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1847 Deer Pond Cir
Use BLUE or BLACK Ink For Office Use -------1 - Permit* City of Eap~ d® I Permit Fee: J I 3830 Pilot Knob Road Eagan MN 55122 i Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 Mi 2011 Staff. 2011 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: 03/21/11 Site Address: 1654 Diffley Rd. Tenant: iBeach Tan Suite PROPERTY OWNER Name: EFH Company Phone: Address / City / Zip: Applicant is: Cromer Contractor TYPE OF WORK Description of work: Add/relocate (6) sprinkler heads for new tenant Construction Cost: $600.00 Estimated Completion Date: 03/25/11 CONTRACTOR Name: Escape Fire Protection License C086 Address: 3020 Centerville Rd. City: Little Canada state: MN Zip: 55117 Phone: 651-771-8874 Contact. Brian Weber Email: briars@escapefire.com FIRE PERMIT TYPE WORK TYPE X Sprinkler System of heads 6 ) New T Addition _ Fire Pump _ Standpipe - Alterations Remodel C7ther. Crther. - DESCRIPTION OF WORK: X- Commercial - Residential - Educational FEES $55.00 Minimum (includes State Surcharge) OR Contract Value $ 600.00 x1% _ $ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge (i.e. a $10,010411,010 Permit Fee requires a $ 5.50 surcharge) $ 55.00 TOTAL FEE 3/4" Displacement Fire Meter - $203.00 $ N/A Fire Meter $ 55.00 TOTAL FEE 'Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 Brian Weber, Project Manager ` Applicant's Printed Name s Signature CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 464-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.ora FOR OFFICE USE REQUIRED INSPECTIONS - Hydrostatic Flow Alarm Drain Test Rough In - Trip Pump Test Central Station Final Conditions of Issuance: 1 Permit Reviewed b Date: / / Use BLUE or BLACK Ink For Office Use j Permit LS -7 City of Eap . Q C-) Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 j Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: j 2011 MECHANICAL PERMIT APPLICATIO7 Date: Site Address: ~ i r, Tenant: D✓hC ~ Suite _57 Pa ~O ~"1 e Phone: RESIDENT / OWNER Name: Address / City / Zip: j jj p7V 1 +'.!G CONTRACTOR Name: 7 r / o Licenge l Address: /,5-0 4 114 , / f- N• City: /VQ•°h Ai State Zip: '~J~~~ 7 Phone: Contact: 5*j b -PC/~ ~ Email: At'A" , L0/Y7 TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: /`e e q e- (f PiA r- 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. \ l RESIDENTIAL COMMERCIAL PERMIT TYPE ><Furnace New Construction _ Interior Improvement Air Conditioner Install Piping Processed Air Exchanger Gas _ Exterior HVAC Unit _ Heat Pump _ Under / Above ground Tank L_ Install / _ Remove) When installing/removing tank(s), call for inspection by Fire _ Other Marshal and Plumbing Inspector r RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x1% $55.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) 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.aophorstatoonecall.org I hereby acknowledge that this information is complete and accurate; that the worts 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 pe ; 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 :5,kv C F -f 0e 4Gi x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground - Rough In -Air Test -Gas Service Test -in-floor Heat -Final Exterior HVAC Screening Inspection s Use BLUE or BLACK Ink For Office Use j Permit #:3 j City of Ea I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 I Date Received: Z2- I Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: S ZZ E{i Site Address: De er -Unit Name: Phone: RESIDENT / OWNER Address / City / Zip: Applicant is: Owner Contractor ptf~ 5Gc C'C' TYPE OF WORK Description of work: SQ. e 6 O d Construction Cost: 3S v Multi-Family Buildtng: (Yes / No ) Company: J i ~ 11 wre S Ucl Contact:4 V~~ L l ✓~l~~l,~ CONTRACTOR Address: 2- o ( EJPj \ A V~ )V L City: C' L&) State: Zip: Phone: q5 ~'5 I z ~ 4~ 1 License d b 3 Lead Certificate Does this project require Lead Remediation? ❑ Yes XNo (see Page 3 for additional information) If no, please explain: v,\ (116 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 _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.cioi)herstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applica 's Si nature Page 1 of 3 . ~7 4 Gi ;-d DO NO THIS LINE T WRITE BELOW SUB TYPES Foundation Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of. Plex Lower Level _ Pool _ Miscellaneous _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Editions SAC Units (25%_ 100%--Y-< Zoning- City Water Census Code i~3 y Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee f ©3 Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA087452 Eagan, MN 55122 . Date Issued: 11/17/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 1847 Deer Pond Cir Lot: 15 Block: 2 Addition: Blackhawk Forest PID 10-14325-150-02 Use Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not acceptable in lieu of inspections. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Lance Rosenberg Inc Linh H Nguyen 13 Westwood Rd 1847 Deer Pond Cir Hopkins MN 55305 Eagan MN 55122--114 (952) 994-8852 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. Applicant/Permitee: Signature Issued By: Signature Address 1847 DEErt POxn rntrrF Zip 5512 2 I.ot '• 6" Blk 2 Sub BLa,.rLUiAwK FO?tEST THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF?'HE FINAL INSPECTION. Date: Yes No Inspector. r Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Pennanentdriveway Permanent gas ? Sod/Seeded grass ? TraiUcurb damage Porch Basement finish (G Deck V Please verify with the builder the removal of roof test caps from the plumbing sysrem and the shuboff of water supply to the outside lawn faucet before freeze potential exists. Contad engineering division at 681-4645 before working in rightof-way or installing undetground sprinkler system. White - City Copy Yellow - Resident Copy Pink - Contractor Copy ? *i o d% . Wer#ificate of CccupancV Wzt4 of ftgaa ??? of joaah% 3*#*Wflan This Cernficate issued pursuant to the riequinments of the Uniform Building Code certifying deat at tht time of issuance this strvcturr was in compliance wrth the variaus oidinances of dre City regulating building construction or use. For the following: ux c?r?o?: SF iY: ew8. Permic No. 26734 pC-P-y Typr 7,mi pishim R.1 Type Const. _VN 'Bawm Aaavw I847 IFE Pm cm8 l.onliryT 14 n? m.rw ,Mggl / .? POST IN /% CONSPICWUS PLACE 3830 Pilc Eagan,IN (612) 68 SITE ADDI PERMIT S EAGAN ?ob Road Bsota 55122-1897 CTI ? IY ? YI 1•1 ? i ::i ' 1 7 O " IV i' lui tb ttf ?ii_i : f UN1 ( PERMIT TYPE: Permit Number: Date Issued: I 1 !'ll AN 110M1 ? a. ?. i r.,t I ? i TYPE OF WORK: I i 1 .1 cs rv! INSPECTION .. . D• , i?nI i"I f:?, ,0tK`,: f'?V' ; h 41 Pt kl IF L ? ,• ? ? J ? I i P•nnn No. I Parmit Holder I Data I Telsphone x I , I ELECTRIC I PLUMBING HVAC I FOOTINGS 1//?? &4 I I FRAMING r, ?/ ROOFING ROUGH PLUMBING AIR TEST J g ? ROUGH HEATING r Y ?f OAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FlNAL BSMT R.I. BSMT FINAL DECK FTG DECK FlNAL IN CITY OF EAGAN 3830 Pilot Knob Road ? Eagan, Minnesota 55122-1897 i (612) 68J-4675 TION RECORD PERMIT TYPE: Permit Number: Date Issued: t+urin1 Nf; d2tsit.*4 06/: ti/9r, .? t 1.(V : i N 3 n i:' Ep 70 f i. SITE ADDR?SS: ,f, l: i,, t? ; ? ? ? i?-? i i?? ? r, t•??r?n ? i r• PERMIT SUBTYPE: 4., I. i ' I F I 101 i N1r", I - F L Y APPLICANT: I ; : I; 1?0 iEI,Mi ? ( fi 1.') t'-" I _(0/ l 1 TYPE OF WORK: V i N A O ?? Permit No. Permit Holder Data Telephone M ELECTRIC PLUMBING HVAC Inspectfon Data Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL ? DECK F7G .,?,,., ?, I? ?/" b ?? L.... „ - , ' ?1V ? 208 m/1 O^ ? OFFI E USE NLY This reqmsl .old 18 monihe Irom validaiion dale printed i^ Pois boO?? ? Uol uja9jg5 5 I PLEASE PRINT OR TYPE Reqmst Dore Roughin inzpMio required2 Yes (] No Inspenion Oiher Thon Raugh-In: 0 Reody Now ? Will Call 11 / 20 / 9 5 (You most mll Ihe inspetlar when reod,) Date Ready: I, [Z licensed confrador ? owner hereby requesf inspedion of the above eledrical work at Job Pddress (Streeq eox, or Rauk No.1 Gry Zip Code 1847 Deerpond Circle Eagan Section No. Township Name ar No. Ronge Na Flre No. Counry Dakota Omupm? Phone No. Ste hAn Homes 681-9777 Power $upplier lddress Dakota Elec YZC Elenriml ConVador (COmpa^Y Name) • Plom Elen. Only? Canhaoar Uanse No. MOnertic No. 1 Mailing Pddreea (Connocbr ar O.m<r Pedorming Inswllmmn) 5 980 Beau D' Rue Drive, Ea an, MN 55122 A.MOnxed SignoNre (Commeor or Ov.ner PeAormlig Insmllall Phone No. 688-6180 EB-OOOOlA-10 6/95 STATEBOAROCOPY-5 N ONSONBACKOFVELLOWCOPY - ?Oa REOUEST FOR ELECTRICAL INSPECTION ?, ?Minnesota Sffite Board of Eledriciry N 1621 Univers'Ry Ave., Rm. S4 8, St. aul, MN 55104 ??Af,? 1 8 G ??' 0* Phone (st2) sa2-osoo // a 11 = t 8ldg A Other: New Addn . . p i R Farm Remod e a r Water Hh. Load Mgmt. 01her: Elec. Heat Tem .$ervice ace ond on the back of me whife copy only. in this s k E 'X' above the work covered by i p s nter remar his request Cal<ulate Inspe<tion Fee - This Inspection Request will not be accepted without the mrrecf fee: Olfier Fee Fee # $ervice Enhance Size fee ? Circvits/Feeders Mobile Home Pork $tall 0 to 200 Amps 0 to 100 Amps Sbeet Ltg./fmffic $ig. Above 200 Amps Abov 00_Amps TronsformedGenemtor INSPEC70n'SUSEONLY TOTAL 50 3 aO 93 Xf l L , . ine tg. mr. Sign/Out , Alarm/Remote Confrol Swimming Pool I hereb ceni ihal I Ins etled the ele cal' elollafi es d hr in on aks amkd IrrigationBoom Roogh-In Special Inspedion ol Fl Investigaiive Fee n TH IS INSTALLATION Me v aF na oeaEO oISCONNECT I NOT COMPLETED WI7HIN 18 MONTHS. ? CITY;OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMITTYPE: BurLoxNG Permit Number: 0 2 8 0 2 4 Date Issued: 0 6/ 2 6/ 9 6 SITE ADDRESS: P.I.N.:I10-14325-150-02 1847 DEER POND CIR LOT: 15 BLOCK: 2 BLACKHAWK FOREST ui,ld.ing>,Permit Type uild'ing4o_5k 7ype ensus Cod!e ar? DECK NEW 434 ALT. RESIDENTIAL } ;aiR ?r? f '{ 1?`?`a.;._ f ;- T { , REMARKS: FEE SUMMARY: Base Fee $45.00 Surcharge $.50 Total Fee $45.50 CONTRACTOR: - Applicant - sT. LzC.OWNER: STEPH-AN HOMES. 16819777 0001457 WENPS KUO 4130 BLACKHAWK RD 114 1847 DEER POND CIR EAGAN MN 55122 EAGAN MN , (612) 681-9777 T heraby acknoAole_dg,e that I bave read this application and state that the infiormatian is correct and agree to comply w'ith all appliceble Stete afi Mn. StatuCes ancE City o?f Esg-an Or`cii-nar[ces. v`?. ?-? /? 1 1(? i n?Q/?? I APPLICANT/PE ITEE SIGN RE ISSUEUBI''?I rUR CITY OF EAGAN 3830 PILOT KNOB RD - 55122 7996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 dew Construction Reauirements ? ? 3 registered site aurveys ? 2 eopies ot plans (include beam 8 window sBes; poured fnd. design; ele.) ? 7 energy calculaHons ? 3 copies of tree preservetlon plan H lol pletled after 771193 required: _ Yes _ No Remodel/Reoair Reovirements ?50UU ? 2 cropies ot plan ? 2 siM surveys (exterior additions & decks) ? ? 1 energy calculations (or heatetl additions DATE: G l7' 1.G CONSTRUCTION COST: Y s"- So oro DESCRIPTION OF WORK: -l ??G4 r r??7 STFjFET ADDRESS: j? y? 1- BIOCK I- SUBD./P.I.D. #: LOT A PROPERTY Name: Phone #: OWNER """ - Street Address• City: State: Zip: CoN7RAC7oR Company: ??-- ' ` Izr+5- Phone #: 7 Street Address: &?/?okli 42 License #: l ?6-;2 City: Ax?? State: Zip: ARCHITECT! Company: Phone #: ENGINEER Name: Registration #: Street Address- City: State: Zip: Sewer 8 water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot i hereby acknowledge that I have read this application and state that the informati is correc? t?n agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY ???EWED Certificates of Survey Received _ Yes _ No J U N S I 1995 Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex 0 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE ?9 31 New ? 33 Alterations 0 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Ailowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acd. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: ? 11 Apt./Lodging ? 0 12 Muiti Repair/Rem. ? 0 13 GaragelAccessory ? ? 14 Fireplace ? ?0 15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq.ft. Building Engineering Valuation: $ 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MCN1lS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Variance =7- l --4L % SAC SAC Units ? CITY'OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: cr-zooq,q BUIIDING 026739 11/20/95 SITE ADDRESS: P.I.N.: 10-14325-150-02 DESCRIPTION: 1847 DEER POND CIR LO7: 15 BLOCK: 2 BLACKHAWK FOREST Bu'ilding Permit Type Bu3lding Wo,rk Type UBC Occupancy . G` Constr:uctinn Type Zoning Building Length ' Building W'idth ` 8uilding stories ,-' ? o? -- , ? _3g"fr'are Feefi - _.; -?- .? 1. W _ . '. 5F DWG NEW R-3 U-1 V-N R-1 64 58 2 2,436 REMARKS: PRV i S& W PLBR - WENZEL PLBG FEE SUMMARY: Base Fee Plan Review Surcharge SAC SAC 8 SAC Units Subtotal VALUATION $1,357.25 $475.04 $97.00 $850.00 10@ 1 $2,779.29 $194,000 MISCELLANEOUS $1,692.50 Total Fee $4,671.79 CONTRACTOR: STEPH-AN HOMES 4130 BLACKHAWK EAGAN MN (612) 681-9777 - Applicant - 16819777 RD 114 55122 sr. Lzc. OWNER: 0001457 STEPH-AN HOMES 4130 BLACKHAWK RD EAGAN MN 55122 (612)6$1-9777 I hereby acknowletlge that'I have resd this infiormation is correct and ayres to comply Statutes and City of Eagan Ordinances. APPLICANT/P SIGNATURE applieation and stat;e that t'he with all applica6le 5tate of Mn. ISSUED 8Y: IG URE ?- J CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) ?,? 681-4675 ? s resistered ene eurveys ? 2 copies W Plan ? 2 copies ot plans (indude beam 8 window sizes; poured fntl. design; etc.) ? 2 sfte surveys (exteria atld8ione 8 dedca) ? 7 energy calculadons ? t energy cakulafions for heated addwons ? 3 topies of tree preaervation plan 'rf lot platted afler 7/1193 required: _ Yea _ No _' 9 `/S CONSTRUCTION COST: ?C?? Qdd DATE: ?? DESCRIPTION OF WORK: STREET ADDRESS: ' /o < i LOT -j L BLOCK ? SUBD./P.I.D. #: PROPERTY Name: Phone #: OwNER urt Iinsr 6treet Address- City: State: Zip• CoN'rw?cTOR Company: /?~'?"5 . Phone #: Street Address: 6 License #: City: State: Zip• - ARCHITECTI Company: Phone #- ENGINEER Name: Registration #• 5treet Address- City: State: Zip: Sewer 8 water licensed plumber: Penalty appiies when address change and lot change are requested once permit is issued. 1 hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ? OFFICE U3E ONLY Certificates of Survey Received Yes NOV Q 2 - 1;.095 Tree Preservation Plan Received _, Yes _ No OFFICE USE ONLY BUILDING PERMIT TYPE ? IV „ .:..,, .a.s'.r•'a": o 01 Foundation o 06 Duplex o 11 Apt./Lodging o 16 Basement Finish ,z"2 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous ? 05 SF Misc. 0 10 = piex o 15 Deck WORK TYPE ?1 New o 33 Alterations ? 36 Move ? 32 Addition a 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actuaf) ? Basement sq. ft. 5-Tf' MCIWS System ?L (Allowabie) - Main level sq. ft. /.9/i City Water ? UBC Occupancy l2-3 4-1 sq. ft. z'?J" Fire Sprinklered Zoning ?- / sq. ft. PRV S/f S # of Stories sq. ft. Booster Pump Length Jp? sq. ft. Census Code. Depth 15°? Footprint sq. ft. 21(3& SAC Code o/ Census Bldg ? APPROVALS ?' 4µ14 Census Unit i ?P 3y Planning Bu ilding E ngineering Variance Permit Fee Valuation: $ r? I O° ?? Surcharge Plan Review A49$A, liflo" f - License MCNVS SAC 16,b 71/ City SAC W C y,r 17 i? ater onn. Water Meter 2X ym 13 K6 - 'z ? Acct. Deposit Zy " f? -? S!W Permit S!W Surcharge 7r 32- ? x zd . 3a /5--- 'T' " Treatment PI. i X 7, s 'J t/ Road Unit Park Ded. 3 ?? '? Trails Ded. 2 ' = Other yX ???f ,lixiy ` ? Copies Zr Y?.?T _- Y! ao K?y '(9 yo Totai: o Z yx s'? "?.'P LF Lv Z: y c A y?3Z (y$ lX % SAC SAC Units 3 K 7, yl z ? I 3 7 3 1 ? - ' ' r r /° /, z 1s - --=- " LOT SURVEY CHECKI.lST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTY LEGAL: Z DATE OF SURVEY: O 2. o LATEST REVISION: 11 ? ? DOCUMENT STANDAROt e?0 13 • Registered Land Surveyar signature and company ?O C) • Building PertnitApplicant 8'13 0 • Legaldescriptlon ? o a • Address O? 13 o • North artow and scale ? 0 C3 • Flouse typa (rembler, walkout, spltt w/o, splR entry, lookout, etc.) ?C E3 • Dlrectional dralnage arrows wBh slope/gradlant % Er' o 0 • Proposed/ebstlng sewer and watet services & invert elevatlon 0- 0 D • . Street nema Q-'13 O • ' Driveway . ELEVATIONS Existlna EY'o Cl • Sewer service Z' 13 0 • Proparty comars Z? 0 13 • Top of curh at the driveway M'C o • Elevadons of any epstlnp adJacent homes Proposed ?O C3 • Garage Door Er' 13 o • Frst (loor l3r' 0 0 • Lowest exposed elevetlon (walkouWoindow) ? Q o • Properly comers ?a 0 • Front and rear of home at the foundaBan PONDING AREA fif aeelirahlwl • Easement line O ? D e NWL . C?-'O O • HyyL o_ 12'? o • Pond # desipnatlon ? ?y 0 0 • Emergenq Overflow Elevatlon DIMENSIONS 13 • lot IineslBearings S dimensions o • Right-ot-way and street width (to back of curb) • d ? ? • Proposed home dimensiona Including any proposed decks, overhanps preatar than T. porches, etc. Q.e, all sfructures requiriny pertnanent foodnps) Or' C3 0 • Show all easements o/ record and any City utllitles within those easements ?? ?? • Setbacks of proposed structure and sideyard setback of adJacent eidstlng sUuctures D 9/ ? • Retaining wall requirements ' Reviawed: N e fD e JuN,t895 . . . . . b s rrE CI71° OF ERGAN DOES i?OT GI ?? ?? i i;E ACCUf1ACY OF UTILI7Y LOCA71 " A s>.'=?'ltt i i=LEVAT10f1S. TH15 D,,`ti? IS hi"F PURPOSES ONLY wrE P F R5 0,sS dS?livG IT SHOt1LD V E RoF Y g HYDRA T ff?rC.qMavTeL7iJON THE 51TE. 6 GA E VALVE IN COM ON TRENCH WYE S- I156 PLAT 350 WYE 6? ° BEND 799'59 S-1+51 - 799.12 EX HYD MH 22 o STA 1+60 . ?\ ro, . ? WET TAf CONNECTION ` 8x 6" 5PL1T TEE Q o? WYE GATE VALVE 2 ? 3 S-1+54 O C? 799.52 ? WYE K 3 Z ? e C S- 0+6 yQ 795.61 \ 9" \ k?p ip SqN m wYE AOe ? Sk'q ? ? 795 723 'N 4.4 ? NF ESTORE ROBIN LANE 0 EXISTING STREET MH 21 :ECTIpN STA 0+00 \ \ ?\ 2331 TYPE 41 MIX \ ? \ ITUMINOUS WEARINGCOURSE ? CONSTRUCT MH 21 OVER ?2 I7YPE 31MIX EXISTING 9', VCP SAN. SWR. BIT INOUS BASE COURSE EX. INV. 792,50 (VERIFY PRIOR ? -? ? ? - 'CL. 5( DIFIED) 100% TO CQN5TRUCTION) CRUSHE QUARRY STONE ? EXIS7ING BITUMINOUS SURFACE ? EX MH DISTURBED BY CONSTRl1CTION ? - SHALL BE RESTORED 10 ORIGINAL ? OR BETTER CONDITION E i ? 7 ? • N ...................? :.........E20...... .............. 1Q....... ...:........... 00..... N • ' ' ? . . . O . . N m . . N F ............. ............. ?"sE"t ?' 'F EFaGF?N DG?'ES P?1G? 1 GU/•`:RMN s ct ? ACiURt'?CY OF :UTILITY LOvATIOPJD' ? . . . . .. .LEVATIO. . . . . . NS. : THIS DATA IS FOR ? ...............................I. .................. . . . . . . `t-;' Ai iO?a PURPOSES 0?!LY Ar?ab. . . . . . vc,ENG IT SHOULD V-r;r-Y THE : 0N THEMTE. : EXISTING GRADE ............................................ ..........:....?.. :. • . . • ..:..... PROPQSED/GRADE? : : ? \ : : . ? • ? x :;. - . .:.....:: .. .:....:..:.........:.......... ? .................................................... .'. ' ? 1 I. . 4 snY tionrtess /S- 1 Sc 2 Family Rcsidential "Cao}:bool:" Mclhon c, ry o(JiLoEri ?7-r ("? I, = ?A I`\) ,s, r i))IC lvfinirnum Critcria: Rim Ioisc H-19 insulation f=ounJ??on ?',indows: Insulatcd E-lazs, I!2" zir spar,c, u-?hxl or vin}'1 fi-amc Lncry doors: 1144 inch soli:l wocnl with st;;nn or bcllrr STEP 1 Window LC, nnar.krca Total'4Vindow & DoocArca In Sq. Fccf PrR'IDOVJS (i,.cludinF Ccundaticn windo•..s): Dimrnsions Qnry. Arca X ' -? ru •' -? ? -?-? -- ? ? L' ? IIfI ? ) - ? X . - L'Cr - - ?, , nJ? x ------ -_? x ?- 1 --- - . -- - y . ? i . ------ --- ---- (Z? -n x -:?' ( x X -- x ---- --- bOORS: i (o ?' X --- - ?-- --- ----- -.1? ?------ lo[al F.rca ot 'V. 'indo:v u? Doors r!'` 7 A =-- Total W.ill in Sq. Pt. \Vall Tolal Pcrirnctcr 1;ciF;Lt rr:i 5"I'L.P 2 C:ilculate arca as :i percent of ?+'all 13px A(window & (loor aita) dividcd by 13ox H(iotal wzll 2r?2) li*ncs 1(?i) cqiizls ILc %vin.low a_^,d door t:rca ,is a pcrccut of wall arca Q3ox C?. i3oxA _i ? ?' - x 1(?= ( ??r l i3 ox T3 ----STI_.l' 3 Dl_sign l"cahn_e-S ,A. S S L= h1I3 (_l` Ol' F1 O?I n:Ar,rr WAr_r_: ?. f.DV.-.NCISDPI<A1.f111G ?----- C?.AT1-y I175t17a:1"tOll ( I2- ?1 t _----"'----? i.f:SS'1-11 ?.1! 1t 5 It-SOIi 1.1GRG __---? VYR7I)0M'S (cxc".p( fouu;laiion uindou;): UFAr-F:iit ? __----'- "-`-- From ihc taldc, dctr_rrninr, ihc Inaxirnuili j? rccn( vrindo?v t (loor arca for ihc dctirn opiions sclcctcd asid cnicr ihc f r=? ) i ----n( u-zll- - ?-- 13oz C rnnst l)( f(_ (li:in rir cqii lI to llr,a I) --- ------ --- f r 1=: Tlie huilding miul nol exceed Ihe maximiun tvindwv and cloor area as a 1; . percenla[,e o( overall exposeci wall area lisled Lelotv for Ille r.oittbinntlon of framing techniliie, lt-valne of insiilation williin lhe insiil:iled ca?•iic, shealhing R-vaLie, and ivinclow i]-(actor. C)llier co:nponenls mnst nier1t lhe requirements nf lhis snbparl. r--- --------------------- ---------- n4Axin1nr,,i Doon Am=-? ,as ,? r'riici:rrr?r???r_,?:?.i i. ?:xrosen Sv:?i_I_ c;,,- It y- i?,?i?,,,• r;-r,I<<<?i tv Framin S a9 - ---05G 0?1 63? STP.NIJARD k-13 It-7 11q?6 ]7.f?9? 21 2 STAIJDARD It-15 ?k-5 129';1 1%.1 iL 10 t;l, 33A 9„ STAH DARD It-1(1 . <lt-5 111 76.O?L ]8 22 S"CATlDAkD It-10 -1t-h 13 18 6 21 25.3;h ADVANCIiI) . It-1(1 1:11-5 1 1 .1';? `17.120.1';L 2A 9';L AnVnNCI71) It-IR [;-5 135"t 192;0 2 ?5 26 _i^t STA1ADARI-) I;-?I I?-5 Il_fi;.. ,1'1Q;,. 79.9 2:3.1';;, STnIdC>ARM It-21 ;:It?S I I.01;1. 11.3:L 2 (1 _1';;1 AI)VANCf:p I:-21 ?_It-S I1.11"1 , ]if.l21.?'::, A() VAt`IClil? R-:?I E:I:S . 1I-0°4 1991L 2l 2C) Subp. 3. Pertnrmance criterin. 'fhc con lbined therrnal lrar?sn,iu?ince ([1??) factors for ?valls , roof/ceilin?;s , a1111 flonrs over iinhea ied spaces rTUi;t l?e li?ss IIi<in nr equal fo: ' A. 0.770 Et2 °I; fnrl?:?alls; 11. 0.026 T3m/h fl' °1' lur rnu(/ccilinI ;s; ancl C. 0.04 Tllii/h 0 °P Fnr Ilunrs. STATAt(1II: h(; § 27EC.Iy f(IS'f: ]8 Slt?36] %670.01110 Ueptnletf, 1!7 SR 2367 ? X? City of Eagan 3830 PILOT KNOB RD EAC}AN, MN 55122 (651) 681-4675 p?50 r,t 1, ?'Ir7 Site Address: 1847 Deer Pond Cir ,(_ ? ? ? Lot: 15 Block: 2 Addition: ??N& \-YO?"' J? Description: Sub Type: Lower Level Work Type: Alteration Description: Census Code: 434 Remarks: P1an reviewed by Craig Novaczyk. plumbingwork. ectrical permit and inspections. I arge - Fixed 0.50 - Fixed 60.00 $6050 T'`t f.IF rr? : r 1.55 90()1 ?ljyfi:? MEF. PUNTJ 321.(] 900:1. :1.i84't' 1;, ?;TINrc ? PERMIT - Owner: Wenpei Kuo 1847 Deer Pond Cir Permit Type: Building Permit Number: EA034907 Date Issued: 03/31/1999 Mn 55122 ind state that the information is correct and agree to comply with all mOrdinances. f's ed By: Signature 1999 BUI3.DING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ? 651-681-4675 z_ ? New Construdion Reauirements Remodel/Repair Reauire C nts ? 3 registered site surveys showing sq. k. oflot, sq. R. o/house ? 2 copias of plan and aff roofed aieas (20% maximum lot coveraae allowed) • 1 set of energy catculations for heated atlditions ? 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) ? 1 site survey for exterior additions 8 decks ? 7 set ot energy calculations ? 3 copies of tree preservation plan N lot platted after 7/1l93 DATE: 9 ? CONSTRUCTION COST: DESCRIPTION OF WORK: STREETADDRESS: LOT: BLOCK: D- V u 0 1'A C-2 ? ?'?e:? ? Phone !l: _ PROPERTY lan F;rsi -'- OV'NER Slrect .9ddress:-/'ry? /C? Gs`'56? Cin - V ------------------- ---- State: `06^ Zip: Phone N: ?---- CONTRACTOR Street Addr s: _!% License #?3-3? __Eap 3= ?d ciq /? --- state: z;p: ARCHI'IECT/ ENGINEER Compan}': { ?C?d Phone t!: Street C,ty Regisvation N: State: '??Zip: 325--/a- -.-;L- Sewer & water licensed plumber (required for new construction oniv): x Penalty applies when address change and lot change is requested once permit is issued. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of OFFICE USE ONLY Certificates of Survey Received _ Yes _ Tree Preservation Plan Received _ Yes _ No _ Not Required' __ ? OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex 13 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling O 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea) ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck O 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ?K 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors )Rr 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove O 45 Fire Repair , D 34 Repair ? 38 Demolish (Interior) ? 42 Reroof GENERAL INFOR MATION A l C 5• J 4134 onst. ( ) ctua t Basement sq. ft. Census Code (Allowable) 5 Main level sq. ft. SAC Code ol UBC Occupancy ? sq. ft. No. of Units I_ Zoning 2I sq. ft. No. of Bldgs o # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Bu ilding ? Engineering 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: Valuation: $ SAC Units L ? s BL a CITY USE ONLY RECEIPT #: SUBD. ?X Cl (? V?r-rC I. (Y? A? RECEIPT DATE: 3?? 1) --34ci y ( 1999 PL[1MBING PEgMTC (RESIDENTUAL) crrY oF EiaenN 3$80 PILOT KNOS RD EAfiAN, MN 551EE (651)681-46T5 Please complete for. ? single family dwellings ? townhomes and wndos when permits are required for each unit ? backflow preventer for underground sprinkler system -------------------------------------------- FIXTURES ------'---------------- EACH -------°----------'-------------'-° # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bafih Tub 3.00 x = Lavatory I , 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drein 3.00 x = Gas Piping Outlet ' minimum - 1 3.00 x = Rough Openings 1.50 x = Water Softener ' for dwellings under construction 5.00 X = Water Softener ? for existing dwelling 30.00 x = U.G.Spfinkler ' fordweliingunderconst. 3.00 = U.G. Sprinklef ' torexistingdwelling 30.00 = Alteretions to existing residence 30.00 Water Turn Around 30.00 - Private Disposal System ' MPC tic. 75.00 = (new and refurbished systems) Private Disposal Systems ' abanaonmenc 30.00 = RPZ (new installationlrepair) 30.00 = STATE SURCHARGE .50 Rem)nder: Call 681-4675 for inspections of water heaters, water softeners, alterations, etc. TOTAL --------------------- ---------------------. _.... ---... ------------------------..... -- --------- • • • - • • ----------. _.....-• ------- --------- - I hereby aGcnowledge that 1 have read this appliption, sWte that the infortnation is mrrect, and agree to mmply with all applipble City of Eagan ordinances. It is the applipnfs responsibility to noUfy the propery ownar fhat the Ciry of Eagan assumes no lia6ility for any damages caused by the City during its nortnal ope2tional antl maintenance activities fo the facilifies constructed under this permit within City prapertyfighbof-way/easement. SITE P,DDRESS: OWNER NAME: INSTALLER NAME: TELEPHONE #: ((65/) 'W - 31A30 STREET ApDRESS: 1'6-4?36 (?11,ri/ d _ &d?h CITY: STATE: ZIP: SIGNATURE (3F PERM .rs 68 CO/PERMI7 EORMSlRPLBG PERMtT (RES) - 1999 L 1,5 BL ? SUBD. 6?0a,rlp , CiTY USE ONLY RECEIPT #: '!?" l DATE: L 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55722 (611) 681-4675 Please complete for: ? single family dweilings ? townhomes and condos when permits are required for each unit x New consiruciion Add-on air conditioning Date: 12-22-95 Add-on furnace Add-on air exchanger, i.e. Vanee system, etc. yL4 =1-1 ? Minimum Fee: Add-on/Remodel (existing residence only) $20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) 2/s6.00 ? State Surcharge .50 j O'rj1L $ 36 . 50 SITE ADDRESS: 184' Deer Poaa circle OWNER NAME: steph-An xomes PHONE #: 681-9777 INSTALLER NAME: xleve Heatina & Air Conditionina STREET ADDRESS: 13075 pioneer Trail `+ITM: Eden Prairie STATE: MN ZiP: 55347 PHONE #: ( 612 ) 941-4211 ? "AOMITTEF- ciTr use oNLY L ? BL o1i RECEIPT #: S/ SUB?Onn DATE: /Ah(p 1995 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? singie family dwellings ? townhomes and condos when permits are required foreach unit FIXTURES -- EACH NO. TOTAL Shower 3.00 x = .Od Water Closet 3.00 x = Oa _U D Bath Tub 3.00 x DO Lavatory 3.00 x = lff-. 00 Kitchen Sink 3.00 x = 3"00 Laundry Tray 3.00 x =-? • d Hot Tub/Spa 3.00 x = Water Heater 3.00 x = ?•DO Floor Drain 3.00 x = ? Gas Piping Outlet * m;nimum -1 3.00 x ?J? Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal ' Dakota Cty. licensa 20.00 = U.G. Sprinkler * home under const. 3.00 = Alterations * to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL G? 3 o SQ SITE ADDRESS: / 8 ? 7 Ag??-?-, .?1e? OWNER NAME: INSTALLER STREET CITY: R' STATE: ZIP: 6' ?47- y PHONE #: ((plp2) N i? -I56_5 lN?DQ-C-SS ? 18`?"t Q?? P4?0 n.kb Q.t 2,64, . Z. ' . ?,? ?.?2,. ?• ?tc°A E?i..oGlL Ef.-, 1a ?- ? de ? ?ti°ri ' Erya' ,' 4? Q s ?Q M1 .,[07 ? t} ZZ,S ?.? d ENGYNEERIII szc N ? ? ? \ c? ? t F?u ??.v? z,, ?.- 1?..1Y QI aJ ' '??.< ? ? ° _ ? z?• ? E A GA N R f V i W E D 5 \/ ? :laS'4$° 3 s ? f I ?fDo?? Sc-O.I.e- o DEt-laT6? tRot?l Mot?.lt?NeEn1T . to ?? nj? ? ?o + ? , ? Vo , 6CP - ?_ ya' N ?p,5,fV7 ,.r . 9 4 II ?f N e :..? m ? Q) ( \., .. ,*111 C. t ?c.L, E f,ae P T1ca" 1..MA ta r' w21 F3l... ?.c. ?-. H Av?i ?t- ?R. E STj DAsG.?TP+ Gc??w1TYg o T A. I hereby certify that this survey was prepared by me or under my direct supervision and that I am a duiy Registered Land Surve,yor under the laws of the State of Minnesota. Ea te: g5? RE'J. ?l-"1(o-9Gi Lei:ey Fi. tp c;il?n _^r Registered Land Surveyo? ?+u. ?--CL +Qd ` ?. j1.-1' - S C. ?i- - ?u.C. t C-C ?kjp ?flS?-. ??'?ra e o I&a i ? l?p? ?d?j?C?Ea-6 i C-::: I... ?j?q•, 2- ° ?'n ? IV r : S' 1-21? ? Stti ;.g ?c ? ?- ' U! 4' ? •r? 5 , f 114 7-u` N ° Pe.?? \ M J c?????, ? ? ? ? S? ? ' _ ?... S ^ ? /?1\lZf?C?t= Q 0 ,=7 16 s \??, ? d i: i? q%, (S-N ? - Y $ >? - - \ kt. Ar P?V,--kQ ?c..b:?? t" ???`?' ?S? ?•C?.t P i 1 ch3? l...C ti ??E ?-l?"T 6? t fZ sat? l?.Ab ?.? a:?. ?4?, "L' !5 P. ?-e^?' A. G. n ? r+ -r Y 9 S hereby certify that this survej was p?????ed ay me 6i° under my direct sup2rvision znd that I am a duly Regis-lered Land Surveyor unde^ the laws of the State of Pr7innesota. ? y.., ,. , • ??fo ?_ ??f GS- ?!/ ??? _----?? r--. _ Registered Lar_d Surveyoi :..,. _C:;•;=" Use BLUE or BLACK Ink For Office UgseQ 41 City of EaEd I Permit S OO I I Permit Fee: I 3830 Pilot Knob Road I /Y_17641 Eagan MN 55122 }Y~ 1 Date Received: Phone: (651) 675-5675 C h-- I Staff: 1 Fax: (651) 675-5694 ! 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: A Site Address: e©~'1 d Tenant: ` Suite RESIDENT/OWNER Name: F)U_4l(~jy, C VC4 ~L v e5; L.G G Phone: ~7 Sod Y 16 "~S Address / City / Zip: t CONTRACTOR Name: 4,, (P i ~~ic I e Pit, 61 b Licensee M 0?? , FY ~ Address: [ l( City: /J• ( ~r State: ~r(1 Zip: 57 S 3 O Phone: r Contact: is Y1 G" Email: TYPE OF WORK - New -4 Replacement _ Repair -Rebuild - Modify Space - Work in R.O.W. Description of work: ."V 11 • C P to f~ G G l /Jl~ 'L u C G t Res-'4"a 2 RESIDENTIAL ho-, K i` *6. ue oU eul Q S W t a r S f~v S PERMIT TYPE Water Heater Water Softener Lawn Irrigation RPZ PVB) Add Plumbing Fixtures C_ Main Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 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.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. ~~)t x RY1VN UP `V6Ar( e, x " V Applicant's Printed Name App it cant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In _Air Test Gas Test Final Use BLUE or BLACK Ink r For Office Use 1 City of Ea I Permit I I I Permit Fee: I 3830 Pilot Knob Road q, Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: aCkIA-, 1,~Avk~v~ Phone: 612 22-6- 70Y Resident/ Owner Address / City / Zip: {8 "I IP~ P®1`4 1r- Applicant is: Owner Contractor Type of Work Description of work: i Construction Cost: Multi-Family Building: (Yes / No Company: 1 ~ P(- ~1-1JC D ~ Contact: d aS o ~ • 4 'J1ll 0 e, Address: 124 City: t~ O' 1 V A 1e- Contractor j State: MV Zip: 1Z~ Phone: 2~~^ License ~C 3 CI (0 Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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: i Licensed Plumber: Phone: : i Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and suppor ting 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.oopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days- of permit issuance. / x Ci~`t/~ ~i111,✓t L~~`- x v Applicant's Printed Name Appftant's Signature Page 1 of 3