965 Coneflower Ct.
CITY OF EAGAN
I 3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
, rd: ? ? ??Wt'1
'. INii1iJN }'IIINI! ltiN
? PERMIT SUBTYPE:
A{IITttSfA[:1.1J
(Cal.:.') A?ita '11.
TYPE OF WORK:
11;11 I til
INSPECTION .. ..
i 14'.Itl f1 f 1??f•? I? i?/11
oN REcoRn
PERMIT TYPE:
Permit Number:
Date Issued:
f3lrirt. f
I I >, n s: r, '; :'N 1, Ia 'w t H R F, i u v r?. n r ?III
Permlt No. Permit Holder date Tolephone Ik
SNY
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectlon DmrDs kisp. Commsnts
Footings I 7/
d-I f j
Foundatbn 'z7
Framing ? v
Roofing
Rough Pibg.
Rough Htg.
? i
Isul.
Fireplace
Final Htg. c
Orsat Test
Final Pibg.
/ 3PIbg. Inspector - Notify lumber
Const. Meter
EngrJPlan
Bidg. Final ? /, Z ?
Deck Ftg.
Deck Final
Well
Pr. Disp.
I L
Y/
tw Ct?? 4ew 3d" 1,0 ,d1j"w 6-14'"
? CITY 00-EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number.
Date Issued:
BUILDING
021374
07/06/93
SITE ADDRESS:
VALUA7ION
P.I.N.: 10-45092-260-01
DESCRIPTION:
.-?
Buiiding Permit 7ype
Building lJa,rk Type
,-'UBC Qecupan y-,
Construction Typ,e
2oning ?
? Building Length ?
6uiiding Width
?
?
-t
$709.50
$461.18
$60.00
$750.00
10@
1
$1,980.68
45
52
?oC?s (??? C aac??(?J'jn
REMARKS:
S& W PLBR - KLUVER MECH
FEE SUMMARY:
Base Fee
Plan Review
Suroharge
SAC
SAC 8
SAC Units
Subtotel
CONTRACTOR: -
MITTEL3TAEDT BR07HER3
785 SUNSET OR
EAGAN MN
(612) 456-9125
965 CONEFIOWER CT
LOT: 26 BLOCK: 1
LEXINGTON PQINTE 8TH
SF DWG
NEW
R-3 M-1
V-N
PD R-1
$120,000
MISCELLANEOUS $1.744.50
Total Fee $3,725.18
pplicant - ST. lIC
14569125 0003443
55123
OWNER:
MITTELSTAE07 BROS
785 SUNSET DR
EAGAN MN
(612)456-9125
55123
I hereby acknowledge that i have read this applicat3on and state that the
information is correct and agree to comply with all epplicable State af Mn,.
SCatutes and C3ty of Eagen Ordinances.
I
? A PLICANT/P/NATURE
I
ssoZBvG111 IR ,?
7-6 `%'3
? N
KCL'ttftClttC 0f cCCltpRYtC4
(Mj °f Cfag'rn . M. L. 4
Te"Vtmew oF 8ttiibiag 3111119pectioa
, This Certificate issued pursuant to the requirements of the Uniform Building Code
' certifying that at the time of issuance dtis strucnure was in compliance wrth the various
ordinances of t7te City regulating building constructian or use. For the following:
um claa;rwnoo: EF UC eag. ramn No. 21374
PD/RI VN_
OccuPa-Y TYPe ? ' ?S Dimia c
; --7ss&as?''39?, %XW--
Ownc? of Buildiog Add?
. I ' r e
B ' mg Add'ccs Locelity
c `?717
? J BWkh.gofficia,
?. -
i P0.ST IN A CONSPI WOUS PLACE
{ c
Address 955 corEFl,OAtt COuxr _ Zip 5512 3 `
L,ot * 26 Blk j Sub LMMCTON P0= $-IH THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 9/7 Yes No Inspector.
Final grade (6" from siding) ? '
Permanent steps (garage)
Permanent steps (main entry) ?
Permanentdriveway
Permanent gas y
Sod/Seeded grass ?
TraiUcurb damage
Porch
Basement finish
Deck
r,IR
.? I?. , .
du2
.I 7'I 1" I R7
r' 6 S
wr•rn?
? Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to 1
the outside lawn faucet before freeze potential exists. .' i
Contact engineering division at 6814645 before working in rightrof-way or installing underground sprinkler system. is J
White - City Copy Yellow - Resident Copy Pink - Contracror Copy
?REACTIVATE CIIY OF EAGAN sS,9Z.J.I?
1993 BUILDING PERMIT APPLICATION
'VI Ik 281993 681-4675
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
if
spec
ications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not plcked up by last working day of month.
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date (o / ?g_ / 51-3 Valuation of wark ?O?SZ22??
Site Address: 4G ? ca?46F,.?
- SiREET SUITE N
Tenant Name: (commercial only)
IAT ? BIAC$ =L SOBD. $
L P.I.D. N
Descri tion of work:
The•applicant is: O Owner Alg Contractor ? Other (o..oribe)
Name Phone
Property L.:r F,RST
Owner
AddresA
i'- SiREET iTE X
;,. City State Zip
Company _/?;ri??tT.9i--?tr Phone
COntf8Ct0r Address -79 License # ?3 4,y3 Exp.?
City State Zip 5a"ix?
' Company Phone
Architect/
;•Engineer Name Registration M
Address
City State Zip
Sewer & water licensed plumber G Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknawledge that I have read this application and state that the information is
correct and agree to comply wit all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
B?02 SF Dwg.
O 03 SF Addition
C] 04 SF Porch
? 05 SF Misc.
O 06 Duplex
? 07 4-Plex
? OS S-Plex
? 09 12-Plex
? 10 Multi. Add'1
WORK TYPE
K 31 New
O 32 Addition
? 33 Alterations
13 34 Repair
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
0 15 Deck
? 35 Tenant Finish
0 36 Move
P"
? - ,
...? I e ent F:inish
Sw m ool7
? 18 Comm./Ind.
O 19 Comm./Ind. Misc.
O 20 Public Facility
? 21 Miscellaneous
? 31 Demolish
GENERAL INFORMATION
`Consi. (Aciuai)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
,..Planning
Engineering
V-N Sa,mirmnt sq. ft. MwCC System YES
v- ? lst Fl. sq. ft. City.Water Yc3
R_3 rn_1 2nd fl, sq. ft. PRV Required
Sq. Ft. total Booster Pump
footprint Sq. ft. Fire Sprinkler
? On-site well Census Code /oi
? On-site sewage SAC Code 0/
I
I
Building Assessments
- Yariance
REQUIRED INSPECTIONS
O Site ?& footing O Framing ? Insulation
C] Mallboard MFinal ? Draintile ? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment R.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
v.tLotid,: g 120, OUo
GARAtsE; 2-0)c22= yyo xl6= -704o
3SM`f': 26 X zl = Sy6 ,8x2= (16)
S is= ? 9 S?
L ow?r Laue?'
? '74Y 30='72oxs`-f= 3bh`6 v
,
no?-?h?SVi 4We0_;
d6x/i-176x ?o= (3/520)
LIGI?EY2 Ltl/EL', ssYrrr= 53 0
I'1zx 6yt- 13
?Zx/o%2, 15
G9 o1v
I2r? X K Su
h 7 36z
?? .
m ?
J ?
? F< F
Z ?
CY 0 ? •
0? 0 •
0' 0 ? •
0? ? ? •
0' ? ? •
av'o o •
6' ? ? •
LOT BURVEY CAECRLIST FOR RESZDENTIAL
, BUILDING
T APPLICATION
%
PROPERTY LEdAL•
pOCUMENT STANDARDS
Date of Survey:
Registered Land Surveyoz signature and company
Building Permit Applicant
Legal description
Address
North arrow and bar scale
House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
Directional drainage arrows with slope/gradient $.
Proposed/existing sewer and water services
Street name
Driveway
ELEVATIONB
Exiatina
0 @? 0 • Sewer service
0? 0 0 • Lot corners
$/? 0 • Top of curb at the driveway
p?? • Elevations of any existing adjacent homes
Proposed
id 0 ? • Garage floor
C? ? ? • First floor
0 ? • Lowest exposed elevation (walkout/window)
0 ? • Property corners
6 01) • Front and rear of home at the foundation
POHDINO AREAS (if aoplicnble)
0 ¢i? ? Easement line
0 C7" 0 • NWL
D 6? ? • HWL
? 8' ? • Pond # designation
0 M? ? • Emergency Overflow Elevation
F' ? ? • Lot lines
Fr'0 ? • Right-of-way and street width (to back of curb)
9,0 ? • Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e.. all
structures requiring permanent footings)
?0 ? • Show all easements of record and any City utilities within
those easements
?d ? • Setbacks of proposed structure and setback of adjacent
existing hom
• Retainin r ire nts, if any
Reviewed: ("" z
C / ate
Octobei 1992
?,o
Fequesl D e rte o
(1- 19-2)-?
1 qough-in Inspeclion
RepwredP
G Yes No
Reatly Now ] Will Notity Inspector
When Reetly?
I licensed contractor ? owner hereby request mspectwn of above electrical work at:
Job Atltlress Street Box or /R/out?e No 1 r'
CI (O? l: -61'lQ
-rc 6G(l? j'' C 7- 1
C
`t
.,
Serion No Townshiip Name or No Range No ?
ppyey --
?R.?d?A? J
OccupanllPqlNTi
Phone No.
°ow S ppL?¢r r-
e?Jl?{4T?/ AtlOress
BecV¢amracbr(COmponyName) ?
S G?Qt?y
rr») /_
Tor)
ConVatlor's License No
7G
M
' Cf}?I
aN
lg Actlress (ConVarlo, or Owner Mening Inslallalmn?
o203,?4? - r C:7, ?
F
1M1
??non Fa,l?
,?^? Ssoa I
u
O"2ec Sgnaure iConlracto'? ner MaRinq InslallaM1On1
Phona Nomber
7 ? '?
...._?!?'-?W'-- CSa-7) -1&3-30&r'
i [ tlUaHO OF ELECTRICI ?-J
Griggs-Mitlwey 61tlg - Rpam S1]3 THIS INSPECTION REOUEST WILL NOT
1821 pnlversity Ave, gt. peol MN 5510< BE AGCEPTED 6V THE STATE BOARD
ihone (612) 642-OB00 UNLESS PROPER INSPECTION iEE IS
ENCLOSED.
?Q?' REQUEST FOR ELECTRICAL INSPECTION
?. r
?
( r See inslructions for complebng this form on back oi yellow copy ?
X ??
d " Below Work Covered by This Request ?.,m.•
ew .,;7d qe'r TypeoiBwldmg AppliancesWiretl EqmpmentWired
Home Range Temporary Service
Duplex Water Heater Elecinc Heating
Apt Bwlding Dryer Other (Speaty)
Comm /Industrial Furnace
Farm Av CondAioner
O-her(syecdy) ConVactor5 qemarks
Com
t
o'`'Irlt G
I
.
pu
e
nspecnon Fee Below.
# Other Fee +t Service Entrance Size Fee # Circmts/Peeders Fee
I Swimmmg Pool 1 0 to 200 Amps 0 to 100 Amps
Transformers I Above 200 _ Amps Above.100 _ Amps
SignS InspeclorYUseOnly
% TOTAL
IrngavonBOOms ?i
??. L'G' ??r
S
eaal In
i ..
p
spect
on
Alarm/Communicauon THIS IN5TALLATION MAY BE
O
Other Fee ED DISCONNECTEO IF N
T
COMPLETED WITHIN 18 MONTHS. '
1. the Elecirical Inspector, hereby Rouqn?? oate
certity ihat the above inspection has
F,nei
6een made, e?
OFFICE USE ONLY
Tnis request voitl 18 mon[hs Imm
J
MINNESOTA STATE BOqpD OF ELECTAICITY
Grigga-Midway BIEg - qoom 5-n3
1821 Umversny qve, St Paul. MN 55104
Phone (611) 643-0800
REQUEST FOR ELECTRICAL INSPECTION
1 @'€ EB-00001.08
? See inslmcUOns lor compleling this brm on pack ot yellow copy ???
+.v?q',
pq 4 Y
? ?? O?1 BBIOw Work Cnvarwr/ hv Thro ?'ss'ti
ew
Adtl
Rep
TypeofBUilding - _ _ _, ...._ .._?
ApphancesWiretl _..... ..,m,...
EpwpmenlWirad
Home Range Temporary Service
Duplex Water Heater Electnc Heating
Apt Bmlding Dryer Other (Specdy)
Commlintlustnal Furnace
Farm Air Condnioner
Olhertspealy? Connactor5 Remarks
Compute /nspection Fee Below:
# Olher Fee 9 Service EnhanceS2e Fee # CirCUrtslFeeders Fee
Swimming Pool 0 to 200 Amps fp 0 to 100 Amps
TranSformers Above 200 _ AmpS A6ov 0_ Amps
SignS Inspemor§ Use Onry O
Irrigahon Booms TAL
69 l
Special InspecM1On . ?
?l
AlarmiCommumcanon THIS INSTALLATION MAY BE
Other F ORDERED DIS
GONNECTED IP NOT
ee COMPLETED WITHIN 18 MON?Tif{$! j
I, the Electrical Inspeclor, hereby Roug"m
oeie
"
cert
f
th
i
y
at the above inspection has
been made
OFFICE USE JNLY
This repuest vaitl 18 mantns Imm
THIS INSPECTION REOUEST WILL NOT
AAW 6E ACCEPTEO BV THE STATE BOAqp
l1NLES$ PROPER INSPECTION FEE IS
ENCLOSED
. . . , DATE
ERTERIOR ENVELOPE AVERAGE "U" COMPUTATION
owNER _ ? . (1 k f? FI ? 2 E Tl?.
SITE ADDRESS q'L9Jr CJOA?,? Ef ?
CONTRACTOA
ADDRE55_') 85 Su,JSFr ?(1. ?RtiA.J PHONE 45(c 41 2 5
DETERMINE WORRING SQUARE FOOTAGE OF EACH.
1. Total euposed wall area .... 2.q0 aq: ft. x• 11 ?
2. Total roof/ceiling area ... 17 S sq, ft. x•026 a L-.1.?.!
Total exposed wall area above floor - 2207.'7
S
a. Total wall window area ......................... 2) --4,0! S
b. Total door area ................................ 140, 0
c. Total sliding glass door area .................. yy,o
d. Total fireplace wall area ...................... p
e. Tota1 wall framing area (average lOx) .......... 2 2G.0
f. Total net wall area above floor ................ 1551
. o
g. Total rim joist area ........................... 12 g.o
Total expoaed foundation area ? e 2. 2's
h. Total foundation window area ................... 1I1115
i. Total net fouadation area above grade .......... ?I,o
Determine "0" value of each wall segment.
a. 2r3.7 5 g flUll _ 45 s 96,2
b. qa x olU?t r) ^7 2,9
c. HLI x „o" . y 2 a 1 8. 5
d. o x ltuf, O - o
e. 2'2.q, o R nU" . I I 2 5
Z
.
f• 1 553.o x "v" .OV3%1
g. 111 g x "o„ , oqLl
h. 11.25 x itU,t q 5
i. 71,o x flo" , 04%2
3 . ...............................xotal - 2 ?.
lf item 43 is ehe same as, or less than item tll, you ave met the intent
of SBC 6006 (c)2.
-1-
Page 2 of 2
. . •1
Total exposed roof/ceiling area - ? 2 75
J. Total skylighe area ........................... O .
k. Total roof/ceiling framing area (average lOZ).. 7 q,?7
1. Total net insulated raof/ceiling area ......... // ?J 5. 3
Determine "U" value for each roof/ceiling segment.
j. o XIfUlt 6 m
k. 179. ^7 R nUrr . 025 $
1. //9 .S. R nUrr • d2.1$' 'L G. I
4 ....................................... .Total ?
If total of 44 is the same as, or less than 42, you have met the intent
of SBC 6006(c)1.
Alternate Building Envelape Design
To utilize the total envelope syetem method, the values established by
the aum of items 93 and 04 ahall not be greater than the sum of items
O1 and 02.
1. + 2.
3. ' + 4. s
-2-
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNH01vtES AIdD
CONDOS WHEN PERMTfS ARE REQUIRED FOR EACH UNIT. ?
NO. FIXTURES EACH
SHOWER 3•00 ?--
? WATER CLOSET 3•00 ? -
,-
BATH TUB 3.00 N
? LAVATORY 3•00 ?
r
KITCHEN SINK 3•00 ?
J LAUNDRY TRAY 3.00 ?K.-
HOT TUB/SPA 3.00
WATER HEATER 3•00
? FLOOR DRAIN 3•00 ?
J
L GAS PIPING O[JTLET • minimum - 1 3,00 '
-
ROUGH OPENINGS 1.50
WATER SOFI'ENER 5•00
PRIVATE DISP. • DaLctr. iic. 15.00
U.G. SPRINKLER • Aome uneer const. 3•00
ALTERATIONS • a austing 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE
TOTAL:
SITE ADDRESS:_
OWNER NAME: d
WSTALLER: LA\?,
ADDRESS: 21-i
CITY:
PHONE #:
.50
a ,
? STATE: ,?/l?J/ ZIP CODE:
SIGNATURE OF MI E
1993 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
FAGAN MN 55122
(612) 681-4675
E TO ?a
1993 MECHAIVICAL PERMIT (RESIDFaVTTAL)
C1TY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTf.
? NEW CONSTRiJC£IGN
ADD-ON A/C
ADD-ON FURNACE
na,TE &?I1193
FEES
HVAC: 0.100 M BT'U $ 24.00 ?
ADDITIONAL 50 M BTU
GAS U.,?j.ETS (MINIMUM 1@$3.00 EACH)
,rv,a. 3 ?
alv'y ?-???? .
?-?.?.?. , ? ?
ADD- N/REMODEL (ExisTIN? CONSTRUCT1oN) $ 15.00
STATE SURCHAItGE
39.?
SITE ADDRESS: %?i
TOTAL
OWNER NAME: /ni76&422!k??,7R"-S. TELEPHONE #: 4c6 - % la,?,
WSTALLER:
w„ljl?„lli? I 1?460„6 ? .., ,,, ... .
ativage,
ADDRESS: 12481 Rhode Island Ave. So.
CI.I.1,: 894-0085 STATE: ZIP CODE:
TELEPHONE #:
S TU OF PERMITTEE
SURVE,YOR'S CERTIFICATE MITTELSTAEDT BROS. CONST.
.
? 4) ?9 8v9)
sao.a ?-73.00 N89006'23't -, 9610.y
`--
s ?I
I P,"DRAINAGE 9UTILITY s
G/ 1
EASEMENT PER PLAT
? LOT 26 - ?
LLJ I ? q79.3? I LLJ
M? p M
?
cg 7`l-8)
m M
o - iQ00 - 978.9 O
N i 45.0
PROPOSED O
HOUSE N 41
N
?
S
0 ?
6ENCH 8 POFPPEK i
ELEV.. 978.35
S
Zs9?
GAR.
i 978.8^ y79?)
POSQ5 L EWAY
I 4M?lv
0
` 73.00
(F79 8) ; I S
?
i $I ? °v_
786--?-
5 pM
_? g
3
CONEFLOWER
x975.1
I
BEYT
N07E: BUILDING qMENSI0N5 SHOWN ARE _
FOR HORROMAL, 9 VERTC/1L lOC- ATION OF S?TRUCTURE ONLY. SEE NOTf ? NO SPECFIC SOILS INVESTIGATION HAS BEE!! COMPLETED
ARCHITECiUAL PLMIS fOR BUIIDING ON THIS LOT BY THE SURVEYOR. T!£ SUITABILITY OF
9 FOUNDATION: DIMENSIONS. SOILS TO SUPPORT THE SPECIFIG HWSE PROPOSED IS
?- DENOTES PROPOSED SURFACE DRAINAGE Nor THE RESPONSIBILITY OF THE suRVEYoR
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = FEET
WE HEREBY CERTIFY TO MITTELSTAEDT BRC6. CONST. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 26, Block I, LEXWGTON POINTE EIGHTH ADDITION, occording to the recorded
piat thereof, Dakota Couniy, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 22ND DAY OF JUNE , 1993.
M R. HILL, INC.
SIGNNBY-.
?
. LARSON, LAND SURVEYOR
HN C
MINNESOTA LICENSE NUMBER 19828
?
W ?
? p r ? ? O < N D ? D
- Q Z A ? ? Vl N? ? Z
0 m ? ? ? D ? W m ? m
T ? O m ? {
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 o BURNSVILLE, MN. 55337 • 612-890-6044
Ir
L? F
Apr. 7. 2014 9:15AM
4,111' City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
4/7/201
No. 9746 P. 2
Use BLUE or BLACK Ink
For Office Use
Permit*: I a t5ta' 1
1105
t i rte
Permit Fee:
Date Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 965 conflower Court Unit #:
[Name:
Resident/
Owner
Brain & Enrica zaidman Phone: 651 452-8751
965 Coneflower Court
Address/ City / Zip:
Applicant is: Owner x Contractor .
Type of Work
Description of work: remove and replace 23 sgaure siding - remove & replace 26 square shingles
Construction Cost 21,071-40 Multi -Family Building: (Yes / No )
Contractor
Company: Builders and Remodelers Contact Mary Anderson
3517 Hennepin Avenue South Minneapolis
Address; City:
55408 612 827-5481
State: MN Zip: Phone:
License #. CR1100 Lead Certificate #. NAT -20683-0
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information) .
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit ale considered to be public infonnation. 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. Cell Gopher State One Cali at (851) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.oro
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permitissuance_
X Mary Anderson
Applicants Printed Name
xt�l/l rte-.
Appliicaktt's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA140134
Date Issued:11/29/2016
Permit Category:ePermit
Site Address: 965 Coneflower Ct
Lot:26 Block: 1 Addition: Lexington Pointe 8th
PID:10-45092-01-260
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Brian M Zaidman
965 Coneflower Ct
Eagan MN 55123
(651) 452-8751
Home Energy Center
2415 Annapolis Lane N #170
Plymouth MN 55441
(651) 766-6763
Applicant/Permitee: Signature Issued By: Signature