1875 Deer Hills Tr CITY OF EAGAN nJ° 10 3 5 9
* `• 3830 PiIM Knrob Road, P.O. Box 21-199, Eagan, MN 55127
PHONE: 454-9100
BUILDING PERAAIT Receipt #
Te !e wmd fm SF DWG/GAR Est. Value $58,000 Date JUNE 6 19 5
Site Addren
1875 DEER HILLS TR Erect IR
Occupancy
R
S
Lot_2 elock 6 ?ec/Sub UN CLIFF ].ST Remodel ? Zoning Rl
. Repair ? Type of Conet. V
Parcel No.
Addition ? No.Stories
Neme KEYLAND HOMES Move ?
li
D
h ? l.enqth 38
Z
3471 W 173RD emo
s
ST Depth 42
? q?rms mt lmPr. ? Sa. Ft.
city JORDAN pnone 492-6646 Install ?
g SAM 435-3323 Avwew4 i"s
Zu
f?
s
f
Name E
Phone
FW Name HALLQUIST & SONS
_? p?,K, 5001 W 80TH
?W ct<y BLMTN pnone $31-1875
I hereby ockrowledge that I hava rcad this upplication and srore that
fha Informotion Is correct ui yd-"ree to comply with oll aDOliwbls
Stata of MinnesoM Stotute an Ci? of r' wncas.
Siqnaturo of PermiMea
A Buildinq Permie I: Issued to: KEYLAND HOMES
dl work zholl be done in occordonce with oll ofmlitoble Sfote Mir
Asseumenr _
Water d Saw.
Polica _
Firo
Erp.
Plonrror _
Councll _
5
BIdg.Off. 6/3/8
APC
Var. Date
aermit S 307.0(
SurCherge 29.0(
Plan Review 153 . $ (
SAC 525.0(
wetar Conn. 500.0(
water rneter 63.0(
RoadUnit 280.0(
. rc Pi. 132 . 0(
?
Perka
Couies
I raai 51,989.51
_ m fhe sxpren caditian Ihai
and City o£ Eapon Ordinancas.
Buildirq Official
INSPECTION RECORD
CITY OF EAGAN PERMiT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued;
(612) 681-4675
SITE ADDRESS:
1875 OEER
SUN CLIFF iST
PERMIT SUBTYPE:
DECK
.: 10-72975-020-0f
LOT: 2 BLOCK:
HIILS TR
6 APPLICANT:
FORSBERG JOEL
(612) 687-9378
TYPE OF WORK:
NEW
BUZI.pING
025893
06/28J95
,
.
,
. ., .. ? -.
., .,
?
a
? _: ' '.. . ` -:.. ... : :.;_. . . ?; _;?.. . . . ....? ?-.. ? .??....... ., . .. . . .._e ?..e.. . .,?_ ,.,,?_._,.?
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
auzLpxtiG
025894
06/28/95
SITEADDRESS: P•I•N.: 1e-72e75-e2e-e6 APPLICANT:
LOT: 2 BLOCK: 6
1875 DEER HILLS TR FORSBERG
SUN CLIFF 1ST (612) 687-9378
PERMIT SUBTYPE: TYPE OF WORK:
SWTM POOL
DESCRIPTION
?
L
JOEL
NEW
A.G. POOL
?
?
REMARKS: SEPARATE PERMIT REQUIRED FOR ELECTRICAL WORK
BUILDIN G PERMIT
To N mud fer
Site Addresa ?
Lot Block
Parcel Nq,
ag Neme
Addresa
Citv 'J1RD71'!,j Phane
(Vame
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Name
tFwt I hove rcod this oppiicotion ond state thct
rrcct and ngree b comply _with all appliceble
Stprtature of Penmiftes
A Building Pertnif Is issued to: `. ?; .• .`'
oll work sholl be dons in occardonce with oll opplicab
Buildinp 4ificiol ^
10359
Receipt
?
` J bote . , 19 ?
_ ?
Erect ? Occupancy
Remodel ? Zoning
Repair ? Type of Conat.
Addition ? No. Stories
MOYe ? Length r , -
Demolish ? Depth
Int Impr. ? Sq. Ft.
Install ?
Approvala Feea ?
Assessment Permlt • 00i
?
Wcter d. Sew. -, • oo
Surcharge
Polite Pian Revfew : 3 • 50
Fin SqC r..:?.QU,
Enp. Water Conn. • 0 Q
Plonrer Water Meter • 00
Council Road Unit ' 0• 00
81dg. Off. Tc PI. '- 2 • 00
i
APC Perks i
Var. Date Copies ?
rotal
,
on the expre3s cOndition tha?
?
wsota Statutes nnd City o? Eepon Ordinances.
Pwmit No. Pwmit Holda DaH TNephono s
Plumbina Sq ?i.cr? ZIV7 - s d
rI.v.n.c. / g /0 7 - A t ?
EbeMc
Soiternr
Irnpection Date Insp. Other
Footings 1
Footinga 11 -
Foundatlon
Framing
Roofing
Rough Plbg. VVIOA-
Rough Htg.
Insul.
Firoplace . c-
Final Htg.
Flnal Plbg.
Final
Cert/Occ.
Watar Dsseribe Locstion:
Well
Sewer
Pr, Disp.
Receipt MECHANICAL PERMIT Permit No.
i CITY OF EAGAN Fee ? Op
FiQ in numbered spaces S/C
Type or Print legib/y s?
Tot.
1. Date 21918i 2. Installation Cost I-T UO
/875 ?.er 1? 1` s T?o., I .? i? c,. ( C•?
3. Job Address Lot C Blk.? Tract
4. Owner t,"'"1 ?A.-- I
5. Contractor Phone
6. Address 19 4 01 N.1p
7. CitY 04 f V--dL? IA.- State 2ip ?? 3) Z
8. Building Type: Residential4 Commercial ? Institutional ?
9. Work Description: New Aj Add ? Alter ? Repair ? •
10. Describe Fuel Type ND?
11.
No.
? Eauinment BTU - M. Ea.
Forced Air 7V' "6 No. Equiament CFM
ndli
Ai
H
:
Mfg. Cq ? r ic V' r
a
ng
Boilers ?
Mfg. . Mech. Exhaust
Unit Heater
Mfg. Other
Ai r Cond.
Mfg,
? Gas, Piping Outlets
12. I hereby certify that the}?bave information is true and correct, and 1 agree to
comply wirning this ty pe of work.
Signed: for
Rough F(nal
Inspections: Date Insp. Dete Insp.
7his is your permit when numbered and approved.
Approved C17'Y OF EAGAN 464-8100
Receipt PLUMBING PERMIT. • Permit No. --
CITY OF EAGAN Fee
I
Fill in numbered spaces S/C
Type or Print legibly Tot
.
1. Date ?r ,• / .? 2, Installation Cost
3. Job Address Lot Blk. Tract
f
4. Owner .
5. Contractor Phone -
6, Address
7. City State J?; e Zip ?-
8. Building Type: Residential 21 Commercial ? Institutional O
9. Work description: New o. Add ? Alter ? Repair ?
I 10. Describe
I 11.
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bdth tubs Septic Tank
Lavatory Softner
Shower W e I I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 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
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
INSPECTIO
' Eagan,
(612) 6
Road
ta 55122-1897
PERMIT TYPE: 10111 1? i M1
Permit Number. sj .• 1F,f11i t
Date Issued: ct i., ;: t3 / v!
SITE ADDRESS: ' ' " ? " ' •' `' ; '' c+ . • H O"
1 ?rr .' 1?1 !t? k
?: ? t: }I1 1 l•. I?
f f 11 i ? i i ? i I
PERMIT SUBTYPE:
?
1 11 o„l iI Wr,: I
APPLICANT:
TYPE OF WORK:
I I hJRI
? _ -
-------------------
Pertnit No. Permit Holder Dats Telephona N
ELECTRIC
PLUMBING
HVAC
Inepwdon Dete Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
dRSAT
TEST
BLD(i FINAL
BSMT R.I.
BSMT FINAL
DEGK FfG 7 3_ ?
OECK FINAL ??a
NSPECTION RECOR
CITY OF EAGAN PERMIT TYPE: I +l I rooi
3830 Pilot Knob Road Permit Number: ti 1a +1
Eagan, Minnesota 55122-1897 Date Issued: G?,/;?+ ??? 5
fy (612) 681-4675
SITE ADDRESS: 10 '` 'I`' /`' 0'1" `" APPLICANT:
r ?? ?: . ?+? i?? r .
.. ,?; ? ? ?i i ? i i i ,,; ,?. ,,.
PERMIT SUBTYPE: TYPE OF WORK:
I 1?? ? i 1 I t I??1?
I ! h11,
t 1 Ni1 I
ro : '-k 11 t'A itr'?) I f'F P hl l I !:t Ull l V{ I) f 1JV f I 1, I It IiA{ Ilf lV 1
Iut I
i1 1, F'ti1?1
? ?
wr,nn No. Pennie Hola.r Dae. Telepnone:
ELECTRIC
PLUMBINO
HVAC
Inspectlon Qate Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FlNAL PLBG
FINAL HTCa
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG 01,
DECK FINAL
n
? ?
?
(?
CITY OF EAGAN Remarks ?.,.. ?
Addition M CLIFP 1ST Lot 2 slk _
owner , r= ?'- L- I ':' ',!•'•+. ?z,/ st,eet 1875 DEER HILIS TRAI L
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF, ss 2220.64 C0102 6 --g
STREET RESTOR.
GRADING
SAN SEW TRUNK 976 76.54 3.06 25 27.58 C0102 ( - -$
*SEWERLATERAL 5 1985 547.94 ?.59 2838.36 C010276 --8
WATERMAIN
* WATER LATERAL 1985
WATER AREA 12.56 (i' 1 2 Ej --8
STORM SEW TRK 105 1971 322.29 16.11 20 80.64 C0102 6 - -8
? 570RM SEW LAT 1985
* Services 1985
'
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
' BUIIDING PER.
sAC 525.00 T+ ??
PARK
.
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
SITE ADDRE
lit4 : 1 1) ;
I PERMIT
I I ; itvti1
, Ll?? • :`0 (sl UfK•
, . , lill 1'; lF?
tf Ii I I u, M
eA.?() <c;1
GiH!! I!<)!
? APPLICANT:
, • , , . , , ?
TYPE OF WORK:
E'. , : ! i i ,sr
I flkpl 11Apifi(O
F
L
Pertnit Holder Date Telephone i
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING 9'll , G
ROUGH
PLUMBING
PLE3G
AIR TEST
ROUGH
HEATING
GAS 5VC
TEST
INSUL
GYP80ARD
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
OECK FINAL
a,d• ^L
TY f)F EAGAN WATER SERVICE PERMIT I '
W-?i!Io.t Knc,b Road CASH RECEIPT
0. gox 27199 PERMIT NO.: -
Man, MN 55121 oATE: CITY OF EAGAN
nirg: i< ' ?+ of Units: ?
r„er: Kevland ???' i ? M "'°° ? P. O. eOX 21-199
b„ess; J??,jpxE,a= ?;;T r,,.! :n?al utiiities EAGAN, MINNESOTA 55121
• Addrcss: - , r rS, ii1 f' f 1^ .
Jmber: ?c . .?..`L3'li DATE
Meter No.: (M 1: bJ i/A 8 K LLJ D 1 Cd64'eflbls Chorye: Jk, v. v v yu
51u: Aocount aeposit: 15.00
Reoder No.: Permit Fee: i?•I)?
I yfiM f0 OOINply M?uh !bN rrlfr Of Kow11 $U1'ChGrgl: • r O
Orllw.ne... Misc. Chorpas: 132.00
?
ol: - 63.00 pci n.eter
6y ZjLr? s Poid:
pate of Insp.: 9=14--iz ? fnsp•t
CITY OF EAGAN
3830 Pilot Kr,ob Roed SEWER SERVICE PERMIT
P. U. Box 21199 PERMIT NO.:
Eagan, MN 55721 D/1TE: - -
Zonlnp: No. of Units:
Owrsr: 1
AddfE53: -
S1T! AddfOS5:
Plumber: - ? ?
'
.r. . • . :
1 ym h eowply wiM !6e Cihr of Eewn Connectlon Chorpa:
OIaIMdON. ACCOUM' DIGpeWf:
PermK Fee:
Surcharye:
gy Misc. Cfwrpes:
Qcte of I nsp.: Totol:
Insp.: Doh Poid:
RtGtlVtD ? .
FROM'
AM04j'h1T
gk ooLLwws
I60
? CASH ? CHEGK
Y
funo cooE arnouNr
Thank You 1 '
? "BY
?
?
?
(r;?,r`rJ
%7
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
This request void
18 r11frRa' 4- 6
?
Request Date Fire Mo_ Rough-in I c n
•? + _? F1e uir . EIHeady Now [or YYheo Ready ec-
J es ? No
icens Ele rical Contrector 1 hereb
y request inspection of ahove
? Owner eleclrical work irstalisd at=
Street Ad ress, Boz or No. CitY
ectio o• To w ip Name or No. Ranee o_ Coumy
Occupant (PRINT Phone No.
Power Su r ? Address r=
.. s -
s? f_
Elec Acal o tr ctor IConwany Nartie) ootract s LicerySe
e
Nlailin r (C(Mractor or r Making 1 t ailation)
- ? L?? ?
?,
Authorized ture o actor i InsWl ion) PMo r
C=i ? • , ?% j// .
MINME TA ST?ABOARD OF CTItICITY
Gri -Midwa - Room N-797
1821 University Ave., St. Paul, MN 55100
Phorre (612) 297_2711
THIS INSPECTION REQUEST NIILL NOT
BE ACCEPTED BY THE 5TA7E BOAND
UNl.E55 PROPER INSPECTION FEE IS
ENCLOSED.
?? ???? R€QUEST FOR ELECTRICAL lNSPECTION Ee-ooooT-a
, See irutructions for completinp tAis fwm on beck of Ysilow copY.
B33 3 8 8 "X" Be1ow Work Covered by Thrs Revuest
Add TVPe of 8uildin9 ADDIianCes wired Equipment Wirrl
HOrne
ilo
?9?
Tertiporary Service
Diiplez Nfater Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldy. Furnace Silo Unloader
Inckistrial Bldg_ Air Corxlitioner Bulk AAflk Tank
Farm Ocne? pec?fy cher (Sper:fy)
ther SVecifY Othor Ottegr
ompute Inspection Fee BeJow
M ef"". Service EntranceSize q Fee Feedess/S.b(eeders 7t Fee Circuiis
.1?t1 0 to 200 Amps 0 to 30 Am rd 0 tn 30 Am
Above 200 Amps 31 to 100 Amps , 31 to 100 Arrsis
Swimming Pool
Transiortners Above 100_Arnps
Irrigation Boorrs
? Above 100_A -
Partial. Other Fee
SignS Specia! Inspec±ion --?
Remarks s1711 ? TOTAL FEE 1
Rough-in ? ?
Date
•
i? ?!N
? , t1e Electr?ca?
Ir?pecta, hereby
Final ce?tih thet the abovs
? Date
" - p?teon has baen
n.se .e ......... ....?. , o ---.? .v? _ J..? nade.
1
? ? • ?.- f w.v?`al/
- ,
z/sa
C!4t, ( . %
" CITY Or EAGAN
'14VI1 APPLICATION FOR PERMZT
• -' SEWER AND/OR WATER CONNECTIODT
(PLEASE PRIN7)
1) PRoP=rDnREss :
r.FrAr DESCRIT?TTCV: ?C.,-
(LOt/Block/Subclivisicn or Tax ?arcel I.D. Numner)
? .Tr ST??C=RE , DAT? OF ORIGi ItIL riiILDI:-? T_SS.;AN=.
PDESL.T Z-?T'1i7+/?T?OPCSL C7.C: , cZ'1 SL= Tj,Y
? R-Z DL1PL= (2?%'O L^'ITS)
? R-3 'IC'.v1II?CC7SE (TT-= + U:7IT5) ( Wi Z^'S1
? it-1 tn;I?,-?1 ( [JDiI?Si
? CCi/LME.°.CL?I./R?,^'AT,L,/OP:'IC::
(3 INOliSTRSr1L
Q IPISTITC,TIOJIAL/GGVEPNnE::T
2) APPI.IG7-.2;T (PLEasE aeiNr)
/
ADCRESS:
CTT'!, STITF.', ZIP: ??r; r• ?Uf?i:? /??i?'?,t? ?_°i` S ?? ?:
PxoiNE: ?g 2- C- G- Y?-
3) PLL?ffiER
DIF1["]E: (PLEASE-VFIYi): ,
? cs
-
7t?= ? -
? PoR CITY USE ONLY
ADDRESS: -
:
'
- - PLUNBERS UCE45E:
Activ
CITY, STATE, ZIP; e
Ezpired
PHOrrE: " MAac?
y?`j-S ??? PLUMBEA LICEYSE N?32zlnvj ? Not of Record
arr nitia
4) OCCUPANP/a?TIEF2 krLcn5t Nnirirj
NAME: ?/11 [= i?c' .?Y
-=?
ADDF2ESS-
Cl'I"1, STATE, ZIP:
PHOrIE:
5) INDIG*,TE W[-]ICH PERfd2T IS BEING REQUESTID:
CO:v'NF.C.TI0.1 'I-0 CITY ScF7ER
? CONN .IO:I 'IU CITY SVATER
? Cl^iIIE12 (PLPr1SE DFSCRZBE)
01 - 1.CrU1l1?!:: U.`ir;:
7) SICaT[iF2E:
? PL°.NSE f?OID APPP,OVm PER+IIT FOR PZCF:-L'P BY ONE OF ABGVE
? PIFASE :T.'1IL APPFtdVfD PERbLiT ?'Q 1, 2,?, 4 AFiOVE
. ll n Ct L(CirCle one)
DATE: cs.. C. ? P?N•.
. . . ? a? s•.+r ?.??:aa+w a? s??a:a:a a ie :faa?ss.r ? ??? ai?saa?
F O R C I T Y
PE?2.MIT °- ISSUED
F°ES: $ sD
$
$
G 3?L
S
S
$ /S-?a
$
$
$
S3s "°
$
S
$
S
S
U 5 E O N L Y
S°:-iER ?'E4Mr; (I:?CL:;'`: SU°C!i?RG,)
WATER PER[IT (Z`:CL.;DE SuP.CF:AaGi)
WATER METER/COPPERHORN/OUTSIDE READER
WATER TAP (INCLUDE CORPORATION STCP)
SE:vER TAP
ACCOUNT DEPOSIT - 4)ATcF
WHC
SP.C
TRliNK WATER ASSESS:?E:1T
TRli:7K SESdER ASSESSMENT
LATERAL BEDIEFIT/TRUNK SE;•:ER
LATERAL BENEFZT/TRU:IK WATER
OTHER kZz?u7iLoa?nv%r? ??cvh?-?lGc?44--
TOTAL
AMOU::T PAID j qECEI?T
DOES UTILZTY CON[VECTION REQUIRE EXCAVATION IN PUBLIC RIG'rIT OF WAY?
? YES IF YES, THEN n"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
C=E??[VO ENGINEERING DIVISION. LZST AS A CONDI-
TION.
SUBJECT TO TEiE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DAT° : 7/./ /h '
on winwomE?s?a???wES?w?wW?n MUM Rawc40 wRNM wPI w.ar* W saGbsM@ w.asW M rM sJU IN M
I ?
4 103 ?-? .?_.
?
F
1985 BUILDING PERMIT APPLICATION - CiTY OF EAGAN
NOTE: ALL CONTRACTORS !{OST BE LICENSED MITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be Used ? /?
Fors?j ?e l?"luatio S%pOtJ 7 p
n: L? Date: "7 O S
Site Addres s: IY?5 Bee2 ?/ IWS r OfiFICE USE ONLY
Lot: =:? Block ?i Sect/Sub Ereet 2< Occupancy ?-3
Remodel -
Zoning Q-I
Parcel II S
Repair
Type of Const ?
L/ Enlarge _
1! of Stories
Owner
? Move _ Length 38
Address
,173? Si Demolish
Grade Depth c?2
Sq Ft
City/Zip Code T0,z017,,, i S"53S 2?
Phone -6 6,/ 6 ql 4{3S `33 ?-3
Contraetor
Address
City/Zip Code /oy
Phone
Arch./Engr,5'(?iS i ? .San/
Address J"?3-0/-
City/2ip Code
0
Phone $ F 3
APPROVALS
Assessments Permit ?0-1 , ``0
Water/Sewer Surcharge E5?1-
Police Plan Review i5 .$O
Fire SAC 5Z5.
Engr Water Conn g?-
Planner Water Meter fo3.°•
Council Road Unit Z.g?J.°
,,
Bldg Of? Parks
APC Treatment Pl 13Z.°=
Variance
TOTAI p ?Jr? c
,
20x `?¢_ ??ox s4? ?Cp?2?
l(o ? I? ' Zg8 ?? i IJ?SZ
,
201? Zz " 440 ? i? = 4-54?
W. . . ? Y"
For: REY-LAND HOMES
NOTE:
o Denotea Woodeti Stake
Proposed Garage Floor E1.903.33
(903.0) Denotes Proposed
Finished Ground E1.
-aq-- Denotes Direction
Of Surface Dralnage
Vertical Datum - N.G.V.D. 1929
el U/, rt , /y
r p, nOqE
D
4 ? ..
?
? o?
rn
1;3 y L3?
? ri
C
r
C. R. WINDEN 6 ASSOCIATES, INC.
LANO SURVEYOtS Ta4 946-3646
I381 EUSTIS ST., ST. ?AUL, MINN. 65106
Scale: 1" = 30'
O Denotes Iron
Monument
J I
=. . ?
045? 31"E C?ye o, ' -_ /
? ? ZO 8
22 ? ? ? I
N N o '" ?`? ? 1 O
y 3 ij /' '??98 D} 1
>
Na
J Lot 2, Block 6, SUN CLIFF FIRST
ADDITION, Dakota County, Minnesota.
N
/Cz?'?S'%??: ?
n?
?
2
WE HEIIElY CERTIfY THAT THIS IS A TRUF AND CORRECT REPRESENTATION OF A SURVEY OP THE
BOUNDARIES OF THE IAND AlOVE DfSCaI6E0 AND OP THE tOCATION OF ALl 6UIlDINGS. IF ANY,
TMEREON, AND All V15161E ENCROACMMENTS, If ANV, FROM OR ON SAID LAND.
Dolod iAit doy ef P1av A.D. 1985 C. R. y'INDEN 6 ASSOCUTES, INC.
br .ki?'U??'?'t. -
Su.voyor. Miene.eto Ropisvation No 772,k
c9e i or v
EXTER[OR ENVfLOPE AYf.. - ?
itAGE "W" COP1('11T,1'fi(IP1 %* 33U
: a. . . --- ---- - _
OwNER:_ _ nnTr: ?.116_
SITE ADDRE55: PIIONf:
CONTRACTOR:?`?
Determine working square footage of each
1. Total exposed wall area..... 11(1_sq. tt. x.11 = Z fD . S
2. Total roof/ceiling area..... 1040 sq. ft. x.026 = 7!1
Total exposed wall area above floor=-- I -?`f ''I_
' -
a. Total wall window area ......................... ..................
b. Total door area ................................ ......
.
c.
Total
sliding glass door area .................. .
..........
...............
d.
Total
fireplace wall area ...................... ...
.............
e.
Total
wall framing area (average IOw)..:....... ..... ?
..................
f. Total rim joist area........................... .............
g.
net
wall area above floor ................... . ?TZ
....
....
h.
wall area above floor ................... .............. ?
.......
i.
'
wall area a6ove floor.... .........
.... ...........
...............
j.
frame
wall area at foundation ................. .
..
....:.............
Total exposed foundation ai-ea=_ _ f0(Q ~
k. Total foundation window area ................... .... .?
1. Total net foundation area above grade .......... ....
Determine "u" value of each wall segment
(e.g. window; (loor, each separate wall section)
a. f5? x
b. 38 x 'lu„ .31 = 11.?
C, 4o x.,u..
d. X „u.. _
e._ 1717_ X „u„ ,
f. 137, x„U„ 01 ' 5
9. 1315 _ x „u „ .05 = ??-: ---
h. X Itut. _
i. X 1, U..
?
j, X
k. X
y Il l ?
?, ?ll??f
w ?
3 . ..................................Total
a 14 C.l.,
1f item R3 is the sani
as, or less <than i tem
B1, you havr. met.the
Intent of SaC b006 (c
? .. . .
*e=-'i5
.
, Px r1ar-?Snvelopo Average "?°=Computation '- -?a9e:Z_of 4
--- _ -=- - - -: _- _ - -,_
. •
. ,_
•? . ,.?; ,
+'i .. . . y . . , . ' .. : '- . . . .
,.
. . . . . . . ..TT` .. . _ . .._ _..
. r . . . . .... .a_ .... i ..-._:,
- Total exposed roof/ceiling area = ? -
m. 7bta1 skyliqht area ............................ ?
n. Total roof/ceilin, framing area (avcraqe 108)... , Q4
o. Total net insulated roof/cciling rirea........... a?
1/-.7«-
- Determine "U" value for oach roof/ceiling segment
M. - _ X uUn _? - a
n. - fpe a ,?u-
o. 13(o_ X „U„ oL
,
a ............................ lbtei = . zi ,Z
If total'of ,y9 is the same as, or less Lhait 92, you have met the intent of
SBC 6006 ?c) 1.
. . Alternate Buildin Envelope Desiqn - ? To ut-ilize the total envelope 'systen method, the values established by tlie s:un of
itens p3 and #4 shall not be greater than the swn of items fll and N2.
1• + z. Z3 = Z37.S
3' ---??-? + 9. ZI •2 = 2 l fo;?_
I
_..._ ,
l.
11
T:
!'.iy„ •r,.?:
'¢: U:-c a,s of npbciuc wall nrea Lor
? _.
linI114 CGhfitTUCI lun {.pn.:trucl inir_- R-Va1u'1
. . _.._...?? ? .?_.__.. ?
_ _?_--__-(?? -• ?,!?YP.._BD_ ...._.__.-..-_._9?
, " 3. - ,???:i??ti ,. ?i? •..,:,;? ?
?_------ ?- ._.._ -----.._._
._---G7 a.
? ?_p ; • _S.,.D.??r.to _ ?Z
F.r.lcriur air (i;m ^ 0.17
AL[. +Z, Z?7
`. --- `W - !
? ? ?' •°g
F1U. N1 T'GPVI1I7 OF INSUI.-
. FIIAltE HALL 1. Tntrrlor ...'--0.671
?. ?? u-tss24?-------------?3:a
, . • 4.
; .
s. ._ ? r?u??6... _- -- .. __._._ __._.... . .. _...VL
G. ExCcrior air Lilc, • ' ? D.1'1
£IG. 12 q'oCal?
O=IIOrs
.
,-•? 1. ]ntei4iM,itr film U.60
? . ^ •
? ?? ? { ? 2 ------°--- --
.._.?_?,._ • - • JN?+?J...__..3?"8.. J .c
----------:? 3. _zKr.t:? ------
1?-?- ? -----(? 4. ? -? &-
'
,SeaC.A : ?.? - ----•-------?'-?a
"_ _'_`? 5• --.?,?La1Nb_..__ .. _?4rZ
"' i ---? 6. }:xt'r-rlor nir fiJm
??'? ????.Tl?? ?I -----?-------{?? ----- - --Yoc;ol_..1??
?. : .
? r:;, ? ??> ?. v • .. 9
?L Vo
? `?•:':?? U _._...._._..? _....---..__...._.--._._
Qi ? _a 1 r f i 1!:?? 0. C.R
a' 1• _. --- - . _.. .._ -.-. .-
- -- -
L o? n•. ?? }• 1?._?2NG• Et..i: _. ..J,.2$
,,i. , •o. •____.._.__.-{lj . a, Z' _54yva
V . • u k!innp? 5. ---- ?-- - ----
?•.' ., L
..•_
?l`• '?' ? r ?.jj,~' G. I::ctcrirr
•?. . ' -----?-------._..- --------...-----`-'--
-?.-; . ?. , ?IoL:il Z L3
,
, ? .
u •?
.? .
- ----. ._ _ ._._..._...- -- _- ----•--....- i
? . . . • ..
. .C.I?A?F-li? ,, . , , ',, •,, ' . ? r'
?' t' ? .?' ; /f( //??_. /h ? . • s . ' /iiri}':.
f ` ??? ? } • . ? . l(I
v; .
Fil;. 04 /!/
# i ? !(t lC J //(?
. y
1' 1 ? ? • . ? .-- - __' ? 3
? -----1 ;1??•iY:: ?ndi,_ntc Vy?,c, dc??:tli anc4
?. '?.:?' , ... ? ?•?_ ' 1 . . pl.??enr•,iC o( i;;?;?:i..zCton. _
i ?
, ._ ?? ._.__. . :: _ _ . .. .... ...
; . ? . . ._ ? _ .._ _
1 ? -. - - -.- ?,
. :
PLAQ ? 33zs
i, .
? .
? LitmE.4L FT, EXposEp W,4LL
=ULL(?;??
= v l.l. Z. : ?--
_
- 4 RrE '?1AcE ; -
,.
,.,
IZ t t?-t : ,? ( 3-tr ,
SGt . ?T, S1CP05ED WA L,_L AiZ.EA
I' L.OGfC',
137. x, S ' ?eCr
V-Kj EE; 13Z X S-
;, .
?
PuLL l ; 13z X
Fu LLIIIZ ;
Fp '' k =
. , ,.
'??? ? 3 Z- }C ? = ?3z
il -
. ? -
To tA L, = f a I?
?KP OSE--D GEILfUC{ LGx4D = /agp
?? 1N D v11S 1?1 ? D oo izs t?'J
h-4 3' '
38
il! 70(?o t? ? Z s ?ATf o DRS.
135M,4 U+Ur+s
?
_ nno,r•/ceiLZNc
znted
TIG. QS
COD9t? O - _ . _ }?„VAIUC , r:
1. Intc=ior aiT film
2. yi G --f T3P
3. W:524. 44•Oa
;, Extcri.or aii filn (still)- OTT
?- To« 2 4s8a .
. : _ . . • ?_ .02 ' .
Fti.4+rt ? • .
1. Intorlor nir f31m , 0.61
z. G 13p
3- 38.35
d. F:xtetier air Liln (sta.l .
Total
U =?.oZ4..
Heat flov
up •
r?.j?_t?-r;.v?:^??"??, `?,.??y_•.,,L"_?JnV.?"1
-- - - -?
? -- - - - -- =-r
/)i???11J?1! 'll,.llll??.'IiUl.l!J?!'rl_?1111,
.-
?
? Y.ecc flov up • 2 -vented
. • TSG_ d6" . _. . ?-. .
Con.y??cvcri mr.__ _
Znsldc air filin 0.61
Z_ .
3. . .
4.
U. 17
S. Outsidc air filin
Total
.?'.C?'1•-? E
2. Inside air filin _ 0:61
.
2.
3. ' . .
4.
S. Outsidc air film •17
Total
. . . . .` -?
J.. Ynside air filin 0.61
2. ' -
3.
4_
5. putsidc air filin 0.17
Tota1
. . . ,,
Note: Uso additional sheets if morc spaco i:
? necdea tor deGails and talcu?ativns.
. , . '
v v '
- ' bQ:7-VINTZA . ? _
' . lteet •
ilov up • '
. ... • . .. -
$Z ._ 27 • ' '•' r
---- ..•....?.?,.... .
_?- --_-
PERMIT
CITX OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
?D
suxLozHe
025893
06/28J95
SITE ADDRESS:
1875 DEER HILLS TR
LO'ic 2 BLOCK: 6
SUN CIIFF SST
P.I.N.: 10-72975-020--06
DESCRIPTION:
B411dlhg.„Permit 7ype DECK
I
Puild3ng 40,rk Type NEW
?a
• ,.
? A;
°
a
,
J
,
y 41-1
y
,
W,av? :fi At'o-.>r?
?vt.r
i
?
? Y
?
m ? y
Y
??smi w
. ?
$3?,'cnR
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
CONTRACTOR:
$30.00
$.50
$30.50
OWNER: - Rpplicant -
FoRSSEae aaeL
1875 DEER HILLS 7R
y EA6AN MN
(612)687-9378
?
T'hsrffby acknowledg:e khaG I have
inftsrmation is co-rra6t4ad agro"O_
Ststates ansl City of EaqAr'n DrdiiP'
APPUCAN /PER ITEE SIGNATURE
. . ? ..?. . ..
CITY OF EAGAN ? -3 ? 50
3830 PILOT KNOB RD - 55122 ?
?j S 7995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681 -4675 r ?
New Construction Reauirements RemodeVReoair Reauiremerrts
? 3 registered site aunreys ? 2copies of plan
? 2 copies of plena (indude beam & window sizes; poured fid. tlesign; etc.) ? 2 aRe survey4 (eaterior addttions & decka)
? t energy plwistions ? 1 energy celculations Tor liealed addkions
? 3 copies of Vee preaervation plan if lot pletted after 717193
mquired: _ Yes No .
DATE: &4ii CONSTRUCTION COST: ?S e-0
DkSCRIPTION OF WORK: - ?S5?M?2 CleCI? ?--r^oU?1? ,?60 ?.
1/ //
STREET ADDRESS: ' 1375 (? JP ? r ?? n"+ ! l5 7 ?' -& 1 ?
LOT ? BLOCK i? SUBD./P.I.D. #: StIeV C(i
PROPERTY Name: 4:?5err?- ?
OWNER u°T Street Address- 1275 ?2e/ I
CONTRACTOR
ARCHITECT!
ENGINEER
?
, i 0
Phone b ? 7 ? ?-2 78""
? !'r4i-/
City: ? H9ff i? State: AN` Zip:
Company: ??nnre- Phone
5treet Address:
License #:
City: State: Zip:
Company: /Ud.vf-- Phone #:
Name:
Registration #'
Street Address,
City:
State:
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information fs correct and agree to comply with all
applipble Stafe of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
?•
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Pian Received
i
i
_ Yes _ No
_ Yes _ No
Zip:
-
??CEVED
J U N 2 0 t99§
---------------
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
0 02 SF Dwelling ? 07 4-plex
0 03 5F Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
0 05 gF Misc. 0 10 = plex
WORK TYPE
aB:? 31 New o 33 Alterations
0 32 Addition ? 34 Repair
GENERAL INFORMATInN
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging o
0 12 Muki RepaidRem. o
? 13 Garage/Accessory o
0 14 Fireplace o
,,,2415 Deck
? 36 Move
0 37 Demolition
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Basement sq. ft.
Main levei sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Permit Fee
SurCharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
SMI Surcharge
Treatment PI.
Road Unit
Park Ded.
Traiis Ded.
Other
Copies
,?-f
Total:
MClWS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code. ?/3y
SAC Code o/
Census Bidg
Census Unit
_ Engineering Variance
Valuation: $ /ZOO
% SAC
SAC Units
/ n '7 r'
I v i..+
C. R. WINDEN 3 ASSOCIATES, INC.
LAND SURVEYORS TO1 645•8648
1381 EUSTIS ST., ST. PAUL, MINN. 6510e
FOR:
KEY-LAND HOMES
N
Scale: 1" = 30'
O Denotes Iron
t4onument
COSe?n; ? ?. l
'91 0fl /i "y
4 `
? 10
Z ?
9
r
Lot 2, Block 6, SUN CLIFF FIRST
ADDITION, Dakota County, Minnesota.
EO?
?
?t
'0e
?
2
WE MERElY GERTIfY THAT TNiS IS A TRUE ANO CORRECT REPRESENTAiION OF A SURVEY Of THE
lOUNDARIES OF iME LAND A60VE DFSCRI6ED AN D OF THE IOCATION OP All 6UIlDINGS, IF ANT,
TMEREON, ANO ALl VI516LE ENCROACMMENTS, IF ANY, FROM OR ON SAID LANO.
Dotod thi, 16?k der oF_ma- A.D. 1985 C. R. WINOEN d ASSOCIATES, INC.
Ho?.SC Gxolec? ?u/yB, /985?e?? ?J?o ? ?/..?+c.?
br .
Svrrayor, Minnowta Raqisfrafion No. 772?
- /.i
Dror'?°9e ?1 ?t°? 6?? I /
?
?
,
?
I
\
4 ` ly11-
N
O
~ Do ? CP,? iO
s
1 G'J g6 ? 11'i Jj vt
i
PERMIT
CITY OF EAGAN
3830 Piiot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT TYPE:
Permit Number:
Date Issued:
1875 DEER HSLl5 TR
LOT: 2 BLOCK: 6
SUN CLIFF 1ST
P.I.N.: 10-72975-020-06
azwsa a-
BUILDING
025894
06/28/95
DESCRIPTION:
A.G. POOL
ermit Type SWIM POOL
da_rlc, TYPe NEW
?',
?. x IT
";., `? ...
m
-,r`.r?yWK px?i
`e 1 x Yg?y???
?y
REMARKS:
SEPRRATE PERMST REQUIRE? FOR ELECTRICAL WORK
FEE SUAAMARY:
VALUA7ION
Base Fee
Surcharge
Tota1 Fee
CONTRACTOR:
$1,500
OWNEFI: - Applicant -
FORSBERG JOEI.
1875 DEER HILLS 7R
EAGAN MN
(612)687-9378
?
Z here;by ackn;uwJ,edge that T 1have read this .ap;pl,i,o-i
infarmation is corr'ect and agree° iCa compiy ,u3tP? aj
St,atutes and:City of° Ela gan dretina-nces =
?
PPIICANT/P qMl SIGNATURE (
_ ..+
$48.50
.75
$49.25
J
the
? Ain;.
c
--? G? cinr oF eacAN d S
3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) C,rl
681-4675
New Canstructlon ReouiremeMS RemodeVReoair ReauiremeMs
? 3 repistorod site aurvays ? 2 copies ot plan
? 2 copies of plans (inGude beam & window sizes; poured fid. design; etc.) ? 2 sRe suneys (exterior atldRions & decks)
? 7 eirergy celwlatinns ? 1 energy wlwlatioire for heated addkfons
? 9 copiea o( tree preeervation plen iF IM platted after 7/1/93
mqulred: _ Yes No
DATE: / CONSTRUCTION COST: ")Z) ' CD
DESCRIPTION OF WORK: -? ?/57H ,I? ?Do U[' ?r ?a r4NC1. 1?? ?
?TREET ADDRESS: I? 75 D P, ef ;
LOT ? BLOCK SUBD./P.I.D. #: Su^j
PROPERTY Name: -Pn fs b P,v"? Phone #:
?. ,
OWNER .,.
(
Street Address?10 ?5 Deei
City: State: Zip:
: ?MG -tv
CONTRACTOR Company: N0 Ne, Phone #:
Street Address:
City:
ARCHITECT! Company:
ENGINEER
Name:
Phone #•
Registration #*
Street Address•
City:
Sewer & water licensed plumber:
change are requested once permit is issued.
License #:
State: Zip:
State: Zip:
Penalty appiies when address change and lot
I hereby acknowiedge that 1 have read this appliption and state that the information is correct and agree to comply with all
applipble State of Minnesota Statutes and City of Eagan Ordinances. ? -7 'i
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes _ No
_ Yes _ No
? ( /
1? i
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish
? 02 SF Dwelling o 07 4-plex ? 12 MuRi RepaidRem.<=aC 17 Swim Pool .9n,?r C<????
? 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Faciliry
0 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Misceilaneous
o OS SF Misc. ? 10 _-plex o 15 Deck
WORK TYPE
6f ie:?31 New o 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENER4l. INFC)RMA?'ION
Const. (Actual) Basement sq. ft. MCNVS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprink{ered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. O S
Depth Footprint sq. ft. 5AC Code 61/
Census Bldg /
Census Unit O
APPROVALS
Planning Building Engineering Variance
Pertnit Fee
Surcharge
Plan Review
License
MCNVS SAC
Ciry sac
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
?
Vaiuation: $ ?SOo
°k SAC
SAC Units
/R 7S '
I C. R. WINDEN 8
/Q,Q??
,?1`??? LAND SURVEYORS
V 1381 EUSTIS SL, ST
FOR:
KEY-LAND HOMES
ASSOCI/1TE5, INC.
f&l 645• 3648
PAUIO MINN, 63108
N
Scale: 1" = 30'
O Denotes Iron
Monument
C Ose?n t '?? c. l
rn
?
ro;na9? ? ??5' 31 E /
/ ? lJ '164
? ? c°„ 22 r ZO AP? ?
1 0
Z ?
ir X"O
? ?C
,A ?
?
r
4 0 ? r? --
,ao?
1 s
o
3 ?'a
Y? i /
, '(:9 040
? i
0 ?E
ri5
/ N
M
/ q)M ?/53
(0 e
?
2
io
Lot 2, Block 6, SUN CLIFF FIRST
ADDITION, Dakota CountV, Minnesota.
WE MERE6Y CERTIFY TMAT TMIS IS A TRUE AND GORRECT REPRESENTATION OF A SURVEY OF THE
lOUNDARIES OF TME LAND A60VE DESCRISED AND OF THE IOCATION OF All 6UIlDINGS, IF ANY,
THEREON, AND ALL V1516LE ENCROACMMENTS, IF ANY, FROM OR ON SAID tAND.
Dotad this 164k doy efMQ?j A.D. 1985 C. R. WINOEN 6 ASSOCIATES, INC.
Noci.x Loca/ed ?u/cJ. B, /985?-e??
by J-_? 1 //?,Y &'?
Sur.ayor, Minnesota Raqittrotion No. 772/--
/89 - /¢
PERMIT
C1TY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: BurLozNG
Permit Number: 0 3 2 9 3 2
Date Issued: 0 8/ 17 / 9 8
SITE ADDRESS:
P.I.N.: 10-72975-020-06
DESCRIPTION:
--;
,. . _.,.._..
i
REMARKS:
FEE SUMMARY:
1875 pEER HIL4S TR
LOT: 2* BLOCK: 6
SUN CLIFF 1ST
REROOFf STORM DAMA6E
Bu;i'1dTng,,Permit Type STORM DAMAGE
B,uilding Gfa,rk Type REPAIR
Censys Cqde434 ALT. RESIDEN7IAL
l?Gf"tC H??I??ryG ? Hppi118950040 20139140 CHRISTIANSON pRVE
1444 CLIFF RD E 1875 DEER HTLLS TR
BURNSVTLLE MN 55337 EAGAN MN 55122
(612) 695-0040 (651)688-3423
I hereby ecknowledge that I have read this appiication and state that the
information is cprrect and agree to comply with all applicable State of Mn.
Statutes end City of Eagan Qrdinances.
APPLICANT/PERMITEE SIGNATURE (JSSUED eV: SIGNAT RE I
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122
681-4e75
New Construetion Reauiremants RertrodeVReoair Reauiremenfs
? 3 registered ade surveys
• 2 copies af plans (inGude Eeam 8 window s¢es; poured fnd, design; etc.)
? 1 energy plculations
? 3 copies of tree preservation Dlan if IM pWCed aRer 711/93
raquired: _Yea _ No
DATE:
DESC ION OF WORK:
STREET ADDRESS: i q ?5 D?Q re-- 11 I II S -T?-> L
LOT: ?-- BLOCK: ? SUBD.IP.I.D. #: 'S lk v`
Name: C4f'?M!!Ibn Phone#: LO9D
PROPERTY Cast First
OWNER Street Address: 12 75 ?P(P? 1'7 1 I15 ` e!
City State: mn) Zip:
Company: ZZ-
` Phonefl: M6-60yD
CONTRACTOR /'
Street Address: Q. License # 2 0 1.?1 /? ?-( '`7 D
City r) Lag 11 r` I I? State: 10 Zip: ?H?? 7
ARCHITECT/
ENGINEER Company; Phone
Name: Registration ff:
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address chang
and lot change is requested once permit is issued.
I hereby acknowledge that I have rd this 9ppliption and state that the infortnas on i; correct and agree to ?Ompiy ? II applicabl
State of Minnesota Statutes and Ci of Ea an Ordinances. ? f
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
qz 79
?
-I ' I[?
2 copies of plan
2 site surveys (extericr adddions 3 decks)
1 errergy calculations for heated addkions
CONSTRUCTION COST; y y 39 JI
hr•
., ?.
1 Tree Preservation Plan Received _ Yes _ No _ Not
City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
r
For Office Use
Permit #:
Permit Fee: 10 5 .aS
Date Received: S)33 f
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Resident/
Owner
Name: Ke\%i f 'J l) Q 11Y-1 Phone: 651- 3C6 - 97.Eq
Address / City / Zip: I q 7 5 Pte- — /L . IPA) L 1 EM --1)-1\I 5_ 5%c
/
Applicant is: ' Owner Contractor
Type of Work
Description of work: V-- S 1 1 W NS(-
Construction Cost: Multi -Family Building: (Yes / No )
Contractor
Company: Contact:
Address: City:
State: Zip: Phone: Email:
License #: Lead Certificate #:
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 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. 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.qopherstateonecall.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 State Building Code must be completed within 180
days of permit issuance.
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Applicant's Printed Name
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Applicant's Si
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