1415 Dolores Lanelu/oo?9?'3 - \V 70 I>O
e
s
2004 RESIDENTIAL BUILDING PERIVIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
- -Telephone # 651-675-5675-- - FAX # 651-675-5694
New Construction Requirements Remodel/Repair Requirements
3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan
(20% maximum lot coverage allowed) t set of Energy calculations for heated additions
2 copies of plan showing beam & window sizes; poured found desig n, eta 1 site survey for additions & decks
1 set of Energy Calculations Addition - indicate d w-site septic system
3 lift
copes of Tree Preservation Plan if lot platted after 711/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date _ 9 / C3 / t- Construction Cost I co . 00
Site Address M ?L I (>Y? l (A ?pJ unitiSte #
Description of WorC(CQ `f ?} (nowr I (? G n
Multi-Family Bldg _ Y _ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner 2
Telephone # &S i ) ucob - C)u (4 3
KMA HUMS N tK V 1CSN,1N L.
Contractor Home Depot Installed Sales
Address 3200 Cobb Galleria Pkwy.Ste. 4200 City,
State Atlanta, GA 30339
- 'p
Telephone #
( )
763-542-8826 BC-20268257
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Category 1
(submission type) Residential Ventilation Category 1 Worksheet
Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
Telephone #
I hereby apply for a Residential Building Permit and acknowledge that the infom
that the work will be in conformance with the ordinances and codes of the City
N If so, 25% plan review
T
is complefe?atid`t
MN
Statutes; I understand this is not a permit, but only an application for a permit, anwc'C oi?is not to start without a
permit; that the work will be in accordance with the approve plan in the case of work which requires a review and
approv 1 of plans.
C1 t ^ p
A icant's Printed Name Applicant's Signature
A NEW BUILDING
_ Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
4.
Installed- -
Siding and Windows
I1M1TE1)'P0WER.0F ATTORNEY
COUNTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sales located at 660 Mendelssohn Avenue North, Golden Valley, MN
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Power of Attorney are
limited solely to the express powers delineated herein and, apply solely to the Work.
This Limited Power of Attorney shall expire and automatically be revoked on the 21 st
day of May, 2004, which date is one year from the execution hereof Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN WITNESS WHEREOF this Limited Power of Attorney is executed this
21st day of May, 2003
11-1) Ji
David .Katz
SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21st day of May, 200
Notary P is in for the State oVGeorgia
My Commission Expires: January 21, 2006
396816A
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 YY?? aA 9-
New Construction Requirements RemodeVReoair Requirements ? D(fiw usaonly
3 registered site surveys showing sq. it of lot, sq. R of house; and all roofed areas 2 copies of plan Cerf of survey32ecdr ?_r Y N
(20% maximum rot coverage allowed) l set of Energy Calculations for heated additions Pres P.,,laa,Racd?,c
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks T?Yee fires RpgF--In. =.N
1 set of Energy Calculations Addition - indicate non-site septic system rsde_Sept System °-.?> ` Yi ._N..
3 copies of Tree Preservation Plan If lot platted after 711193 i
Rim Joist Detail options selection sheet (bldgs with 3 or less units
"
j
Date L 1 1 O Construction Cost 3 11
/
?
Site Address (7r ?S? V n O r-CC q
[? Y11 Unit/Ste #
Description of Work -1 C (]
Multi-Family Bldg _ Y _ N Fireplace(s) _ 0 2
n `(& 1 - `f SG -0'4
Property Owner Telephone # (. )
Gas!-sSa s6 9?'
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category I _ Minnesota Rules 7672
Energy Code Category • Residential'Ventilation Category 1 Worksheet New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the
and
that the work will be in conformance with the ordinances and codes of the City 19artd" ea e o MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans. (?
W CA f1I) e.tS oJ, ec
Applicant's Tinted Name
Applicant's Signa
OFFICE USE ONLY
Sub Types r .
? 01 Foundation ? 07 05-plex ? 13 15-plex tk 20 Pool F? ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. 7? 54 PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
- Footings (new bldg) - Final/C.O.
- Footings (deck) - Final/No C.O.
- Footings (addition) - Plumbing
_ Foundation _ I-IVAC
Drain Tile Other
_
Roof _ Ice & W ater _ Final Pool _?.s Ftgs _ Air/Gas Tests Final
Framing _ Siding _ Stucco _ Stone - Brick
- Fireplace _ R.I. _ Air Test _ Final _ Windows
Insulation Retaining Wall
Approved By: a n Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
I
POOL PERMIT - APPLICATION SUBMITTAL REQUIREMENTS
Address: 14 / hlsl W LS )- n
Applicant Name:
GENERAL INFORMATION
v
o z
.? ?
?
? ?
?
? Applicant - name, address, phone & fax numbers, signature
Property owner name
Legal description and address of property
gel ? ? North arrow, scale 0" = 30' or 40') and date
? ?
L'? ?
? Location and name of all streets adjacent to property
Site Plan drawn to scale showing location of house, pool and other existing or proposed structures
? ?I ? Directional drainage arrows (existing and proposed)
ELEVATIONS
E)dstina
? 0 ? House corners
? 0 ? Property corners
? A, ? On property lines at point of measured dimension to pool (see below)
? .!? . ? If applicable, ground elevation at each end of retaining walls and at wall's greatest height
Proposed
? A ? Finished pool deck corners
? f1f ? Top of retaining walls (if any) and at each different elevation (if it changes)
? ? Pool bottom (or max. depth)
DIMENSIONS
Existin
? ? All property/lot lines
Proposed
? ? Pool
? Z ? Pool plus integrated deck/patio
A ? ? Shortest distance from outside edge of pool deck to lot lines and house
Reviewed:
Name Date
GTORW/Pwl Pe 4ChecklisV06-02-04
Dakota County Real Estate Inquiry
Dakota County Real Estate Inquiry
Data Updated 4!29104.
zDb Select option and click m+ap 1Z,oom In
L&P I. , I?Ili.tr° '1# N d q al?1u 41111 ?
t}
e1
I
Copyright 2004, Dakota
Page 1 of 1
i
Legend
Real.Estate Parcels
® Parcels
® Common. Ownership
M W ater
®. Rnm. Easemerc
? Dedicated RMJ
Choose a search method, enter
criteria, and click Go or hit enter key.
A1'?'EN I,?y
Ouse #:___.. '
ddress:
nn M,
EWER
This application was developed by the Dakota County Office of GIS rr?? r
in cooperation with Assessing Services, Treasurer - Auditor and Property ReCONs DepartrriRnts CJ
EAGAN ENGINEERING DEn
C O Y ry T
T
Click on the Dakota County Logo above to return to the home page
a http://207.171.98.200/scripts/esrimap.dll?Name=webgl&Left=538503.0985&Bottom=214835.4065&Right=538873.3365&Top=215144.... 5/6/2004
WCO-1 iZ
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
a CITY OP EACAFf rrLl l 153 . -25
qZq?? 3830 PILOT KNOB RD • 55122 13ArcYun.rc
851-8814875
New Construction Rearire nrent. ,,y 157.25
D 3 registered site arm" showing sq ft of lot. sq. R. of horse 2 copies of plan
and gll roofed areas f20a'e maximum wt coverage dlowem 1 set of energy cdculations for heated additions
D 2 copies Of pksns (show beam 3 window sizes; poured did design; etc.) 1 stie surrey for exterior additions A decks
? 1 set of energy colcumm
D S copies of hoe preservation plan If W plOted after 7/1/93
DATE: Qq- W- 0
CONSTRUCTION COST: -4 '1115.
DESCRIPTION OF WORK: ieay- ckf and i'f'- r t
STREET ADDRESS: bO[ OVfS L,Cl Y12,
LOT: z BLOCK I_ SUBD./P.I.D. #:. loin View malwy,
:Re Name: P I (? (re r d JaYl l i Phone #: ) A lJ-HJ
PROPERTY Last First
OWNER "
Street Address: 1141 J L) I OYcS Lcy)e,
City E2=9 State: M n Zip: 551 as
Company. L IC LUX Cww? T I rYi rxa-,;' Phone #: 'JZ 86 8 -11449
(area code)
CONTRACTOR
streetAdctreas alIn N RiVP! 1Z cater NY-(,. -- License#2U? ?,Exp. IZc?U)
City B-L1` n u l, I i e State: R.1 n . Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: (
Street Address: Registration #:
city
State:
Sewerfwater licensed plumber (H Installing sewerhyater): Phone #:
Zip.
I hereby acknowledge that 1 have feud this application, state Riot the Information Is coned. and agree to comply with all applicable Stale
of Minnesota Statutes and CRY of Eagan Ordinances.
Signature of Applicant Q CA CA A 4 A ,.A RoIVI.'
1, L)
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation Cl 07 05-piex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Aft - Multl
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. At - SF
? 03 01 of_plex O 09 . 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 04 02-piex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
Q 05 63-piex ? .11 10-ptex pne _Yor_N ? 25 Miscellaneous
O 06 04-plea ? 12 12-plex O 20 Pool ? ' 30 Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition penmit
GENERAL INFORMATI ON
SAC Code # of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INS PECTIONS
0 Stucco/Stone
APPROVALS
Planning Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SAN Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
CITY OF EAGAN
CASHIER: SS TERMINAL NO: 040
DATE: 09/21/00 TIME: 10:52:15
ID:
NAME: MIDWEST CEDAR TIMBEROOF CO
3210 9001 1415 DOLORES LN 153.25
2155 9001 1415 DOLORES LN 4.00
I
Total Receipt Amount: 157.25
CR137776
USER Tn- TAN
CITY OF EAGAN Remarks
Addition ?in View Manor Lot 2 Blk 2 Parcel 10 78200 020 02
Owner 113 lf4 Street 1415 Delores Lane State Eaganomm .5,512.3
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 17-1 1983 31687.77 368.78 10
STREET RESTOR.
GRADING 13-IL-IL . -
SAN SEW TRUNK 6
197 X00
1 15.00 15 Paid
SEWER LATERAL {Q (?c
WATERMAIN
WATER LATERAL 19 U
WATER AREA 5 280.00 CO06567
6-7-79
*Services
- 1-982
STORM SEW TRK (Q -19S2- bb-L.00 37.40 15
STORM SEW LAT 1982 lb
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 5-18-81
BUILDING PER.
SAC 525.00 24707 5-18-81
PARK
t TY OF EAGAN
95 Pilot Knob Road
gon, MN 55122
ning:
Owner:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan
Ordinances.
By
Date of Insp.:
Insp.:
CITY OF EAGAN
379S Pilot Knob Rood
Eagan, MN 55122
2oninn-
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account De
osit:
p
Reader No.: Permit Fee-
l agree to comply with the City' of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
Date Paid:
WATER SERVICE PERMIT
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
-Misc. Charges:
T MA.
PERMIT NO.:
DATE:
No. of Units:
09:24
14955 Oa
Tel
) 891-7011
DATE: May 19, 1993
TO: Tom Colbert/Wayne Schwanz
FROM Water and Land ttanagement
RSs well Permit 4: 93-9090
Nunicipality :Zagan
NOTICE:
The Water and
BL aislist linysted esr-ions or oona
response from your??office witour f
hin
hol3daY8) we will assume that yo
the parm t. Please note that per
the permit applicantis observance
laws and codes. A copy of the we
office when completed.
Fax #: (612) 681-4612
Well Type: dealinq
Reviewer : Farr
the
no
cation for
ication or
mvironmonta,
thheere is no
issuance of
your
WILL CONTRACTOR INFOMTION:
Don Stodola W911 DrLIIL CO.
,?ligation Redd: 05/06 1993
k2 icipated Drilling/Sea ing Date: 05 /19/93 Time: s
WCATTON OF WELL:
.PLS Coordinates , k, k, k, Sec 33, Town 27 , Range 23
Well Location 1415 Delores Lane
Property Owner Lori Ranalds
Well Owner Lori Renalds
PID lumber
HELL INFOMATION:
Diameter 4
Casing deppth
TTotal dspth 300
Aquifer Unconsolidated Sediments
CONMTS:
?uvrY saw. crR. 001 ?
..a/ / I /J? AMYf/ V ?NN 55124
612 891 7031 05-20-93 09:25A)A P001 #38
EAGAN TOWNSHIP
BUILDING PERMIT
Owner .....6.arr/al--- 6-----------------------
Address (present) --- ---- )--.------- l.` ---- ................._......_.'
Builder
Address
DESCRIPTION
N° ].075
Eagan Township
Town Hall
Date ?14./?
Stories To Be Used For Front Depth Height Est. Cos! Permit Fee Remarks
,% LOCATION
Street. Road or other Description of Location Lot Block Addition or Tract
°Z ti7.'t' /vZ
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does if give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that ----------- -------------------------------------- ------------- as permission to erect a....................... ............._......._.........-...-.upon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955. q
_.... ...._.._.. ..............................
...-_...._---°--..,Y.--"`-- n?airman ..?q. of .':""..-` Tnwn Y;:f....:....
Board ?:..._._. Per ----_k 8utldininInspector
Ch
or
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C
_ , ADD-ON FURNACE - o`!<
DATE IV - [? - `13
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
Q t? lug r 1` /5? mg-, Dr(' (
FEES
-6
ADD-ON/REMODEL (EXISTING CONSTRUCTION) $ 15.00
STATE SURCHARGE .50
TOTAL '
16-,50
SIFE ADDRESS: 1511T Z)""';ve'a Gate
OWNER NAME: D el-r. TELEPHONE #:
INSTALLER:
ADDRESS: I `-Z S `7 TL+ et c iii rr ?'p?
CIFY: T r, elm, STATE: ZIP CODE:
TELEPHONE #: fl i d - /i-e- SIGNATURE OF PERMIT7EE
MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3530 PELOT KNOB RD
EAGAN MN 55122
(612) 6814675