3569 Coachman Rd"R-E.ALiTAr FC?R DECK- i'LRi ^OriWED 7/15/87 ; . ..- -. .-
T= & JWr HA,TAN 452_5060 CITY OF EAGAN
? 9
' , -- ; : - 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?- 125?,
PHONE: 454-8100 ?7-5 / / - v-,
BUILDING PERMIT
Site Address -
Lot 16 Block
oc
W
2
3
0
Receip`t tk?
$67,000 Date SEPTEMBER 4 19 36
Z o Name S?E
U ¢ Address
~ City Phone
Address
of
Erect 15 Occupancy R3
Remodel ? Zoning PD
Repair ? Type of Const. V13
,
Addition ? No. Storias
Move ? Length
, Demotish ? Oepth 40
? Int. impr. ? Sq. Ft
Install ?
Aaprovals Fees
Assessment
Water & Sew.
Police
Fire
Planner
Council
BIdg.Off.
Permit ? 3.24 . uv
Surcharge 33.50
Plan Review 167• OQ
SAC 575.00
Water Conn. 500.04:
Water Meter 63 . 50
RoadUnit 290.00
Tr. PI. 156.00
Var. Date
Gopies-,..00
Total
A Building Permit is issued to: EKUNl'lZlt ?.VrlrHtvlr.? on the express condi6on that
afl work shall be done in accordance with all applicpble State of Minnesota Statutes and City of Eagan Ordinances.
1 I PsrmR No. I Parmit Hddw I Date I Tetephone # I
Plbq.
Occ.
Fty.
DIsp.
PERMIT #
? r PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ?
Sec/Sub
m Name
? Addre
c City _
? Neme
3 Addre
O CnY --
FEES
GaMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMMlIND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
PERMITTEE
FOR: CITY OF EAGAN
BLDG.TYPE
Res. x New , XI
Mult Add-on
Comm. Repair
Other
NO FIXTURES TOTAL
7 Water Closet - $3.00
=Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
ZKitchen Sink - $3.00 - ? -
Urinal/Bidet - $3.00
?Laundry Tray - $3.00
? Floor Drains - $1.50
=Water Heater - $1.50
Whiripool - $3.00
77-6as Piping Outtets - $1.50
So(tener - $5.00
Well - $10.00
Private Disp. - $10.00
=Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL: ? ? r! ?
? ? •• . . ? ' _ yr '..`? . . ii'+ f'4°:'Yt ? ,°• r ' - . . - . . , , . . . --rn_?
. •PERMIT #
" , • . • MECHANI CAL PERMR RECEIPT #
CfTY OF EA(3AN
3830 PIL OT KNOB RO AD, EAGAN, MN 55121 DATE
CONTRACT PRICE: $ ltf 5 U. u i. PHOHE: 454-9100
Site Address ` TYPE WORK DESCRIPTION
BLDG
4 .
Lot " Block Sec/Sub
N
R
?
Name 'LGiiAN`CA" es.
ew
n
M
lt Add
) -o
u
? Address ?
rive
R
i
1 m.
epa
r
c Ciiy `' Phone 4 2-
. 5 Oth
e
Name ` Fr otitier Companies FEE3
c )
Address >ibla j- Memorisl Iii f:,ii
= :11AES. HVAC 0-100 M BTU -$24.00
p Ciiy Phone 45 4-0433 ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK ?ju U:1(.} 24.00 GAS OUTLETS - 1.50 EA.
Forced Air ? M BTU COMM/IND FEE - 1al6 OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond M BTU STATE SURCHARGE PER PERMIT - .50
. (ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM 1.50 BEYOND $1,000.00)
Gas Piping Outlets #
Other
25.50
FEE
, 5!'1 SIGNATURE OF PERMITTEE
S/0.
TOTAL• UO
FOR: CITY OF EAGAN
PEFMIT # f? 41- r
PLUMBING PERMIT RECEIP7 # 7,11 11fo
CITY OF EAGAN
3830 PIL07 KN08 ROAD, EAGAN, MN 55122 DATE: ?'7
RACT PRICE: PHONE: 454-8100
Site
Name
? Addre
c CityL
? . .... ,
3 Add
p City
Phone
FEE - 1% OF CONTRAGT FEE
' APT. BLDGS - GOMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20A0
STATE SURCHARGE PER PERMIT - ,50
?(ADD $.50 S/C IF PERMIT PRICE GOES
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Ki!chen Sink - $3.00 -
Urinal/Bidet - $3.00
Laundry Tray - $100
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $SAO • ~ V ?
well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE: f ?1 O
STATE S/C:
FOR: CITY OF EAGAN
GRAND TOTAL:
CITY OF EAGAN SEWER SQtVlCE PERNIIT
3830 Pilot Knob Road p??T NO.:
P. O. Box 21199 ?
Eagsn, MN 55121 DATE:
Zoninp: No. of Units: -
Owrnr.
.__
-
Add1ESS: . t (• YrG t _ 't -
l
; j
ry^ _
Site Address: `
r
Plumber.
.? ?. cw .f s...¦
I?w te N?plq c??? aaro.: 7 ? a-
???t.
O?ri?aN.
Prm-A FM: '
Surel+a++po:
B AAtsc. Choros:
y
Date of insp.: Totd:
._? . Dote Pald:
CITY OF FAGAN WATER SERVICE PERMiT
3830 PNot Knob Road
pp Box 21129 PERMIT NO.:
i n 7(1-8 b
Esyan, MN 55121 DATE: 1 _
Zoning: No. of Units:
Owner.
Address:
Site Addess: ?* a
Plumber. ?, ?p
Meter No.: °lp?RnC?dt
?Coti D?i??*?
Size:
e .
Reader No.:
I agroe to complY wfthhe C? g99a^` h
Orcllnances- ?QvI,?• harges:
TotaL• ?
gy Date Pafd:
4,?
Date of Insp.: lnSp°
/ a - i? - ?6 _ ----- _
.? F.xtt•r3or F.nvclapn Avcragr. "U" Gomnut.ztioiz Pago 2 oF 4 .
1 •,'•. '
Total expo:;ed raoffceiling arca = Ca 4?'
m. lbtal skylight area ............. I ............... `- " .
n. Total rooF/ccilin, franinq arca (averarye 10%)... G
o. Total net insulated roof/cciling area...........
Determine "U" value for each roof/ceilinq seqment
M. "mr- " x ~vu a
n. O ,; S.U„ o Z _ _
0. d? !2!gt x nUn •`I Z a
4 ........................... Zbtal m
?- ..
. •
.! ` 2Z
If total of #4 is the same as, or less L•han #2, you have met the intent of
sbr. 6006 (c) l.
Alternate Building Envelope Desiqn
Zb utilize the total envelope'systesn method, the values established by the sam of
items $3 and 04 shall nc t be 9reatex than thQ sum of items #l and #2.
Z. ?? •?T 4 'f' 2. ???? a • ??
3. ct. lacl + 4. ?.-1 • ZZ 1). 1 Ci
-?-.
?
CASH RECEIPT
. ? ?-
?
BLDG. PEP.MIT N0.
01-3210 Bldg. Permit
01-3422 Plan Check /67
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 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.
TOTAL ?I 7U ? v
CITY OF EAGAN
3795 PILOT KNOB RQAD
EAGAN, MINNESOTA 55122
?J
V (p
DATE / 19
, -
e¢ceIvffo
FROM
AMOUNT i? DOLLARS
+oo
? CASH ? CFIECK
? FUND cooE AMOUNT
i.
?
?
?
Thank You
s r
6628!
White-Payers Copy
Yellow-Posting Copy
'? -.___._._?........._...._.... . Pink-File CoPY
EXTERIOR ENVELOPE ;
OWNER:
Page of 4
iGE. . "II"_ COMPUTIITIO
ftom'
. . . . ??+lC w??i.L.
nnM---5' Z S?S
S I TE ADORESS : ' Pt10NE :
CONTRACTOR: FK,ONY"(m
Determine wurking square footage of each 1. Total exposed wall area.....93 CA sq, ft. x.11 = ?4 4
2. Total roof/ceiling area..... I OAd sq, ft. x.026 = ?fAf
Q
Total exposed wall area abovc floor
a. Total wall window area..........
. Total door area..............................................
bc. Total sliding glassdoo.r.area... . . . . . . ?? ? I
d. Total flreplace wall area .................................. .
e. Total wa11 framing area (average 10%). ? ?????????? "?
f. Total rim joist area. , ,,,, ??? ???????? " " '
g. net wall area above floor.?.)c:1 , .........................
h. wall area above floor ... . . . . ........................... .
i• wall area a6ove floor.. .. . . . . . . . ' " " '
j. frame wal] area at foundation ...................................
Total exposed foundation area= G c.,
k. Tatal foundation w3ndow area.........
----?
l. Total net foundation area above grada,,,,,,, G
Determine "u" value of each wall segment
(e.g, window, door, eacfi separate wall section)
a. f 37 x
:
b.__ x
C. 4 z x
d . Q- X
e._ X
x
x
"u 14_____? .% y
„u„
„u„
.
„U„ r ? cz' = l
_ •
l.u„
•
v Z 3
„u„ , 0 3 =
.
,.U,. , Q
h. X i,u,l oll
1. X It u to
?
?• X "U"
s
k. X $lu„
s
? • 6PC. x „u„
3. ................................. Total
• ._
. ?...?_?..._ ----. _ _..
I f i tem 13 fi s the san
as, or less.*.han iten
81, you have met..ttie:
intent of SSC .6006?{
, ??
1987 SDILDING PEAMTP APPLICiTION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLQDE 2 SEfS OF PLANS, 3 CSRTIFICATSS OF SOBVEY, 1 S6T OF ENERGY CALCQLATIOHS
HOTE: ADDRESSES FOR COEAER LOTS - CONTR9CTOR/HOMEOSiNER MIIST DESIGHARE WHICH ADDRESS
IS DESIRED. NO CH9NGES WILL BS ALLOWED ONCE BDILDIHG PERMIT IS ISSIIED.
MOLTIPLE biiELLINGS - RBSIDENTIgI. RffiiTAI. UAITS FOR SALE OHIYS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRVEY - CHECK iiITH BLDG. DfiPT.,
1 SET OF ENERGY CALCULATIONS
COl'4ERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2, 000 L$NDSCAPE BOND ?e? C+`I Vc-
l(ax20
To Be Used For: ??r^v- Valuation:
Site Address ?l( (( ? ???A
Lot ? Block 4 On Site Sewag
MWCC System
Parcel/Sub My,? ?lqA ? On Site Well
?_ City Water
Owner `-?? ?l ,IT-1f VI
Address
City/Zip Code E??.y?
??a - ?C> APPROV9LS
I Phone ?
Contractor
Address
City/Zip Code
Phone
f-I
Arch./Engr. ?
Address ?-
Date:
e_ Occupancy
Zoning
Type of Const
(9etual)
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
FfiES
Assessments Permit n
Water/Sewer Sureharge
Police Plan Review
Fire SAC, City
Engr SAC, MWCC
Planner Water Conn
Council Water Meter
Bldg Off Road Unit
APC Treatment P1
Varianee Parks
Copies /
TOTAL
City/Zip Code I
Phone # ?jC-l ( - $ u )>Rfz?)
??P,Jj ? /r? t?Jcbr-D
1986 BOILDIHG PERHIT dPPLICATIOH - CITY OF EAGgN
AOTEs ALL CANTRACTORS MOST HS LICENSSD iIITH TBE CITY OF EAG6H
SINGLE FAMILY DWELLIPGS
INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLE DiiELLINGS - AESIDENTI9L RENT9L i1NITS FdR SALS UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SDRYSY - CHEC[ SiIT$ BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCI6L
INCLIIDE 2 SETS OF ARCHITECTURAL & STRIICTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS, ?
$2,000 LANDSCAPE BOND
35 C?7ccxo
'fo Be Used For:C,7kbLF- ?j?`? Valuation: Date: ?-C? ?},(?
Site Address
Lot (o Bloek ?
?p
Parcel/Sub ?
l
Owner
Address
City/Zip Code
Phone
Contractor FRnNTIER COMPANIES
3908 Sibley Memorial Highway Blclg. t
&ddress
Eagan, MN 55122
City/Zip Code
Phone
Arch./Engr.
Addre:
City/2
4hone #
Erect y(
Remodel _
Repair _
Addition _
Move _
Demolish _
Int.Impr.
Install
APPROVALS
Occupancy ?
Zoning ?
Type of Const
S oP Stories
Length -5O _
Depth 'AID
Sq Ft
Assessments Permit 32A
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn 500
Planner Water Meter G
Council Road Unit O
Bldg Off Treatment P1 1 0
APC Parks
Variance Copies
YUTAI,
? l19
NOTE: ADDRESS6S FOR CORNER LOTS - CONTRACTOR/HOMEOiiAER MOST DBSIGNATE NHICH 9DDRESS
IS DESIRSD. NO CHANGES WILL BS 9LLOiiEp ONCB BDILDING PEANIIT IS ISSUSD.
CITY OF EAGAN N 0
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT ReceiptiY
7o be used for SF DWG/GAR Estvalue $ 67 . 000 Date SEPTEMBEI
12569
? 4 .1s 86
Srte Adtlress 3569 COACHMAN RD Erect ? Occupancy R3
Lot
16 Block
4 Sec/Sub HAMPTON
HTS Remafel
? P?
Zoning
Repair ? Type of Const. \j.p
Parcel No ?
. Addition No. Stories
w
Name FRONTIER COMPANIES Move
Oemolish ?
? Length
Depth 40
o Address 3908 SIBLEY MEM HWY, BLDG E Int.lmpr. ? Sq. Ft
ciry EAGAN Phone 454-0433 Install ?
a SAME APProvals ?s
i o Name
V p Address
? Ciry Phone
V a
w Name
? Address
?
a w City Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagary?Ordinancesy ] „
Signature of
A 8udding Permrt is issued to: r?rv a iaac ?.vrarev
all work shall be done in accordance with all appli e State of
Bwlding OBicial
Assessment
Water & Sew.
Police
Fire
Planner
Council
Bidg. On. 9/3/86
APC
Permit $ 334.00
Surcharge 33.50
Pian Review 167.00
Sac 575.00
Water Conn. 500.00.
Water Meter 63.50
Road Unit 290.00
Tr. PI. 156.00
Var. Date Copies
7otal $ 2 .119 . 00
on the ezpress condition that
.$tatutes and City of Eagan Ordinances.
2007 RESIDENTIAI. BUII.DINCi PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reouirements
3 regislered stte wrveys showing sq. R of lot, sq. ft M house; and all roofed areas
(20% maximum lot coverage aAaved)
1 Sals RepoA if proposed building's lo be placed on dislurbed sdl
2 copies of plan showing beam & vnndow sizes; poured found design, etc.
1 set of Eneigy Calwlafions
3 copies af Tree Presenafian Plan d la[ platled after 711/93
Rim Joisl Detail Optiwis selectlon sheet (6uiltlingswiN 3 or less unils)
Minnegasto mechanical ventilation fam
RemodeUReoair Reauirements
2 copies of plan showing footings, beams, joists
1 set of Energy Calculatlons for heated additions
1 site survey fa additions 8 dedcs
AddiGOn -indicafe if on-site sepflc sysfem
A NEW BUILDING
Plans are considered oublic information unless vou state thev are trade secret and the reason.
Date /0 / /1 / -7 Construction Cost
SiteAddress 55v / 6}I-C14?rtf-j 12C/. UniUSte #
D
DescriptionofWork 7ii
r.Jg
Multi-Family Bldg _ Y_,??,N Fireplace(s) 0 _ 1 _ 2
Property Owner b44 y Telephone # (?5? AOL
Contractor JY` ![? .?.,7??LYir,?24',ti?
/?/v
?, ?.?/G
Address 1- ,
/
,?/J
16/ z? /0dSf Lt ' Cih',ed?/?
State ?? ?
Zip `7 S3 S?S Telephone #(?ji1/?? t.+ ?S?S S-
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
ResitlenGal Ventilation Catego7 I Worksheet
(Jsubmissiontype) Submitted
. Energy Envelope Calculations Submilted
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
In ihe lasf 12 months, has the CiTy of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of masTer plan:
Licensed Plumber
Mechanical Contractor
Sewer/water Contractor
apply for a Residential Building Permit and
Telephone #(
Telephone #(
Telephone #(
OHice Use Onlv
CaAOfSurveyRerA _Y _ N
SdISRepat - _ , =Y _ N
72e Pres Plan Recd _Y _ N.
TreePresRequired, _Y_ N
Onsite Septic System _ _ Y'_ N
that the information is complete and accurai
e;
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.
?--
? iaUn??J
Applicant's Printed Name ApplicanYs Sig a retu
• 4fAI.L 'SCf"1'ibtl:l ??Q
jSl ?uf r.Ul• ualt nCe1 lut'
.$ ' U.r- w
l!liR1?7 l:unLl I'uCI LUn I:. V.i h..•
PAQ
'• 3????, ?„ •. ,.,[I ,. ,
a. /0!!.V1@y r!+ e?ww1. . 7_ c'o
` .s.lA?..y. . ALwn• . .. . .. . _ • (o I
an s. _
ry? ..r, ..
G. Er.l-•t ii.t lli ( 1''o
??.?. - -----? _._ ... ---- .._ ..... . . .:,:?; ??.?_..._-•? 3 L1
- Q .
. • ? wa'?' ?I ?8
FIC. 91 TOPVIEti OF
FIlAI1E NALL . tnl•t-rlnL• iit• 'ilm q.GN
' 2. S ?i
. • . ' a.
. ? ,
_ .._: _.?0 s . P_?wrn._ ScnPwS -. . _._.._.. . . .... 1
?• ,1 G. F.xlxri(jrair (ilia._`_
'I'ul.al?
Fic. az
. . )nt.rr?vr nt.r_fm.-°•-------..._??_r,n
?---0 • . . L.1
•'•? _ Ll 2•
.._..?`T-
?•? ?----? . .-- ? ---- -?? ? v
------?'-
lscacfx s_ ? ?? ? _??1?1 s. .P.l.srrc??..?.?9siv.Gc•-_•--- ---?So!
6. F:xtt•rloc nic lilm _. ---•--0.17
•a,?? _? ?},?? (11 -----_- ? Tota l Z, 1• 7 1
, --. r ?, __? . - o•?. --,--- u? . a 3
---------01
??,? ¢. n.? .__..,.'-?-Q 2. InG•t io[ al r f il•.,
?
`^ ro • \? • 2. ., l?'?_.?1._?t.?L 8?.__._ a8..??. -?
.
? • ll • : ' ?. _. !_ fL?.?.9 .. . .. ... Sr.?_??.. •-•-.--
.L
• ?i' • ?0' 'Q . ..P?stT?'I T'wC.. ?A..RL[EM... ?_
? u • ?-'-;?!?o C 5 .
' <rI-!'/ .R. r ' ?'. _ _ 0. 1'J
I _ •. ' . . •°---.-- .._?._.• ----•-•--?._.._--
,
1 h /l . '1'uld l ?_ `. ?
1??" • 145
st.ntt ari ?:tu?ut
.? /
?? ?• u : ?, ??? `C`
G. 13
a ? .
. -_ ? v-. i.. • - ' .
--? •- ._ .. _...__.--.- ?----_..r...?
'? . . . • ? ? ? ,
. 1? .
• ' ?' i
?? !ll?- . • Is? - ,
?! ( v ? b • . ? % j I 1 -.-
-
1 . 1 ?• /?r
1 ' ? • ?"
C'1??• [I4 a !
let
' ??? /?? `?.'•??: ? l?? .'r
nnd
' pla•:rnc?ir. o( irr;ulaCinn.
.nis ,e4uast .tod ?c% 7 i 8 c- C; -2,53 Y
18 months Irom
ff' 62062 ? ??_ ,??k H Q11...a?-??r? 1?l?s ?tjv?co
Request Daie s?
y?
? 3'
y(
/ ) Fire No. RouBh- n Inspecuon
flequire
?
?Reatly Now L.YKII Noufy Inspec-
mr When FleatlV
•
(7
T O
V [?M
?No
aiiKscensed Electncal Contracmr 1 hereey reu.est mepaciwn of above
? Owner eieclncal work installed at
t r, Boz or te No.
St?e ? ? ?itv
#
^?
Cf
ecLOn a. Township Neme or No. Hange o. Caunty
Occu IPRIy?I
/ ??J • V
?Jl p
? 1
?
Phone No.
..?!
Pow upplier Atldress
Elactr cal Convactor ICompany Name)
KrMMTC'K FLFCTRIC C rar.mr's Li
? ccnse No.
Z`v
Mailinp7Aairess IContrac1or o 9 nn1
a ACA61 1! ?1L 1"11d
Aut?onz u( ner 1 Phone Number
MINNESpTp STATE BOAND OF ELECTqIC1TY TNIS INSPECTION PEQUEST WILL NOT
Gripps-Midwev Bld9• -?om N-191 BE ACGEPTED BY THE STATE BOARD
1821p l?niverein'Ave.. St. Paul. MN 66704 UNLE55 PNOPER INSPECTION FEE IS
PhOrSe (6t21 642-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION es-ooooi-oe
II, See instrueliona for comoletinre this form on back oi yellow copy. / ! p f, ?,? ?
"X" Be/ow Work Covered by Ihis Request
62062 4. ?
AGINM tl Rep. ol BuilEina Aooliantee MireA Equiumenl Wired ?
ce
p Fee SarnceEnlmnceSixB p Fae Fexdors/Subleeders Fee C?rcurts
0 to 200 Am s 0 to 30 Am s 0 tn 30 Ani s
Above 200 Amps 37 to 700 Amps ?Ck,{ 31 to 100 Am s
Swimmin Pool Above 100-Amps Above 100_Am s
Transiormers Irngation Booms Partial."Other Fee
I I I si ns I I Jspeciai ms ection $ 9 ? Vy TOTAL FEE „ )
.............. ? i- / ?,? ?'..UJ?
?
Roueh-in I,the.Elec<ricel/
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CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*10'PF': PAYWlN.C' QF ME AT TIlM OF
rPrrIcATION DOEs Nom CENSTzTUITS
APPRC7V11L OF PFRMIIT.
INsrnCriorr oF SUx ArID/CR WATER
XrMONS WIIS. NOT BE 9CHED-
nr.Fn vNrB. PM= [IA.s BEM
r,pPFovm.
36'0 ease Print 1) PROPERTY ADDRESS: ?
LEGAL DESCRIPTION:
Lot Block Sub ivision or Tax Parce ID
IF EXISTING SIRt'CZL'RE, DATE OF ORIGINAL &?ILDING PERMPf ISSC'ANCE: -
' (Mon earT
_ PRE'SIINP ZONII9G/PROPOSID LTSE:
? CaAMMCIAL/RE.TAIL/OFFICE
Q IPID[.TSTRIAI,
rl INSTI'ILTIONAL/GOVERMTr
PM R-1 SINGI,E FAMILY
Q R-2 DI.'PLEX (iWo Units)
f-I R-3 TOWN3OLISE (Three + Units) ( t?ni.ts)
rl R-4 APARTMENT/COPIDOMINIUNl ( Units )
a) LTJu-Frw',T%VR ?
NAP7E: FRONTIER MIDWEST HOMES CORPORATION
- ? ADDRFSS: 3908 Sibley Memorial Higtiway Bldg. E
CITY, STATE, ZIP: Eagan, MN. 55122
' PHONE: 454-0433 , 3) For City Lse .
NAME; STAR PLUMB2NG Plimiber5 License:
ADDRESS: 1018 Mound Springs Terrace Active
? CITY. 3TATE, ZIP: Bloomington, MN. 55420 ?recorded ;
' PAONE: 884-4149 MAS1ER LI(ENSE# 3329
St??'t3a1
4) e • •' • i?-
-.*AME:
ADDRESS:
CITY. ST'ATE, ZIP:
PHONE:
.5) r •5R :n - f - ai . _.:.
cocaNEcrzotv z+o cx1^r sEM ER m=x.-riorr rno cixY waTEx p omAER ?- .
6) " ' • '' EM
. ?
PLEASE HOLD APPROVID PII2MIIT FOR PICK-C?P BY ONE OF-ABOVE
PLEASE-MBII, APPRdVID PERMIT 10 1. 2. 3. 4, ABOVE
/ \ 1r:..,.1 .....,,..%
FOR CITY USE ONLY
PERMIT # ISSUED
Pd w/Bldg. Permit EEES:
$=d??D $ SEWER PERMZT (INCLLDE SURCHARGE)
S $ WATER PERMIT (INCLODE SQRCHARGE)
$ $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ D $ ACCOUNT DEPOSIT - SEWER
$ 15. nU $ ACCOUNT DEPOSIT - WATER
$ $ WAC
$ $ SAC
$ $ TRDNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRCNK SEWER
$ $ LATERAL BENEFIT/TR[?NK WATER
$ /7) $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ TOTAL
.
w-
RECEIPT - RECEIPT
DOES UTILITY CONNEC TION REQUIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A" PERMIT FOR WORK WITHIN POBLIC
Q
NO ROADWAY" MUST BE
DIVISION
LIST ISSUED BY THE ENGINEERING
AS A CONDITION
. .
SIIBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
? - .I -rt i-- ?
TITLE: ^ ° s
DATE : I L? Z? d?
SIOMA
8URV
SER
3908 Sibley
Eaga?. M
Phone: (
6'iG,4 A-OI
EYINO
VICEB
Memorlal Highway
innesota 55122
612) 452•3077
?--*-_.
0
?
? --
???
E CERTIFICATE FOa;
w HOME PU4IfENS
? IANUOEVEI<N'FAS
NEAt WaS
'? COMPANIES
MODEL: CON[pRD
Q ci°Mo?k?u
\
x$,??{ 0
I
I
ye
U
?
J
?Y
10
'b
n Q?
4
.?
l t
30`
x BTtA
?C I-I?A
-LEGEND-
O Llenotes lran Maiurcnt
a Denotes Woai Hub Set
x S7L.O Dpnotes Existirg Spot Elevatron
(„ :?ew ) Cksrwtes Proposed Spot Elevat ion
?--- Qenotes L1ra i nage D i rec t i on
-PRLpEltTY DESCRIPrIpV-
LOT ice , BLCCK _4-
HAMPTON HEIGHTS
xcordirg to the recarded plat thereof,
Dakota Cqunty, Yirr+esota
X6'f3.o
PROPOSEO GARAGE FLOOR ELEVATfON= $-73.0
PFi0PO5ED Top of 81ock ELEVA110M- i13.3
PROP05ED BASEMENT FLOOR ELEVAlION= 70 3
NOTE: Verify a!f ffoor heights •ifh final Havse Pfans.
4UH/EM CE[t'fIFICATItNI-
1 hereby certify fhst thie survey. Pfan or reporl
was prepered by me or u?der ny direcf suprrvisicrr
ard that 1 am e duly Registered Lani Surveyor
wder the laws of the 5tsfe of Yimesota.
/) 0
Dete: -I zL186
Wayne Cordes. Minn. Reg. No. 14575
?
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA173025
Date Issued:10/26/2021
Permit Category:ePermit
Site Address: 3569 Coachman Rd
Lot:16 Block: 4 Addition: Hampton Heights
PID:10-31900-04-160
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kathy Marie Lake
3569 Coachman Rd
Eagan MN 55122--124
Summit Construction Group Inc
5325 W 74th Street, Suite 11
Edina MN 55439
(218) 343-8884
Applicant/Permitee: Signature Issued By: Signature