3482 Coachman Rd
Use BLUE or BLACK Ink
1 ror C)Fice 1i
Clay of Ea a~ ~ Permit _F9 d
I 1
I Permit Fee: vv I
3830 Pilot Knob Road
~-g
f _ :
Date Re ived
Eagan MN 55122
Phone: (651) 675-5675 1
I Staff:
Fax: (651) 675-5694 1 I
- - - -
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: (t,~,V-
_tt ~ Phone: ("rl-~ l4Z
RESIDENT / C_ W
OWNER Address JCity /Zip: 7) Z C_,gac ~
Applicant is: Owner Contractor
TYPE OF WORK Description of work: 2R,~nu-~ f-(Z_0p.C(y~ 64- 4 Aksgl Sllie ~eC
Construction Cost: ! r2 yc,-
Company:. , Multi-Family Building: (Yes /No X
Contact: b r~r~eSS
CONTRACTOR Address: 1 Y(4 It City: 4;,- l44- ~
State: _Zip: ~i2( Phone: 71-7 h,-70
License Lead Certificate
Does this project require Lead Remediation? ❑ Yes WNo (see Page 3 for additional information)
If no, please explain: ~-o O ~ rr td._L2 A ,
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.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x ~i~P
Applicant's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
I For Office Use
I
Permit
I I
I Permit Fee:
3830 Pilot Knob Road I X02 _
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 L Staff:
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 10 Site Address: COP 0-9 AAC,- t2(z~
Tenant: Suite
RESIDENT / OWNER Name: raue c u cr-+ v G Y-z Phone: ~ S
Address / City / Zip: c4 (2,0 w C-Ln ''V\. owti-
CONTRACTOR Name: License
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK - New VReplacement _Repair -Rebuild - Modify Space _ Work in ~RO.W,.
Description of work: ~ a--z `T"t wig Uj c"-& / ^ _ '1
PERMIT TYPE RESIDENTIAL
Y Water Heater Water Softener
Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main Lower Level)
Septic System Water Turnaround
_ New
Abandonment
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 $166.00 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 $
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orp
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 ca a of work which requires a review and approval of plans.
x c7 ell 1tit C~-c x
Applicant's Printed Name App icant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground -Rough-In Air Test Gas Test Final
' . ' CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagsn, MN 55121
B
I
PER PHON E: 454-8100
U
LDING
MIT Receipt #
? i Dt?
To be used for Est. Value
Date
Site Address ' x{) OFF ICE USE ONLY
Lot Block Sec/S
b On Site Sewape _ Occupancy
u . MWCC System _ 2oning '
ParCel No. On Site Well _ Type of Const
City Water (Actuaq
ac Name _ (Allowable)
W * of Stories
3 AddresS Length '
° Ciry Phone Depth
Total
F
S
.
.
o Namg Footprint S.F.
Ov
_~
Address
APPROVALS
FEES
v<
?
Clty Phone
Assessments _
Permit
,
? W
W
Name Water/Sewer _
Police
- 3urcharqe
Plan Review .
-'
i= Address Fire _ SAC, Cfty
"
uo Ci Engr. _ SAC,MWCC
? W ty Phone Planner _ Wate? Conn.
I hereby aCknowledge thet I have read this application and state Council _
Bldg. Off. _ Water Meter
Road Unit
;0
that the informetlon is Correct and agre e to comply with al4 pplicable APC _ Treatment P1
State of Minnesota Statutes and Gity of Eag?ryOrdin es. Variance _ Parks
Signature of Permittee Copies
TOTAL
,-.?,?,,, ,,, ,,?,?,;, ., ? ,.. •
A Building Permit is issued ta on the expresa condltion that
all work shall be done in accordance with all applicable State of M innesota 5tatutes and City of Eagan Ordinances.
Building Official
Permit No. Permi! Holder Oate Tslephvns ?
Plumbing
H.V.A.C.
Electric
,
Softener
Inspectfon Dato Insp. Comments
Footings I
Footings II r
Foundation
Framing 71V P?
Roofing
Rough Plbg, y-,7-ir7
Rough Htg. k
Isul. ?
Fireplace
Final Htg.
Final Plbg. :
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
DeCk Frmg.
Wetl
Pr. Disp.
1
Site Address -
Lot
? Nan
? Add
c Ciry
Name J
3 Address
0 CiH -,t;-
- PERMIT # a c37i5
PLUMBING PERMIT AECEIPT #
CITY OF EAGAN Q
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?/?/
COMM/IND FEE - 19b OF CONTRACT FEE
APT. 6LDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES.RATE APPLIES
MINIMUM - RESIDENTIAL FEE ' - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
BLDG. TYPE WORK DESCRIPTIDN
Res. ? New i--
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING
NO. FIXTURES TOTAL
-LWater Closet - $3.00 $ -?- rD
_/-Bath Tubs - $3.00 3. Q D
J_Lavatory - $3.00 3_ i7 O
Shower - $3.00
---/-Kitchen Sink - $3.00 ,3. 0
UrinaliBidet - $3.00
_/-Laundry Tray - $3.00 G O
-LFloor Drains - $1.50 00
-/-Water Heater - $1.50 0
(MINIMUM - 1 PER
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
,,3._Rough Openings - $1.50
Sli0U?OF PERMITTEE FEE; ? r 10
STATE S/C: d
a
FOR: CITY OF EAGAN GRAND TOTAL: ' S
. ,
_ ., ,- _ . . .
PERMIT # K ?1 ' '-^
MECHANICAL PERMIT 17
' CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ???? ? ?
'RACT PRICE ?' - ? ?? ?' • u'? PHONE 454-8100 '
- Name _
? Address
c City _
? Name _
c Address
0 CrtY -
TYPE OF WORK
Forced Air 'n , OU0 M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other
FEE
S/C:
TOTAL•
$2d.U1) 11
BLDG. TYPE WORK DESCRIPTION
Res. " - New
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000,00)
._ ,
SIGNATURE OF PERMITTEE -
FOR: CITY OF EAGAN
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS•
INSPECTIUN RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
• 1 1,1 1
f1l11.I114f1N it1.1
?I??HI? I +?ta 1!i { I?li r??
PERMIT SUBTYPE:
4 Hi fil i i APPLICANT:
Hlt [ I li t Nt?
H?,/Nt l''?4
M i F E I,JA1 t( N IInMf 1 MIji2(jVMN 1
1.' ):i () 4 9 4, -i tl
TYPE OF WORK:
Ilt 10.1ifl' ( (i1N
(1li I I Nloi`,
f rhAI
N f t-1
1 f1I1?11FtF I111141 {1)
Permit No. PermR Holder Date Telephone #
S/UV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectlon Date Insp. Commertts
Footings I
FoundaGon
Framing
Rooflng
Rough Plbg.
Rough Hlg. I?
Isul. I
Frepl2ice
Final Htg.
prsat Test
Final Plbg. Plbg. Inspector - Notity Plumber
Consl. Meter
EngrJPlan
Bldg. Final
Deck Ftg_
!
Deck Final 7
Well
Pr. Disp.
CITY OF EAGAN Permit Na ' S 5 9 Date: 1?-8 '
3830 PIIM Kneb Road Meter Na k 7e 6 3.5- Size: '
P.O. Bgx 21199 Reader No: /1?? Date:
Eagan, MN 55121
Owner rroatier Xiu;aest
Site Addi
Plumber.
Conn. Chg:
Acct Dep:_
Permit Fee:
Surcharge:
Tr. Plant-
Meter. _
bZ Coac
ar Plun-
525.
WATER SERYICE PERMIT
CiTY OF EAGAN Permit No: 3559
3830 Pllot Kpo?v RosdAYMeter No:
P.O. Box 21189 Reader No:
Eagan, MN 55121
,. _ Frnntier :.ic:west
Site
ts
?i
.GA
N,
ot Eagan
Da'te: 3 - l ? ?E. 7
Size:
Date:
;
Conn. Chg `').`.I.1?1?
. ?'
Zonin
Acct. Dep: No. of Units:
Permit Fee: . ? ??
` ?
Surcharge: ?
I agree fo comply with ths City of Eagen
Tr. Plant ?" `' ' ? ' Ordlnances.
Meter f
Misc.: BY
WATER SERVICE PERMIT
CITY OF EAGAN SEWER SERVICE PERMIT °
3830 Pllot Knob RoacLa
P.O. Bcyt 241S9 PERMIT NO.: 3_ V_ 1 ;
Eagan, MN 5§121 DATE: 1
Zoning: rl No. of Units:
Front ier : Sidwest
Owner:
Addr
to comply wilb the Clty o1 Eagan
of tnap.:
Connection Charge: 525 • Wad
Account Deposit: 15, 0OjL_
Permit Fee: 10. 0032d
Surcharge: • 50PL,-
Mfsc. Charges:
Total:
Date Paid:
CITY USE ONLY
L ? BL ? RECEIPT #:
SUBD. Z2??KpT?3v GTS RECEIPT DATE:
? •?_
1999 PLUM$INfi PEtMTT (ftESIDENTIAL)
crrY of E,tsArt
3830 PaoT Kxos ftn
EAHAN, bIN 55122
(651) 6$1-4675
Please complete for: ? single family dwellings
9 townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTilRES
EACH #
TOTAL
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
GaS i i?1 Outlet ' minimum -1 3.00 X = $
Hot tub/s a 3.00 x = $
440aMm sink ,v-nrf.eavA7 3.00 x = $
Laund tra 3.00 x = $
Lavato 3.00 x = $
Minimum fee alterations to existin dwellin 30.00 x = $ ?-
Private Dis osal S stem newlrefurbished ' re uires MPC iic. 75.00 x = $
' Private Dis osal S stem abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x = $
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x $
Water heater 3.00 x = $
Water softener if dwellin under conswction 5.00 x = $
Water softener if existin dwellin 30.00 x = $
Water turnaround 30.00 x ---- _ $
State Surchar e .50 --> ----> ---> $ .50
Total _> ___> $
, sv
Reminder: Call 681-4675 for inspections of water heaters, water softeners, alteratlons, etc. ?
------------------------•------------------------------------------------------------------------------------------------------•-------------,
I hereby acknowledge that I have read this appliqtion, state that the informadon is corred, and agree to camply with all applipble City of Eagan ordinances.
It is the applicanPs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance aciiviGes to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: ??gZ C-0-19CNl?J'7/9'y /?i? ??'? ?irl Z?
OWNER NAME: uCf 0' fi£/L04'Gf-
INSTALLER NAME: S?G f TELEPHONE #: 16r/-
STREET ADDRESS: ?r9r+-? ? ? i??z?3??
CITY: STATE: ZIP:
CO/PERMIT FORMS/RPLBG PERMIT (RES) - 1999
P7ge 1 of 4 -^ ?-
EX; ERt4Z EIl'1ELQf'E J1VFR11GF "li" COMf'l17ATiON
" ? ------- -- - - - .
?` • . '
ownER:
I I nnrr:_ 3 -
SITE ADDRESS: .?CON TRACTG;? :_P-Cv}?_M &T.
Determine working s?are footac?e of each
.
-
,1. Total exposed wall area..... t
A 1? sq. ft,
r. .11 •
2. 7ota1 roaf/ceiling area.....? q4, 5q, ft, x.026 S
7ota1 exposed wa11 area al?ove Floor- t?Z4?*
' a. Total wall window area.
? b. Total ............
door area...........? ..... ... ...... ....
c Total .......
sliding glass door area ....... . - ?" 4?---
:
d Total ...............
fireplace ?rall at-ea ,,,,,,,,,,,,,,,,, ._,_,
.. .,..
-?-Z:
? e. T o t a l wa l l fram ing area ;averaye lOft:) ... .;:: ;:;'
, f. Total ...........
rim joist area............ ....
--?'?9• net .
wall area above floorZl4i ?
h. .
.................
wall area above fioor .....
.........
.... _ o• l?
I
i. ? .
wall area ab?ve flaor................... ......... .... --? .
? J frame wall area at r"o?;r;dation.....? ................ .....::
.? iotal exposed foundation area=
k. Total founda?ion yrindoti•r area.....
1.
Total ..
net foundation area above grade . ,_...,,....
,
?•?
Determine "u"
{e.g. ?vi ndow, value
door, of cacii wall se(jmenl
each separat e wal l seci:icn}
a ,?, x „u,l`
b.
---?-_
C. 42-- x -Uu
•
A S
•-^_----?? .._ •
d. X )full ?.?
_
WO.......
e. x 1- U,, L
x „u„ -
•O _
3
?• 5!
q
g.., 1?(rp. t? X "U„
h. X liuli _
i . X IIU,l _
?• X
k. ( "S • +Z Z`,, X w
1. G
_O.7S X
3
1i u 11 _
„u„ *
.
ltu ot .tS
. . . . .. . . . ... . . . . . .. . . . . . . . . . . . . . . Total _174,!75
_ • :?,;t:;?;:
If item #3 is the same=
as, or less than,;- item;?:
#1, you have ,.. ,.??;.,.
me tF:
the
intent af SBC..?6006,;fc:?.?i
.
. , _ ,.. ?.
icensed Electrical Contractor I here6Y revuest insdsciion of above
h1_, electrical work installed at: _
REQUEST FOR ELECTRICAL INSPECTION ? EB-00001-05
a/U / 5, ?7
3 1? See instructions for completirq this fwmlon back of yellow coDY•
. ._ . _ . . TL:_ O_.?....nf
Ro
?h-in Oate
?? tfie Electn e
nSPdctoi, hereby
?%• certify thet the nbove
? Date inSpectio? has been
Final
n . 97
rrede.
TMi ?eVuef[ rwo Ia m.anw.o ....... ,?
?
? 4,n?.r, ;:r.r.??;??ia?
a ? n ? ? ? ? a a ? • • ?. •
f•.. U:'r? ?'?i V?? t`I']?i?lr! W,11 1 AYt 1 rui'
+ fr;jj%-: 'r.c,iir.t rucl fun . .
?.?
I rl _ - w
P I C. p 1 TQl'V I E:f,l OF
. FltNlk WAI.T.
?P" ^
('?.?i•?l ? ui ; ir.i?
?. ". , ." I At[ AL-n'?.- --
?.
a . •_ .. .. . . . . 1"?1 t Rww?
?; . .s_l R Q.wn. . - - ?
?I?I• ..ill
I:...'.t{ii,? .
0-.y,b
A .4.30
7. Vo
. _U,I7
•,??.? ? ,, i 13, Lj
7/?' ? ? • ?42P
0.
2.
4• %?r/_1?!1..-- -- ..------•..---?- --??5??
5. ?,ttvm,_ S[1a?? . _ . ._._ . _?.??t
v, 41 (
?t z • C+ 3
.,_--•-----Q
.__ __... _._._..?
. ]n tr.i io r ii ir f'ilm
2. _..
....
.
3. . .. ..
_?J!.!?v__#.,:._ . .???. - -•._.. _.---.... _?_?•C70
4 . _?"? ?r_? - •, .. . ... .. . _.
-- • •- --- ?, V i?
•
6. }:xt??i•l??r nir (; lm •
? -......_-
---•---•------•--? ---.1'a! i?. i?1
c
, t¦
z
?L?k UZ ? a 3
2 . .. . . r . __. . _ . . ... . ...--- - ?? -._.. . ... _
_ i?`.? _ .Q?9i??C 8?
a?
r,? . --?--•-
?
.
.
.
- ---•-` .
T'Y.LQ .. . _ .. I .!.?.. . . --...?..
..._.:...--
5 . _ . . _- -- ?- ---. _ .. _ - --- ---- --- --. _ . - - -- .---
G. l::ci?•ric, r .,i1• ; i!?•, c).1';
.T;ul.il
fA "" • !45
SI.hll OPI GINI)L•'
•. ,. ', ? ?
r . ?
.y?• ?'• ' .'
G. 13
? • V ••+ `?
+ ,? p • ? , ?- St?? ? I-
' . .
% .?. _. _ .. .._..?._.?. _ .- •-- f ` •--::?t • /
f t?`? . •.. ? ?' ,. . •,? ' ± . 1
- ?rr? i , ?. . • ? ?-,,.?
!1( . ? • ? I!( ?
04
Ll a `
(l( /!' `` ; 17,
,',,:i;01 nnd
? jii.??:rr?4•it. ;?( in•:?il.??_ir?n. ?
0?
- +4
;9 A' 1,7
. • - w
(lierti#iratt of (IDrrupanry
Citp of (Eagan
arwumi af vwlding jwrriiua
Thrs Certifreate issued pursuant to the requirensenis of Section 306 of !ke Uniform Buifding
Code certifying thar at the time of issuance this structune was in compliance with the vrrrious
ordinances of the Cety regulatfrrg buidding construction or use. For the following.•
Uae Claaaifialion SR ffiwCx1.R Bldg. Rrntit No. ) 33 ;'+
..._......_- __ ...?_____..__,.._.._-.. ..._.?._ ....__._.?--------..___•?
POST IN A CONSPICUOUS PU1CE
•?f.?rior I:nvolol)o nvci-cL(JO "U" COirf)ul't?l:io»
r. - ••
Tol•al expo;;ecl rool/rciling nrca = Qt • Z?7
M. '.ibtal s1:yJ.i.c;l)t area ........
... ... .. ... ,r?'?-?
n. Total roof/cciling framing area (1vcrayc 10%)...
o. Total nct insulatcd roof/cciling urea........... _4"
_t'83
Determine "U" value for eacli roof/ceiling segment
?
m. _ X
n. bq AZs x
.a Z?-
o . , x „U- O Z _ ?
.
4 • • • • • . • • . • . • • . .• . . . . . . . • . . . Total L
2.G3
r ?
Pac;e 2 Of n '.
If total of 1#4 is the same as, or less t.han 112, you hcave met the intent of
SHC 50','?Eh (c) 1.
nlter;laLe Builclinq I.nve].o-e llesi<In
Zb utilize the total, envelope'system method, the values established by the sam of
items #3 and PM shall not be greater than the sivn of items 4l1 and #2,
1. t 51- . iq + z. ZJ .4s = r s. 5 3. -.?f?4 aJ? + 4. . (0 _ _.114? ??-
:
,. _.............. :N
'?.
.,
? . . • ?;?;
..'.`" I
BLDG ? PfiRMIT N0.
..
f?. . . . _ - f .. . __: /!
01-3210 Bldg. Permit
01-3422 Plan Check
01-3445 Surch,/Adm.
01-3446 SAC/Adm.
01-2155 Surcharge - ' '._...
17-3860 Road Unit
I
20-2275
SAC i
?
20-3865 Water Conn.
20-386$ Water Trmt. ?
20-3716 Water Meter ,...-,
20-2252 Acct. Dep.
20-3713 Water Permit ?
20-3743 Sewer Permit -
79-3866 Sewer Conn.
11-3855 Park Ded.
...,_.,-?• ?,-, :
CASH RECEIPT
?
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN. NIINNESOTA 55122
? D,ATE 19
RECEI V ED ? FROM
AMOUNT Is {
I
& ooLLwws
?oo
? CASH 0 CHECK
FOI? _ 1.-. . ,/ f " -' .
f
White-Payen Copy
Yellow-Posting Copy
Pink-File Copy
6Y }
',
•-- 7156q
X5142
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
t0.f? 0
RECEIVED-
MAY 2 0 1994
SINGLE & MULTI-FAMILY
I
2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
I specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date ¢e'?G24 /.Ad Valuation of work
Site Address:,3VAZ Cd,-_?, c zw•w /F.4 7 dr? V ?-
STREET SUy7 a
Tenant Name: (commercial only)
LOT ? BLOCK -L_ SUBD. P.I.D. #
Descri tion of work: -eL 74U(`e_- (' nOmf 1
The applicant is: ? Owner ?Contractor ? Other (Deseribe)
a
Name ('rl4'ZLue.e, PhoneG?
Property LAST FIRSr
Owner pddress u?ff`J? (2r_ )
STREET STE #
City State,Y,/6?1 Z i p .?s%?,?
Company Phone ?3 q? %03y
Contractor Address f,?.7 l? 1`?ll? ?Z 'of_ License #O ? . Exp4A?
City2?Jb'r«/: fL State42?&Zip vr??.7
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
^
?
5ignature of Applicant: ??T?
????•?
--?
. 3 ? ..
1986 BOII,DING PSI?IIT 9PPLICATIOA - CITY OF E9GAN
AOTE: 9LL CONTRACTOES MfJ3T BS LICENSBD HITH THE CITY OF EAGAN
SI9GLE F9bIILY DWEI.LINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFZCATES OF SURVEYt 1 SET OF ENERGY CALCULATIONS
M[TLTIPLfi DWELLINGS - RSSIDEBTIAL BEpTAL DdITS FOR SALS QNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATS OF SDRYEY - CHECg SiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COIYAIERCIAL,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND t SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Valuation?? Date:
Site Address OFFICE DSE ONLY
Lot 4 Hloek ? Ereet ? Oceupaney ?•3
Remodel Zoning QI
Pareel/Sub Repair _ Type of Const ?
Addition _ # of Stories
Owner Move _ Length 40
Demolish Depth 8
Address ? Int.Impr. _ Sq Ft
? Install _
City/Zip Code
Phone f 21 - 752P _ APPHOVAL4 FEES
9ddress
City/Zip Code
Phone 4S-4
Areh./Engr. _
Address
City/Zip Code
Phone #
Assessments Permit 354. s-o
Water/Sewer Sureharge 3 >•
Police Plan Review 1q Z.'?f
Fire SAC (02S .
Engr Water Conn 5 ZS
Planner Water Meter ln7
Council Road Unit 30 S
Bldg Off Treatment P1 150.
APC Parks
Variance Copies
TOT9L , ? ?//
?
HOTE: ADDHESSES FOR CORNER LOTS - CONTRACTOR/HOMEOi1NEE MQST'DESIGN9YS iiHICH ADDRESS
IS DES2HED. HO CHAPGBS WILL BE ALLOUiED ONCE BQIGDING PBRMIY IS ISSIIED.
. , . ,
CITY OF EAG AN
(j ? 13354
3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121
BUILDING PERMIT •' ' PH ONE: 454-8100
Receipt #
To be used for SF DWG/GAR Est. Value $66, 000 Date MARCH 17
87
,ig
Site Address 3482 COACHMAN RD OFFICE USE ONLY
Lot 4 Block 1Sec/Sub. HAMPTON HTS OnSiteSewage _ Occupancy R3
ParcelNo MWCCSystem _ Zoning R7
. OnSiteWell _ 7ypeofConst
w
Name FRONTIER COMPANIES City Water (Actuap
(Allowable) V
V
z Address 3908 SIB MEM HWY #otStories
? Ciry EAGAN Phone 454-0433 Len9m 40
oeptn g B
o
Name SAME
.F.rotai
S
Footprint S.F.
i
?? Address APppOVALS FEES
? City phone assessmants Permd $ 3$4. SQ
?w
w
Name WateVSewer _ Surcharge 5?.00
=
F w
Pohce
Plan Rewew
-
i o 9
?w25
?
? AddreSS Fire _ SAQCity -_?Qno10Q
aw CitY PhOn Engr. _ SAC,MWCC 525 .00
Planner WaterConn. ----52-5- 00
I hereby acknowledge t I h e read this application and state Council
Bldg. Off. WeterMeter
RoaC lJnit _67 . 0 0
thatthein}ormationiscorre dagreetocOmplywithallapDlicable
APC
TreatmentPt ?r Q n
U
, State of Minnesota Statutes ' of Eag Ortli es. Variance -
_ Parks ?Q
Signature oi Permittee ? copies
roraL C ? 7 5
A Building Permit is issued o: FRONTIER MPANIES
on the express condition that
all work shall be done in ac6ordance with all appl' ble State
f i
o n ta Statutes and City of Eagan O rdinancea
Building Official / Z??
--- - - - - / 17f'
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1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 JV ? U
?
651-681-4675
C'"
New ConsWCtion Reauirements RemodellFteoair Reauirements
? 3 registered site surveys showing sp. R of lof sq. R o/house ? 2 copies of plan
and al! roofed areas LO% maximum lot eoverane allowed) ? 1 set of enetgy plwiatlons for heated additions
? 2 copies of plans (show beam 8 window sizes; poured fid. design; etc.) ? 1 site survey for extedor additlons 8 dedcs
? 1 set of energy piwlatlons
? 3 wpias of tree preservation plan if lot platted after 7/1193
DATE:
DESCRIPTION OF WORK:
/"ii?is H d?
CONSTRUCTION COST:
i ?o?s„L
?// /?.¢Ti'f Q- ,
STREET ADDRESS: 9?0 Z C4//4Cfff'?AfI"i? XO 6?(n9-?'!/ Z
LOT: ? BLOCK: ? SUBD./P.I.D. #: ?9??fd? l7?rT.I
Name: /'/u CGo, O'CT9_du'T Q?yi??GL _ Phonek: (oSrl"ro?0-6(GZ _
PROPERTY L?t
ONVIVEIt ?St?? ??rl?I?y?/ /l_? ?
Street Address:
City Sta[e: ZI?/? -- Zip: Z 2- `
CONTRACI'OR
ARCHITECT/
ENGINEER
Company:__,'? Phone #:
Street
City
State:
Company: _5?_LC -----------
5[reet
Ctty
Sta[e:
Sewer & water licensed plumber (reauired for new construction onlvl:
License #
_ Zip:
Phone
Registration #: ------
-- ------ ZlP' -
Penalty applies when address change and lot change is requested once permit is issued.
t hereby acknowledge that I have read this application, state that the information is correct, and agree to omply with all applicable
SSate of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ? A r
OFFICE USE ONI.Y
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No - Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace 0 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 PorchlAddn. (4sea.)
? 03 1 of
plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
_
? 04 2-plex ? 09 7-plex ? 14 Apartments ?19 Lower Level ? 24 Storm Damage
? 05 3-piex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Misceilaneous
WORK TYPE
31 New ? 35 Tenant Impr ? 39 Gas Line On ly ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
GENERAL INFORMAT IDN
Const. (Actual) Basement sq. ft. Census Code N 3y
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units ?
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. Csty Water
Width Footprint sq. ft. Booster Pump
' PRV
Fire Sprinklered
APPROVALS '
Planning Building Engi neering Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
Valuation: $
% SAC
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) PROPERTY ADDRESS:'
LEGAL DESCRIPTION:
xxrx?zxsx?rxxxrxxx::::x?r?rxr:rF?
"CITE: PAYMFNT OF FF? AT TIIM OF
APPLICATION DOES N(7P Q011SPIZVIE
APPR()VAL OP' PERbSLT.
rwsvFr-rroN oP' SEWM Brm/03t MM
IINSTALL.ATIONS WIIZ NOT BE SCHED-
OLFD UNPII, PIIMT AAS BFEQ
APPROVID.
tL0t/610CK/SllbQ1V1SlOA or Tax Parcel ZD #) .
7F E7QSTING STRLY.`iVRE, DATE OF ORZGINAL BIJILDIN:, PFE2MIT ZSSPANCE: ". -
(M= ear 1 ..
PRFSENf ZONING/PROPOSID L'SE:
? CA?P7ERCIAL/RErAIL/OFFICE PM ->R-1 SINGLE FAMILY
Q IhT)L'STRIAL Q F-2 DL'PiEX (i4? Lnits)
? ZNSTSZSJTIONAL/GOVERtag,'NT Fl R-3 1UWNHOL?SE (Three + Units) ( Units)
. r7 R-4 APARTMEDPP/CODIDOMINZCTi ( Units)
2)
6IIAh1E: FRONTIER MIDWEST HOMES CORPORATION
ADDRESS: 3908 Sibley Memorial Highway Bldg. E
CITY, STATE, ZIP: Eagan, MN. 55122
PHONE: 454-0433
3) ' 4?:7• NAME: STAR PLUMBING
ADDRESS:
CITY, STATE, 2IP:
PHONE:
884-4149 MASTII2 LICENSE# 3329
Plumbers License:
Active
FScpired
Not recorded
StaTE Initlal
4)
::kNE:
ADDRESS:
CITY, STATE, ZIP:
PHONE: -7
.5) v'wee. " 3 a• •?• - a 1? • a? U- ti?a? -
[r]x coNrEcrioN Tu ciTSr sEWER ? CONNECPZON ZO CITY WATER p arHM . .
6) ? r• ? r ? PLEA5E HOLD APPROVID POihffT FOR PICK-DP BY ONE OF ABOVE ----- -
?PLEASE MAIL APPROVFD PII2MIT TO 1, 2, 3. 4. ABOVE
(Circle one) f l
7) r r. u• ??? . ?zg ? / 1 ? / ?4
1018 Mound Springs Terrace
Bloomingtos, MN. 55420
/
FOR -CITY USE ONLY
PERMIT # ZSSUED `
Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLUDE SORCHARGE )
$ ?O SZ' $ WATER PERMIT (INCLIIDE SURCHARGE)
$ $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ I S D Z' $ ACCOLNT DEPOSIT - WATER
$ 5 2 S D? $ WAC
$ ? z?-c o s sac
$ _ $ TRL'NK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ $ ER
_ _ WAT
TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ _ / y- y? CiZI $ TOTAL
--71G 63
RECEIPT - RECEIPT
DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A" PERMIT FOR WORK WZTHIN PUBLIC
Q
NO ROADWAY" MUST BE
DIVISION
LIS ISSPED BY THE ENGINEERING
.
T AS A CONDITION.
SUBJECT TO THE FOLL OWING CONDITIONS:
APPROVED BY:
TITLE:
DATE :
.
?
j _op?? RESIDENTIALBUII,DING
?? b Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction RenuiremenGS RemodeVReoair Reawrements Office lJse OnH
3 registered siie surveys showing sq. ft of l04 sq. ft. of house; and all roofed a2as 2 cropies of plan CeR af Surrey ReW _ Y_ N
(20%maximumlotaveregeallowed) lsetotEnergyCakulatlonsforheatedaddiGons TreePresPlanRecd _Y _N
2 mpies of plan showing beam 8 window sves; poured found design, efc. 1 site survey tor additaos & dedks Tree Pres Not Reqd _Y _N
lsetofEnergyCakulalions Add'rtion - indkateifonsilesepfksystem On-site5ep6cSystem _Y _N
3 copies of Tree P2servaGon Plan it lot platted afler 711/93
Rim Joist Detail Options selection sheet (bkigs wAh 3 or less units
Date q_! _03
Site Address ? y?( 2 L O?
Construction Cost ?!7 ()b
)QUI }'y)aj') /?d UniUSte #
Description of Work
Multi-Family Bldg _ Y? N Fireplace(s) _ 0_ 1 _ 2
PropertyOwner _Bv'(,"(-e 4
Telephone#( )
mt,?CCf C°r
U IrGLL(t
Contractor A,{9-1/YYl /H ,a[n!',{
Address ii
State M n City
Zip 5638 ? Telephone #0b 3) 7q(e - O SR
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy COde Category . Residential Ventilation Calegory 1 Worksheet • New Energy Code Worksheet
(q suhmission type) Submitted Submitted
• Energy Envelope Calculations Submitted
?331. Z?
Have you previously corstrucfed a buildina in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
7elephone #(
Telephone # ( `16
11
Sewer/Water Contractor
Telephone # (
AUG 1 8 2003
I hereby apply for a Residential Building Permit and acknowledge that the informatlo$-is co e e an accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
5 iw, l..- t vt ?Lh an QX.21 Et"
Applicant's Printed Name Appli t's Signature
SIOMA
?
.,_N-
: ?
hGAL6 ; I ??= 40 _
SUFaVEYINO
SEAVICE9
3908 Sibley Memoriai Highway
Eagan, Minnesota 55122
Phone: (612) 452-3077
I
N7p oS,oo
'_NM:SSS?Iv
-7?
?
-LEGEND "
O Qerwtes Iron MaK.ment
a Aenotes Wad Hub Set
„ 843.0 ppnptes Existirg Spot £levatian
?„?K) Glsnotes Proposed Spot Elevafion
.,?Aenotes Drainege Direction
_raaPErrrrr oEsCR+Pria-
LOT_4 , BL0.'K i_
NAMP'foN 146iC214'V2
accordirg to the recarde7 plat thereof,
= DkKOTA Cotnty, Nimesota
HQUSE LERTIFICATE FOR:
a NOMEBUIlOENS '
? LANOOEYEIOPER9
? PEALTORS
4fi_IE? COMFANIES
-, _69,F1'I
c-
EL:
HAMPrON
PROPOSED GARAGE FLOOR ELEVATION=?yl
PAiOPOSEO Top of Block ELEVATION? SO
PROP05E0 BASEMENT FLOOR ELfVAT 10N? \ 3-ii. WIO'
NOTE.- Verify all floor heights with Final Hase Plans.
alraMnK CERTIFICATI
1 hereby certify tMt this survey, plan or report
was prepared by me or under ^ry direct supervisim
erd thaf I am a dufy Registered Lard SurveYa'
iader the laws of the State of Winnesota.
J? =?===Gr,e: "l? ?
Nayne D. Co?des. Minn. Reg. No. 14575
Re%P:sed'- 3/ial8i 0&Y*5et Grereles - -"00
,
..oAVEYI NO
SERVICEB
3908 Sibley Memorial Nighway
Eagan, Minnesota 55122
Phone: J612) 452•3077
t10USE I,ERT 1 F I CATE I'DR ;
NOMEBUIlDEH5
? LANO DEVELOPERS
? PEAL70R8
J'T? COMPANtES
--68•9"I SB9°41o?'E?
-N- ?dNo
N!W'L.SZ-1,O
N.w,?.83z.Om
N O.
ytALB; I?=A-O
sw"`y ? ` UT?LIT^f
l:..e
5 ?
0°
? A$ r3ti :7-1_-
??/1
os 3??
1(837 p ?
?ao -
* pruD°s?SE
0\ N
„ G
N
` gN3 •9 / O ??.? 2? ?' / ?
? /S`OrJ` / N
• ??S
N7oo S•oo `° ? 'eyZS
cp?cs5'w
?41 °
?
m
-LEGEND
O Penotes 1ron MOrgmnt
m fknofes Wad Hub Set
x 843,0 penotes Existirg Spoi Elevation
?„?,,) Aenotes Proposed Spot Elevation
,,,?Denotes Dra i nage D i rec t i on
-PAOPElffY DESCRIPfIU!-
LOl 4 ,BLGYK i
f{p?-?IP'foN 41EICaHT?'i
accordi?g to the recorded plat thereof,
DAKOTA [ounty, Mimesota
MQDEL:
HAMProN
PROPOSED GARA6E FLOOR ELEVATION = C"Y,1
PFdOPOSED Top of Block ELEVATION- 8Y5.0
PROPOSED BASEYENT FLOOR ELEVATIdNo-dl'-_4._
NOTE: Verify all floor heights with Final House Plans.
.?...?
41F?/EYLiR$ CEI?TIfIC/ITIa-
1 hereby certity fhet ihis survey, PlBn Or report
was prepered by me or urder my direct supervision
erd tlut ! am a duly Registered Lard Surveyor
under the laws of the 5tate of ?'nnesota.
n D , Date: ???19(,
Wayne D. Corde/s. Yinn.n Re9. No. 14675
!i .?
3'l?fl I'nn/.?osu? Gr?P:
W'0
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
c? u4#
PERMITTYPE:
BuxLaxNG
Permit Number: 0 2 3 7 4 2
Date Issued: @ 6/ 91 / 9 4
SITE ADDRESS:
P.I.N.: 10-31900-040-01
3482 COACHMAN RD
IOT: 4 BLOCK: 1
HAMPTON HEIGNTS
DESCRIPTION:
J"°. (FUTURE PORCH)
6,uildinc'-3?errnit Type DECK
iuilding WQ•r.k Type NEW
.__.,
3 ?
? -
n
1
,. ? ,? •r.,-= ?
1 1 E"3 ?
.?? D C?? u
.?3 ? !t:?
t
REMARKS:
FEE SUMMARY:
Base Fee $30.60
Surcharge $.50
7otal Fee $30.50
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
MIKE WALLIN MOME IMPROVMNT 18949034 0001805 GROUT BRUCE
12213 AILEN C1R 3482 COACHMAM RD
BURNSVILLE MN 55337 EAGAN MN 55122
(612) 894-9634 (612)668-6102
I hereby acknowiedge thet S'heve read this applieation and state tMat tiie
information is correct and e,gree to cnmply with all applicatale State of Mn.
Statutes and Caity of Ea.gan Ordinances.
L _ . ?
?APPLI ANT/ ER TEE SI ATURE -'ISE?1 D B f.SMNAI UH&
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: euzLDzNe
3830 Pilot Knob Road Permit Number: 0 2 3 7 4 2
Eagan, Minnesota 55123 Date Issued: 06/01/94
(612) 681-4675
I? SITEADDRESS: Lor: a BLOCK: I APPLICANT:
I 3482 COAGHMAN RD MIKE WALLIN HOME IMPROVMNT
? HAMPTON HEIGHTS (612) 894-9034
PERMIT SUBTYPE: TYPE OF WORK:
DECK NEW
pESCRIPTION (FUTURE PORCH)
Use LUE or BLACK Ink
For Office Use
I
j Permit fity V lC/ I
of Evan
.1 I
3830 Pilot Knob Road Permit Fee:
Eagan MN 55122 I
Phone: (651) 675-5675 1 Date Received:
I I
Fax: (651) 675-5694 Staff: j
2013 - - J
MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all co ercial applicatio
Date: Site Address:
t~
i
Tenant: Suite
Name: Phone:
WIMA
Resident/Owner
,Address/ City /Zip:_ =&g-4)
Name: License _r
c
.4.A #1 Ode%
Contractor Address: City:
State: { Zip: Phone: Z/J ~,o(TN
Contact: Email: ric
i
New placement Additional Alteration Demolition
r
Type of Work Description of work ~ v TO la v 4,d ~71133L
I
NOTE. Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL .....~.w,.~~.... COMMERCIAL
Furnace _ New Construction Interior Improvement
Permit Type Air Conditioner Install Piping Processed
i - -
_ Air Exchanger - Gas - Exterior HVAC Unit
Heat Pump Under / Above ground Tank Install Remove)
t
Other
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) dry
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE
COMMERCIAL FEES:
$70.00 Underground tank installation/removal Contract Value $ ~v x1%
$55.00 minimum = $ Permit Fee
"If the project valuation is over $1 million, please call for Surcharge = 5.00 Surcharge"
= $ I1 TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. (Call 48 hours before
you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that.,-this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand" is not a permit, but only an application for a permit, and work is not to start without a permit; that t e vuork will be in accordance
with the a proved plan A the case of work which requires a review and approval of plans.
x- ~4
Applicant' Printed Name plicant's Signature G~
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final OVAC Screening
' ' '' `' Use BLUE or BLACK Ink
• �------------------
. � � For Office Use �
' j Permit#: ! ���� / I
ltI �• � I
`°,� O ���� Permit Fee: /� �
3830 Pilot Knob Road RECEIVED � �
Eagan MN 55122 � Date Received: 7 5 j
Phone:(651)675-5675 °��� � � �� I I
Fax:(651)675-5694 I Staff: I
I �
�________________J
2014 RESIDENTIAL BUILDING PERMIT APPLI�A�T�I�OI�,�,�, ��j�
Date: l SiteAddress: ✓��� ������ /��'� ����t#:
Name: �C/�e� ��lJ���� ����LCf�',t�(33��� Phone:� " (�
Resident! , �
� Owr��r,�������"� aaa�ess i c�ty i zp: :���'Z- ��h�`'��.�/� ���� � ��r�
"` Applicant is: Owner �Contractor
' 1�9r��1
Type of Work Description of work: � ,� �
i
Construction Cost: ��p Multi-Family Building: (Yes /No_)
Company: � Contact:
�8i'tf1'8Ct01' Address:`�Y'�1� ��i���" �i� City: ��L���
�i J���� �
State: ��N�ip: JJ ( ZP>'Phone:` ' �
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
�`l� � ��
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:�Pians a�d su� �!-� ��rtentS#hat you sub����`�aai�considereal to�be p � a�it�� �, ns� �:
the in€ormat���taa����`��a� ��'h��r�i�n �� ,���},`�f�rov provide sp�i�c reasons:#hat a�;. ,,� thhe�ity t� °�°
,.<< . , ���M.
� concitt�����`iey ace traale secrets.��� �
ic A >
..ffi..�= Y.�.rt. ' v� r .
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota uilding Co t be ete 80
days of permit issuance.
�
X �� �z�� �� ✓ �
Applicant's Printed N me nt's g t
Page 1 of 3
_ . -� -, 3 �f�a ����� �� �. 3
� � � DO NOT WRITE BELOW THIS LINE ��� /
.
SUB TYPES
Foundation Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of Plex Lower Level Pool _ Accessory Building
WORK TYPES
New Interior Improvement _ Siding _ Demolish Building*
Addition Move Building _ Reroof _ Demolish Interior
Alteration Fire Repair _ Windows _ Demolish Foundation
}G Replace _ Repair _ Egress Window _ Water Damage
��
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation ����� Occupancy ��� MCES System
Plan Review Code Edition SAC Units
(25%_100%�) Zoning � City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Sprinklers
Type of Construction � /�rt Width
�T�
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) � Final/No C.O. Required
Foundation HVAC_Gas Service Test Gas Line Air Test
Roof: Ice&Water Final Pool:_Footings Air/Gas Tests _Final
Framing Drain Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge ��^,� /�� ��""
_j��,�
Plan Review ,yf�
MCES SAC �����
City SAC
Utility Connection Charge � ' / �� �
S&W Permit 8�Surcharge �T � � ��
Treatment Plant �
Copies
TOTAL
Page 2 of 3
. • � . . � ����3�/
. �
' � � NOUSE CERTIFIC/�TE FOR;
�` HOME 9U14UEH5
JA�EY�N� � L�DPEVEIOPERS
fiE1�LTC►qS
8EAVICE� '�''' "�+��^'`""""'
3908 S�b1ey Memorial Nighway F��N 1 f� �Q��A�t��J'
Ea�an. M�n�esata 55t22
Phone:�612) 452•3U77 ,�r
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_ �• Q_ PROPOSED 6ARAGE FLOOR ELEYA T10N= �'.,,r-.'- �' '
a L�notes �ron ��xx.�vr�nt PAiDPOSED TnF of 81ock ELEYATI�N� ��
� Aenotes Woai N�b Set
PROP05�D BASF�IENT FLaOR E�EVATlt�N° '1, ��0
x8`�3�40renotes Existir�g Spot Elevation �r�: Verify ar1 floor herghts with Frnal Novse Ple�.
(x�{CN Il�
L1e»otes Proposed Spot Elevation """�"
�,,,�------O�enotes Dra i nage R+rec t i on � S�F 1 F 1 CAT 1 -
1 h e r e b y c ertif y t�at this survey, pfan or reFnrt
-P�� ��1��(�J- was prep�arcd by me or urder my direc t superv is i c n
l.OT 4 9l.laCK 1 ard tha t I am � du t y Reg is tererJ Larrl Surveyor
crr�ler the laws of the 5tate ot Yinnesota-
�}A�-�►P'fOht 1��I�a�T�i � , E,e � R/�
accordrrg to the reccrded p�at thereof. � Date:—..
UAK�'�A tour�ty, uimesota Wayn�e D. Cor3es, �inn. Reg. No. 14675
R��•S�� : l����� ���� G���: