLD APPROVID PERMZT FOR PICK-t'P BY ONE OF ABbVE
WPI.EASE MAIL APPROVID PERNIIT TO 1, , 3, 4, ABJVE
/ I (Ci cle one) J
7) 2
FOR C I T Y U S E ON:,Y
PER.`tIT °- ISSUED
F°ES: $ /?).5e
$ 1(i } (l
$
S
$
S /•-?,?
+S J•1G cr,
$
S
C
y
S
$
+S ?o?. v cJ
/
$
$
SE:':L.D. n.r'..RMTT (INr.T..:iE
W-ATER PElTU1IT (INCL'uDE SiiRCAi2Gc.)
WP.TER METER/COPPERHORN/OUTSIDE REi,DER
WATER TAP (INCLC7DE COR?ORATIQN STOP)
SEWEB TAP
ACCOliNT DEPOSIT - S•7A:ER
wac
SP.C
TRliVK WAT°R ASSLSC.iF::T
TRli?1K SE:dER HSSLSS;:ENm
LrITEP,aL SEDIEFIT/TRUVK SE': ?R
LATERAL BENEFIT/TRUNK ?4AT°_R
WATER TREATMENT PLANT SURCEIARGE
OTHER:
TOTAL
AMOU:;T PAID/RECEIPT n
DOES UTILITY CON.IECTION REQUIRE EXCAVATION IN PUBLIC RIG'rIT OF WAY?
YES IF YES, THEN A"PERMIT FOR ;90RK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? NO ENGINEERING DIVZSION. LIST AS A CONDI-
TION.
StiEJECT TO THE FOI.LOWING CONDITIONS:
APPROVED BY;
TI:LE:
i
DAT£ :
/
PERSON3r REQUILRZNG- p,DDITIONAL OOPIES WIiSi, BE' CHARGED A $20.00' FEE TO
CITY OF EAGAN
APPLICATION FOR PIItMIT SE47ER ANID/OR WATER CONNECTION
(Please Print)
1) PROPII2TY ADDRESS:
T.FYiAT DESCRIPTION:
IF EXISTING STRC'CT[JRE, DATE OF ORIGINAL BC?ILDING PERMIT ISSC'ANCE:
(Nbn Year)
PRESEN'I' ZONING/PROPOSID USE: R-1 SINGLE FAMILY
R-2 DL'PLEX (Trro L'nits)
R-3 TOWNHOL'SE (Three + L'nits) ( ['nits)
R-4 APARTMENP/CODIDOMINICM ( [:?nits)
CONIMERCIAL/RETAIL/OFFICE
INDCSTRIAL
INSTITC'TIONAL/GOVII2NMENT
2) ?173d4? :?r / ?
NI?ME: °? /4
ADDRESS: A(:ia. zZ i?,,
CITY, STATE, ZIP:
PHONE: ' ?/ 7 J
3) • r.?'
NAME:
ADDRESS: 5 ,b /,y ?
CITY, STATE, ZIP:
PHONE:
MASTER LICENSE #Qp/,gtj?h?
For City Cse
Plumbers Licens:
rArE: (;oo C? U /-7 /ti!5- lg-,e?'
r,oDREss: 4?6 o q? .C .qrv?-
CITY, STATE, ZIP: gIJ9 L?yF ?f7 .Al
PHONE: '7& G-.S$
5) i1 ' ?• • a• ?+?
%CONNECTION TO CITY SEWER JO CONNECTION 'PD CITY WATER
Q OTI-LER (Please Describe)
6) u • •
? PLFASE HOLD APPROVID PERNffT FOR PICK-L'P BY ONE OF ABpVE
? PLEASE MAIL APPROVID PERMIT RO 1,? 3, 4, ABOVE
(Circle one) /
?? ? z6e 2/? ? 7111x3l.?S?
F O R C I T Y U S E O N L Y
PzPHIT °- ISSUED
?
FEES: $ sg',:.?.. --v nrR:-- ..tr1 (z_ L.,-??r ? st;.._ or-ci?Gc)
..tr.-....
S rC. s?- waTER PE?P1I: (IiICL'uDE SiiRC:iARGc)
WATER METER/COPPERHORN/OL'TSZD° READER
$ WATER TAP (INCLUDE COR?CB?,iZO?I STOP)
$ SE'.vER TA?
$
$ / S U D ACCOUNT Dv?OSIT - S9AT°_2
$ i C.c WAC
$ -?.? S^ o c1 SP.C
+S TTZli-NK SqAT°R ASSESS:?E.:T
$ TRGNK SET•iER YSSESS:e°_:iT
+S Lr1TE?-AL BE:3EFIT/T'2,U`IK SE: ?=
$ LATERAL BEVEFIT/TRUNK ?•;A^E? ,
$
WATER TREAT.*[ENT PLANT SURCF?ARGE
$ OTHER:
S TOTAL
$ AMOU;;T PAIJ
a
/REC°I2T
r
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR TrlORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SLTSJECT TO THE FOLLOL4ING CONDITIONS:
APPROVED BY:
TITLE:
DAT°
I
NAME: G,GEA O.N
ADDRESS: Z &
CITY, STATE, ZIP: ,?G??yQ/j y fh rv S? 6 73
PHoNE: Sr33 ?S/ > /
CITY OF EAGFIN
APPLICATION FOR PERMIT SEWER ADID/OR WATER CONNECTION
(Please Print)
1) PROPII2TY ADDRESS: .
T•fY:AT• DFSCRIPTION:
IF EXISTING STR[:C'IS7RE, DATE OF ORIGINAL BL?ILDING PERNffT ISSL'ANCE:
(Nbnth Year)
PRESENT 20NING/PROPOSID USE: R-1 SINGLE FAMILY
R-2 DCPLEX (Trro Lnits)
R-3 TO4NI30L'SE (Three + Cnits) ( Lnits)
R-4 APARTMENT/CONDOMINIL'M ( Units)
COn,ERCIAL/RETAIL/OFFICE
IAIDL'STRIAL
INSTI7['TIONAL/GOVEF2NNIENT
2)
3) • i:?•
s i I ••• 9 • i e% m ?• • u r ?. •?.
•a?• • •a• •?? ? • •• r • ?? ? ? ?? a? • • ;
•? •
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5rV/'n ez-
MASTEEt LICENSE #422/8-rZiy,?
For City L'se
¢nbers- Licens(
Ac ive
Cr pired
/Not Recor(
Staf Initial
4) ? • i?• --
tVAME: ??rY V AlGC 6 ?arnC-S
ADoREss:
CITY, STATE, ZIP:
PHONE:
5) u a ?+• a? ??
WCONNECTION 1CO CITY SEWER PrCIONNECTION TO CITY WATEE2
p OTI3ER (Please Describe)
u • ? i
6)
? PLEASE HOLD APPROVID PERMiT FOR PICK-L'P BY ONE OF ASOVE
?T PLEASE MAIL APPROVED PIItMiT TO 17 3, 4, ABOVE
(Circle one)
7) P! /3!?'?
F O R C I T Y U S E O N L Y
PER'V!IT °- ISSUED
?--1
?
Fr...r
..5:
PER?1Ty (In.T.l .=_ JU'.?..r.=.;?.RCiL)
$ /G' SU WATER PERPIIT (I.:CiuDE SliRC::ARGc.)
$ WATER METER/COPPEBHORN/O[ITSIDE READER
$ WATER TAP (ZNCLUDE CORPORATICN STOP)
$ S::iER TAP
$ ?rCcu:i'r ???CSI= - c_..=:2
$ /S-uo AG:OliNT DrPOSIT - WATER
$ c c WAC
$ SPC
$ TRu:IK WATER ASSES52?E.1T
$ TRli't7K SE:dER yS5E;5?iE?iT
+5 L`n; ;?,<`-.L BENEc IT/T:?UVK SE".=
$ L :Tr'.2rlL BENEFIT/TRUNi{ WATER
$
WATER TREATMENT PLANT SURCEiARGE
$ OTHER:
$ TaTAL
$ S94, c U AMQli1'T PAID/REC°'?'t n
DOES UTILITY CONNECTION REQUIRE EXCaVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMZT'FOR WOR?C WITHIN
PUBLIC ROADWAY" MUST BE ISSL'ED SY TY.E
? NO ENGZNEERID]G DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOI,LOWING CONDITIONS:
APPROVED BY:
TI':LE:
DATE:
? -?
, RESIDENTIAL BUILDING
„ Permit Application
` City Of Eagan
/ 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694, _,
New Construction Reauiremenls RemodeVReoair Reauirements ??x
3 registered sile surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan
(20°h maximum lot coverege albwed) 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window s'izes; poured tound design, etc. 1 sife survey tor addNOns & decks
1 set of Energy Calculations Add'rtion - indicafe tl on-sRe sephc sysfem
3 copies of Tree Preservation Plan rf bt platted after 717193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
I ?-j (),C) 6
-I --1 _03
Oifice Use Onlv
Cert of Survey Recd
Tree Pres Plan Reod
Tree P2s Not Reqd
_ On-site Sep6c System
Date 0 6_ _ /.c r
Site Address qq i / o -s
=3 C( C) VeA- L-o ConstrucHon Cost
y, UniUS[e #
Description of Work A cld Q4a C-L d &2= ?_k
Multi-Family Bldg _ Y-k-FT Fireplace(s) Afo?O _ 1 _ 2
Property Owner A A(Xw?l Up pAca „,A Telephone # (6Y I ) ?j FS? ' B I ?'L7
Contractor
Address
State Ciry
Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category
(J submission type)
Licensed Plumber
- Minnesota Rules 7670 Cateeorv 1
• Residential Ventilation Category 1 Works e
Submitted - "
• Energy Envelope Calculations Submitted?\
Mechanical Contractor
Sewer/Water Contractor
Minnesota Rules 7672
. New Energy Code Worksheet
Submitted
Telephone # (
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approv l ?lans.
7- C?flk'? R c_? _ ?A ?A
ApplicanYs Printed Na e Applicant's Signature
Sub Types
OFFICE USE ONLY
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex p' 18 Deck ? 23 Porch (screenlgazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Work Types
,tD 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation 2/ Dvv
Census Code q3
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const v ?
Footings (new bldg)
? Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Fratning
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Width
REQUIRED INSPECTIONS
FinallC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
?
r ,
? 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
`Oemolition (Entire Bldg) - Give PCA handout to applicant
Occupancy MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
July, 26, 2002
Ta The City of Eagan
Building Inspection Department
RE: Building Permit for addition of deck to 4473 Clover Lane
OWNERS: Adam and Rakia Copeland
To whom it may concern:
Adam Copeland has asked the Eden Homeown?rs _"-_°??r•?'?*? ^r F= ?° __,"'- '"-:''' "
to kis tuwlitiome at 4473 Clover Lane in the Ciry of Eagan. Having
u.??Cu um ?yu..: .Wa«u„b ?iu ?,ians be has pre:is:r.ar}' appmr•n_ to build this adct:t:on.
: --.
Since rel?,
?
,-
L._
Homeo ers ssociation
`?1??? 3 Go? ?F.,K, ?a,a.,, ss?z2,
?
?
?
?
?
I- UwNJ o4` W SM;i J I
ClCa vcfi
7?u &?
soos RESIDENTIAL PLIJMBING PERMir aPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date /D ! ?3 1 49 6, '
Site Street Address -1y71 a Covr? ?.?rlG Unit #
Property Owner _jaeC /;;A21c4 Telephone #
Contrector Norblorn PLam bf n? Telephone# ((p12-)
Address 2qD5 Cnar-hfld Av.So. cicympts Statefl'1N 2ipr?,6q Dg
The Applicant is: _ Owner V Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alteretions to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener andlor water
heater at the same time. !f you are lnstal!!ng onlv a water softerer and/or water
beater, do not complete fftis section; move to the next section and check the
appliance(s) you are instatling.
_Septic System Abandonment
_WaterTurnaround (add $130.00 if a 5/8" meter is reciuired) OCT 2 5 200
Other:
Water Softener ? Water Heater $ 15.00
_ new X replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total S /rSO
I hereby apply for a Residential Plumbing Parmit and acknowledga thet tha Informatlon is complete and accurata; 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 per it, work is not to start without a permit and work wili be in
accordance with the approved plan in the event a plan is requifydi, to be,r)Lgiewed and approved.
jefi'-reV L_ Norblorq
Applicant's Prin d Name
City of ?agn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
------------------
? ?m om?e ose i
j Pertnitlt:
? Permit Fee: ?
? Date Received:
i s+ae:
I
-----------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: I' 04 Slte Address: "7'Y 7 f 4' W 7 3 C I.OUE( 1-.O
Tenant:
Suite #:
RESIDENT / OWNER Name: r) D+h % !.r?hone:
Address / City ! Zip_
Applicant is: _ Owner _X_ Contractor
TYPE OF WORK DescripGOn otwork: 1C'e (DD P
Construction Cast$ {,?F,?co0, op Mu16-Family Building: (Yes X / No
CONTRACTOR Name: "? A.CmP 'C?D(bJ.-""46nse#: `ZOq?lQ'i)
Address: 141q 240 W •
City: - f;.1 Mi f14 b?o ss State: MAJ Zip:?T70Z<l
-
/ '/ n-' n L
?1 ' 2'? `J?V'3
Ph
23 C
P
L? '?QO
one:
ontact
erson:
Y
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Ene?gy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Wrnlcsheat
Categoty Submitted Submitted
(4 Submisalon type) • Energy Envelope Calculffiions Submitted
In the last 12 months, has the City of Eagan issued a permit for a simflar plan based on a master plan7
_Yes _No It yes, date arW address of master plan:
Llcensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supportlng documents that you submit are conaidered to be pub!!c intormatiort. Portions o/
ihe lnformation may be classHied as non-pub?ic H you provlde specific reasons that wouid permlt the Ciry fo
conclude thet the are trade secreta
I hereby acknowledge ihffi this information is complete and accurate; that the wofk will 6e in conformance with ihe ordinances and codes of the Ciry of
Eagan; that I understand this is not a permit, but only an appliwtion far a permit, and woAc is not to staR withaut a permit; ihat the work will he in
accordance with the approved plan in the case of work which requires a review and approval of plans.
xkr?4"?
AppllcanYs Printed Name Applicant's Signature
Page 1 of 3
&be 33 r 37
{r7OYE COHSUlTIHO ENOINEE85
ENGINEEAING PLpHNE85 ond LfIND jURYEYORS
COMPANY, INC.
? 1000 EAST 1461R STREE7, BURNSVIILE, NIHNESOTA 65337 PH 432?3000
Ce TlZ?ZCGLj? S7?C.T"'YeIV
DC.7Cl'Ge22072: L075 9, lo, /!, ANU 12, BLOCK l?rDEN AaolrioAl,
? D4K07A COVn/TY. MINNESoTA
C'5Z--9% DEN07E5 EX/5T/N6 ECEVfIT/OA/
(9to.o) pgNOTES PROPaSEU ELEVAT/ON
/A/O/CATES pI/ZECTloAl oF SvRFACE pRA/NACz"
92o.S = JSjN/SHED GARA&E FLPOR ELEVfIT/ON
N O R-i' H
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I hareby cnrtify that thia ia s trueiand/c?d`rract rapreeentatio6t a tract of
land aa sAoxn'and deacribed hereon.. As prapared by me on this _34P day of
Q=ya? , 19 Ff5 . '
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,aOBE CpNSUlTIHO EN31NEEflS
ENGtNEEA1NG PLpNNEflS ond LAND iURVEYORS \1jjvaj
COMPANY, INC.
?1000 EAST 1461h STREET, BURNSYtLLE, MINNESOTA 55331 PH 4432-3000
?04I ?GlCf"?p?201L: LO"f5 9, /o, ll, ANp 12, 6LOGK (1' i5DEN ADD/T/DN?
zAAKOTA CoUA-ITY, M/NNE5077a
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(9ZO•0) DENOTES PROPoSEO ELEVAT/ON
- !dlDICATES UIReGTioa oF SvRFACE pRA/NAC'6
?ZO•5 = JS/N/SHED C?4RA6,E FLOoR ELEVAT/ON
NORTH
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I her+by cartify that this ie a true and c"ct rapr,assntation i a tract ot
land aa ahovn'and deacribed hereon.. Aa preparad byma on this }ea day of
Grrc,B?2 . 19 £f5 . '
. leE. Ho. .?i'.ecs
D C C~ E D C
D , For Office Use k
City o
f ~aan JUN 1 2009 i Permit 0: 3830 Pilot Knob Road , Permit Fee:
I
Eagan MN 55122 1 Dale Received:
Phone: (651) 675-5675 I - "
Fax: (651) 675-5694 staff:
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: L4 ' Tt 015), l -
Tenan Suite
RESIDENT / OWNER Name Phone X11__ PA%
Address / City / Zip:4LA- - lf~ _Otavg~ . -V-~ ~ 21
CONTRACTOR Nam OCL - - icense H: ~ - ~-LqwX
Address: ~U _ -
City: Stale: L b~ Zip: _ J "r V L -L-
Phone: Contact Person:
TYPE OF WORK _ New 4 Replacement _Repair -Rebuild _ Modify Space Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ PV13) Main _ Lower Level)
Septic System Water Turnaround
_ New
Abandonment s-
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
'Water Turnaround (add $136.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $
TOTAL FEES
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 approva7fpf ns.
x ~ x _kZ J
Applicant's Printed Name Appc is Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground Rough-In -Air Test Gas Test `Final
PERMIT
City of Eagan Permit Type: Plumbing
Eaaan, Permit Number: EA100492
Date Issued: 08/09/2011
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 4471 Clover Lane
Lot: 10 Block: 01 Addition: Eden
PID: 10-22750-01-100
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments: Kris Oien
3670 Dodd Rd
Eagan, mn 55123
651-365-1340
Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
Total: $».00
Contractor: - Applicant - Owner:
Champion Plumbing Christophe R Louisiana
3670 Dodd Rd., =100 4471 Clover Lane
Eagan NIN 55123 Eagan NIN 55122
(651) 365-1340
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 Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type: Plumbing
Eaaan, Permit Number: EA100492
Date Issued: 08/09/2011
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 4471 Clover Lane
Lot: 10 Block: 01 Addition: Eden
PID: 10-22750-01-100
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments: Kris Oien
3670 Dodd Rd
Eagan, mn 55123
651-365-1340
Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
Total: $».00
Contractor: - Applicant - Owner:
Champion Plumbing Christophe R Louisiana
3670 Dodd Rd., =100 4471 Clover Lane
Eagan NIN 55123 Eagan NIN 55122
(651) 365-1340
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 Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
From:ALLSTAR CONSTRUCTION 19529427464 09/17/2013 08:29 #582 P.014/079
Use BLUE or BLACK Ink
I For OfficeUse--------- I
j Permit M City j
of EaflaIl I Permit Fee: J 0 , r7
3830 Pilot Knob Road
Eagan MN 55122 I Date Received: i
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: q 1,512-013 Site Address: 'Iy1I,4~h1 g,yy13.yy13B CtUve►~ Lahr unit
Name: Ean big CIO*, &_Qlal I COMWA Phone:
Resident/ i~ ~n~
Owner Address / City / Zip: tt/13t G tm Y ~a1 1 Pa1,m C'CiG') IPM Ae f MN 55391 t(Applicant is: Owner Contractor
Type of Work Description of work: T@GY and Ve-=f
Construction Cost: 5,1150 • y0 Multi-Family Building: (Yes / No
Company: AiMar MwWw Mau , L LC, contact: (hit alftrgd
Contractor Address: uy s Indunjoi l M+ *103 City: Mapt , I iai n
State:M N Zip: ~J3 Phone: q~JZ" q~1Z" -I~'IS"1
f
License Bu.24 G- 1r, Certificate N T" i0y
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
r~ 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:
E 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 they are trade secrets.
CALL BEFORE YOU DIG. Cali 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.oooherstateonecall.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 pe completed within 180
days of permit issuance. rfl
X_ Hai&
Applicant's Printed Name Appff/ant's Signature
Page 1 of 3
ff
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® I I
e r
®
�.•• •®,V®
EAGAN
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
buildinginspections a�cityofeagan.com
-------------
For Office Use
I
I Building Permit #: I
I I
I I
S&W Permit #:
I � I
I I
Permit Fee:
I I
I I
Date Received: I
I I
I Date Issued:
I
t----------------------
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Applicant is: ❑ Owner Contractor
Unit #:
I
Name: IGt e sA b ul�e— (z:> �_�� y,_ ._- _f4s�5 o C' A Ot_4 k 6 In
Homeowner Address: J "i -�, I N—t! � i q "1 —+ D"�/ City: �aaOL
State: Wip: S51 ?—Phone: OoQ6-✓ LEmail:
I Description of work: �2 C, tD,
Type of 2
Work Construction Cost)
of building: ❑ Single Family ❑ Townhome,
of units 14,Twin Home
Compan �ThQ��tl
Building Address: �� T KAA/. City:��iLe
Contractor � / '/
State:M&6: 5-37 Phone�otZ�7)' Email. _Vlke�C ,\^_e,v�
License #: o O Ex Iration Date:
Sewer & Company:
Water
Contractor Address:
Required for State: _
new construction
Zip: Phone:
Contact:
Email:
License #: Expiration Date:
City:
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 v~.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.
X
Applicant's Printed Name A licant's Signature