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1625 Donald CtGEO. SEDGWICK HTG. & AIR COND. CO. - HOUSE HEATING TEST RECORD ? _ 9 7_07 ADDRESS 1(0?% .lg?`l?,v CAn., ? CITY OCCUPANT OWNER HEAT LOSS DATE HTG. I ST. SOLD BY INSTALLED BY- Electrical Work By Gas Line By TYPE OF HEAT GA_ FA HW_ STEAM_ SPACE HTR._UNIT GAS DESIGN MAKE Model Serial INPUT THERMOSTAT Valve Limit Limit Setting Fan Setting _ Pilot Type - Pilot Make - Pilot Model Pilot Timing. L.W. Cut Off MAKE OF BURNER Model _OTHER_ CONVERSION Max. BTU Rating - MAKE OF FURNACE Model CONTROLS eat Plug Vent Size KIND OF LINER SIZE NONE Draft Hood Regulator =s Filters Size Nu Chimney Location Insid Outside Chimney Construction C ,411 Pressure 41 Percent CO2 Input CFH QQp Percent 02 Stack Temp. Percent CO Smoke Bomb Wiring Draft Test Tag - Door Pressure Lighting Inst.. 1;1 Date Tested Company Testing Name of Tester Form 235 GEO. SEDGWICK HTG. & Al R COND. CO. / n p4 HOUSE HEATING TEST RECORD ADDRESS 110Ml A-INXX CITY. OCCUPANT- HEAT LOSS SOLD BY electrical Work By TYPE OF HEAT t GA DESIGN MAKE Model Serial INPUT CONTROLS THERMOSTAT 7 Heat Plug Valve Limit Limit Setting Fan Setting Pilot Type Pilot Make Pilot Model Pilot Timing - A,6Z,2- '? L.W. Cut Off'/ 7Pressure - Percent CO2 J.. Input CFHin Percent 02 Stack Temp. -z? Percent CO Pw" Q MAKE OF BURNER _ Model Max. BTU Rating - MAKE OF FURNACE Model i• Vent Size KIND OF LINER SIZE NONE Draft Hood Regulator Filters Size Num Chimney Location Inside Outside Chimney Construction __g 4r? , Smoke Bomb Wiring Draft. Test Tag Door Pressure Lighting Inst. Date Tested Company Testing S , Name of Test , CONVERSION Form 235 N2 5397 BUILDING PERMIT APPLICATION Receipt # / ` - To be used for SH Duplex Est. value 38,000. Dote 9-10 , 19 79 Site Address 1625 Donald Court Erect KJ Occupancy R3 Lot 19 Block 1 Sec/Sub. Cameron Court Alter ? Zoning R2 Parcel # Repair ? Fire Zone 3 Enlarge E] Type of Const. V W Name C8Si12TOI1 Development Move ? # Stories 3 Addr ggss 715 Raymond Ave. Demolish ? Front 24 ft. o L. CI d Phone 646-8643 Grade ? Depth 40 ft. p Name Same Approvah 1 Fees ut13 Address t ran, Name _ Address I hereby acknowledge that 1 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. Signature of Permittee A Building Permit is issued to: CORlerori _ 10 all work sholl be done in adanc ith all-11'a licable State it Building Official 2z_? > CITY. OF EAGAN 3795 Pilaf Knob kaad Eagan, MN 55122 PHCNEf 4548100 Assessment - Water & Sew. Police Fire Eng. Planner - Council Bldg. Off. _ APC Permit y"..,., Surcharge 19.00 Plan check 55.25 SAC 525.00 Water Conn. 270.00 Water Metqr 60.00 Road Unit 75.00 Total 1,114.75 on the express condition that Statutes and City of Eagan Ordinances. CITY OF EAGAN - 3795 Pilot Knob Read Eagan, MN 55122 - NO 5398 PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt # To be used for Duplex Est. value 38,000. Date 9-10 19-7-9- Site Address 3 1627 Donald Court Erect r] Occupancy R3 Lot 20 Block 1 Sec/Sub.Cc-arer°n Court Alter ? Zoning R2 Re air ? Fire Zone 3 - Parcel .# p Enlarge ? _ Type of Const. V W Name Cameron DeyelO7;Awnt CO. Move ? # Stories Address 715 Raym ond Ave. Demolish ? Front 24 ft. ° C; St. Paul phone 646-8643 Grade ? Depth 40 ft. o Nome SatCe Approvals Fees Address Name _ Address I hereby acknowledge that I hove 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. Signature of Permittee - A Building Permit is issued to: all work shall be done in acco Building Official _ Cameron Assessment _ Water & Sew. Police Fire Eng. Planner Council Bldg. Off. - APC Permit 11U.DV Surcharge 19.00 Plan check 55.25 SAC 525.00 Water Conn. 270.00 Water Meter 60.00 Road Unit 75.00 Total 1,114 75 on the express condition that Statutes and City of Eagan Ordinances. CITY OF EAGANN C? Include 2 sets of plans, 1/ I BUILDING PERMIT APPLI TION 1 site plan w/elevations 6 1 set of energy calculations. To be used for S; ?e Valuation ?, 6n!. Date i, Site Address / i2.S D., ald' 0411,,7 OFFICE USE ONLY Lot __L12Block Sec./Sub. .,,ova., Lea?? Erect Li Occupancy Parcel U Alter Zoning Owner: 'Ov6 n F?erio.`t lJmQu 7'( "? IL Address: Phone #: Contractor: (!?? Address: Ae, ,/ Phone #: /z1 - e4g3 Arch/Eng.: Address: Phone 0: Repair Fire Zone Enlarge Type of Const. Move 9 Stories Demolish _ Front ft. Grade Depth =/n ft. Approvals Fees Assessment_ Water/Sewer Police Fire Eng. Planner Council Bldg. Off. Permit //. Surcharge Plan Check SAC Water Conn. 70 Water Meter fs - Road Unit 7.5'? TOTAL I / 4' r' Include 2 sets of plans, CITY OF EAGANC) 1 site plan w/elevations & BUILDING PERMIT APPLICATION 1 set of energy calculations. To be used for S/` _ ?'s Valuation ' 3 nC%: Date -13 Site Address %6 '2 - Lot Block / Parcel S? 7 r Id Ota,. Sec./Sub. (^ fn,?r?/?H Ceu.? gC e??v Owner: ( ??s?P?aN. / pro%or,ni .71 Address: Phone #: /? Contractor: Address: BLS c? c1 /JCaa/[iv.d'hat- Ne?A /? sv``a?? Phone U: Arch/Eng.: Address: Phone #: Erect Alter Repair Enlarge Move Demolish _ Grade OFFICE USE ONLY Occupancy Zoning Fire Zone Type of Const. # Stories Front ft. Depth - - ft. Approvals Fees Assessment 7117 Permit /hD Water/Sewer Police Surcharge Plan Check t-= Fire SAC !; - Eng. Planner Council Water Conn. Water Meter Road Unit - Bldg. Off. APC TOTAL I 1 This st void 18 months from L-t?=Ct -R D a Date w this Request C ?e l z, 9-7 S 7334 1, as (Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. A,? - A ? 7 &,q,4 -o 01;r-, rite 5 AGi*V Section Township Range CountyK6 7W Which is occupied by l Is a roughin inspection required on this job? No ? Yes I Ready Now ? Will Call'V ??ro ? /7l??CtIFGL, /t'O Power Supplier S/9 ?)O Address ///I_?Lt r/ - SSO rS' Electrical Contractor. ?Contractor's License No./_Y_2J 74 (Company Name) Mailing Address.->ZO5 6 LVftr F?J; 1?14 a < SS / D C7 (El ttrical -Contactor or Owner Making This Installation) Authorized Signature Phone No. 7?( (EI trlcal Contractor or Owner Making This Installation) n ?, ?D n [r' j 1`U This inspection request will not be accepted by the ;? G' u 'J L ?b J tiy1 J? `J State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity t' niversity Ave., St. Paul, Minn. 55$04-Phone 645-7703 aEQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST ?CO ac ? - r `7334 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ? ? Range Temporary Wiring ? Duplex ? ? Water Heater Lighting Fixtures 19 Apt. Bldg. ? ? ? Dryer Electric Heating ? Commercial Bldg. ? ? ? Furnace Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ? Farm C] E] 0 ppList hersl List hersi Other - O ? ? _,.. He re He re COMPUTE INSPECTION FEE BELOWI)' Service Entrance Size: # Fee Feeders&Subfeed Fee Circuits: # Fee o 100 Amps. cK- / .00 0 to 30 A 0 to 30 Am eyes 101 to 200 Amps. 31 to 100 A 31 to 100 Amperes , Above 200 Amps. Above<) ps. Above 100 Amps. Transformers Rem te- trol uc. Partial or other fee Signs Special Isis tion Minunum fee $5.00 Remarks 'n//?? 6 -li cHA/?' TOTAL FE ' S=+ L I, the Electrical Inspector, hereby cc at ffa? ve ion has been made.<G 30 7f?' (Rough-in) (/cJ u/? Date 0 /d = ? (Final) Date This request void 18 months from CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE' - 19 RECEIVED AMOUNT I & -DOLLARS loo ? CASH ? CHECK FOR 1 ' YJ/// <+ C FUND CODE YAMOUNT - Thank You ms=s BY- White-Payers Copy Yellow-Posting Copy '.? ''? Pink-File Copy CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEI V 6D • FROM AMOUNT $ I gk DOLLARS 100 ? CASH ? CHECK FOR,`- ?,!! •Gr'? / ?/, .. ' FUND CODE AMOUNT Thank You _ // BY - V U ?N Sc) i 7-47 f aj.I White-Payers Copy Yellow-Posting Copy Pink-File Copy 0 yt?BUILDING PERMIT CITY OF EAGAN 3795 Pilot Knob Rood Eogon, MN 55122 PHONE: 454-8100 Receipt # 38,000. Site Address Lot Block Sec/Sub. Parcel # C yx>rt- t c o Name L-11 ; 1-2`121111""L W _ Address ?? l r? T t ?al O? Name _ 0 0? Address F' ni, Name - Address 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. N0- 5398 Erect (] Occupancy Alter ? Zoning Repair ? Fire Zone Enlarge ? Type of Corot. Move ? # Stories Demolish ? Front ft. Grade ? Depth ft. Aaaeavals Fees Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Permit ZIL Surcharge Plan check SAC Water Conn. nr Total Signature of Permittee I A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official .s Permit # Deft lowed Pam"" Plumbing _ /.S( C Mechanical INSPECTIONS DATE INSP. Rough-In Final Footings 9? 3 r?2DDZ Date Insp. Date Insp. Foundation Plumbing /-] Frame/ins. /- -? Mechanical Final Remarks: '?-/7- 7' .?ct t?l xj AO r 7-;Po ?o? i BUILDING PERMIT 9 CITY OF EAGAN 3795 Pilo Knob Road Eagan, MN 55122 PHONE: 454-8100 Receipt # 38,00( Site Address Lot Block Sec/Sub. Parcel # e, Name W „ we . Z Address s Name _ 0 Address city W Nome _ H 2Z Address 1 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. N? 5397 Erect ? Occupancy Alter ? Zoning Repair ? Fire Zone Enlarge ? Type of Const. Move ? # Stories Demolish ? Front ft. Grade ? Depth ft. Aenraveh Fees Assessment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APC Permit Surcharge Plan check SAC Water Conn. Water Meter Total Signature of Permittee I A Building Permit is issued to: - on the express condition that all work sholl be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Pe It # Daft I=mW P*Mfttee Plumbing /S/ 4 Mechanical /$g 3 INSPECTIONS DATE INSP. Rough In Final Footings Date Insp. Date Insp. Foundation - Plumbing Frame/ins. Mechanical Final Remarks: / I7 / if CITY OF EAGAN 379S Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 TT7 A''TT PERMIT l I-F--74 Date: 125 1iio?ald ?srt Site Address: 1^ 1 Cameron Ccnst Lot Block Sub/Sec. _- Cameron Deael?:t Name 715 Raymanc r`-P-. e Address 5t. Pahl ?4E- 864 City Phone: (-+t sedgWick 11tx?. .AfC Name 10"I "OC i.a Aw. S<vth ddress e o _ City _ Phone: This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eagan Ordinances. OCT," r17M 1 AIR Rl TI No. 1583 1625? Receipt No.: Single Residential Thlalex ?: Multi Res., Comm./Ind. New/Alter./Repair Cost of Installation 2o. nn Permit Fee .5? Surcharge Total done in accordance with all applicable State of Building Official CITY OF EAGAN 3795 Pilot Knob Rood • Eagan, Minnesota 55122 Phone: 454-8100 ?" - PERMIT Dote: 1'x-79 li2? k ?1.' Ccoxt Site Address: ,- 1 Lot Block Sub/Sec.' No. 17-14 Receipt No.: Single Residential Multi Res., Comm./Ind. Name .mr-rot: DPW-lG° New/Alter./Repair. Address Cost of Installation City Phone: Permit Fee ?7t. Paul C. t?)ffrLarl Name Surcharge ddress a city Phone: TotoI This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN 3795 Pilot Knob Rood Eagan, Minnesota 55122 Phone: 454.8100 '`Fjter Softener PERMIT Date: Site Address: Cron Ct. Lot Block Sub/Sec. _- Name sa,:., e Address City Phone: No. Receipt No.: Single Residential Multi Res., Comm./Ind. New/Alter./Repair Cost of Installation Permit Fee 50 Name Surcharge Address 0 v City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with ail applicable State of Minnesota Statutes and City of Eagan Ordinances. Building CITY OF EAGAN Remarks Addition Lot 19 Blk I Parcel Owner Street 1625 Ronald ('ours State Fagaii, /90 -o/ ) Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1975 PAID UND ER P. 10 1 00 12 4 01 STREET RESTOR. J 71 1975 66.41 6.64 10 26-57 A009809 1 17 /80 GRADING . 1 .? SAN SEW TRUNK yG' 1974 26.92 1.12 24 1 15.35 A008809 117180 * SEWER LATERAL, 1974 142.49 11.88 12 ** Sew Lateral /? ? 1974 358.09 18.84 19 119 S9 A008809 1 17 180 ** WATEW MA "Lat 16,1 1974 12 . . * WATER LATERAL/ 1974 19 WATER AREA 1973 PAID UN ER ORIGINAL ARCS ** Storm Sew Lat/ ri 1974 19 * STORM SEW TRK 1,5el 1974 12 STORMSEWtAV# Trunk, 1974 35.15 2.51 14 16.43 A008809 117180 1149.79 A008809 1/7/80 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 71; nn 0/10 179 WATER CONN. 971) ()Q , of BUILDING PER. - If S25-00 15837 10110/7-9 PARK U 7, CITY OF EAGAN Remarks Addition CAMERON COURT Lot 20 Blk I Parcel 930 t Al Owner? W- -? -f - Street 1627 Donald Court State Eagan. as / -? Aao -, it Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1975 PAID UND ER P 10 413 00 12 0 STREET RESTOR. 1975 66.41 6.64 10 26.57 A008810 117180 GRADING STREET S SAN SEW TRUNK {d 1974 26.92 1.12 24 24-9-2 ""55 1 8 * SEWER LATERAL 1974 142.49 11.88 12 85 5 3 A008910 117180 ** Sew Lateral 1974 358.09 18.84 19 119 3q A008810 117180 ** WATEI#N AOW#Lat 1j -y 1974 12 * WATER LATERAL ,2q 1974 19 WATER AREA 1973 PAID UNDE R ORIGINAL F ARCEL ** Storm Sew Lat i 1974 19 * STORM SEW TRK f 1974 12 STORM SEW # A1f# Trk % 1974 35.15 2.51 14 16.43 A008810 1 7/80 CURB & G ER SIDEWALK STREET LIGHT Road Unit 75.00 15838 10/10/79 WATER CONN. 270.00 1 n BUILDING PER. +t SAC 2-1; - Q0 ++ PARK sA"N WATER SERVICE PERMIT A Knob Road PERMIT NO.: IH 55122 DATE: No. of Units: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to Comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: SEWER SERVICE PERMIT Knob Road PERMIT NO.: r: 55122 DATE: - No. of Units: t Donald Court, - "- Address: agree to comply with the City of Eagan of Insp.: Connection Charge: Account Deposit: _ Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: M OF EA"H WATER SERVICE PERMIT ig6 Pilot Knob Road PERMIT NO.: Eagan, MH 55122 DATE: Zoning: No. of Units: :Owner: ;'Address: Site Address: Plumber: Meter No.: Connection Charge: Size: _ Account Deposit: Reader No.: Permit Fee: I agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By D t P id a e a : Date of Insp.: I ns : p. OF EAGAN SEWER SERVICE PERMIT JS Pilot Knob Road PERMIT NO.: 7 Eagan, MN 55122 DATE: Zoning: - No. of Units: Owner: -- Address: Site Address: Plumber- I agree to comply with the City of Eagan Ordinances. P„ Date of Insp.: Connection Charge: o'? -- Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: Date Paid: . .?..,;,. :^. a >i„..aa-? K '_::i:'?.. .:x.+,...:ak ? ..w.. ,:,.v:•:.w?+..r? ., .-srr-.cFrat:?.c?. :.ac ?.+etia. R E 9 G L U T I 0 N CITY OF EAGA7 WHEREAS, a public hearing pursuant to notice was held at a regular meeting of the Eagan Advisory Planning Commission on November 27, 1979 concerning the application of Cameron Dev. Co. for waiver of subdivision requirements under Eagan Ordinance No. 10 covering the following described premises: lots 19 20 B ock 1 Cameron Court WHEREAS, a majority vote of the members of the Advisory Planning Comission, with a quorum being present at the hearing, voted in favor of recommending approval of, such application, and, as attached MHEREAS, a regular meeting of the Eagan City Council, Dakota County, Minnesota, was held on December 4, 1979 at the City Hall at 6:30 P,V!. all members being present except: none NO41 THEREFORE, upon motion of Parranto seconded by, Egan all Council members voting in favor except: none it was RESOLVED that said application for waiver of subdivision requirements covering' the above described premises be, and it hereby is, approved. DATED: December 4, 1979 CITY COUNCIL - CITY OF EAGA7 EXEVTT FP.ON STAVE By; DEED TAX STAVE'S Its Mayor C E R T I F I C A T I O N I, Alyce Bolke , Clerk of the City of Eagan, Dakota County, Minnesota, do hereby certify that the foregoing is a true and correct copy of a RESOLUTION adopted by the City Council of the City of Eagan, Dakota County, Minnesota on December 4, 1979 DRAFTED BY : - `. `- GIT7 OF EAGAVI City Clerk 3795 Pilot Knob Road City of Eagan Eagan, Minnesota 55122 (SEAL) CITY USE ONLY LOT 0a BL I RECEIPT /yTo 6- SUBD?? RECEIPT DATE: 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 Date: (o - 3 - °17 Complete this section only if you are installing HVAC in single family, townhome, or condos that are under construction and are not owner /occupied. • HVAC: 0-100 M B T U S 24.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets (minimum of one required @ $3.00 ea.) • State Surcharge: .50 • TOTAL: Complete this section only if you are remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. L ?J ?4ce furnace fvidmn air conditioning Add-on air exchanger, i.e. Vanee system, etc. Other Minimum fee applies to all remodel or add-ons_of existing residences S 20.00 State Surcharge .50 Total: $ 20.50 SITE ADDRESS: .I (P a S D D h a ?d Cf - OWNERNAME: _GOKCIOh ri ehdl ti° h PHONE #: 4-54--"33+ ''II INSTALLER NAME: W4f ? ?, I-eVS SDIA'-k I k_, d+9 d P f G lhGPHONE #: A 31- 7099 STREET ADDRESS: 14-232, PLLLOck- Ay-- -. CITY: STATE: Mk' ZIP: S57 J,;4 l?nll ?? SIGNATURE OF PEPWITTEE N? ??• ' Gordon K. Hendren •? 1625 Donald Ct MV, A7N 55121-1709 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 c? 651-681-4675 f U New Construction Requirements • 3 registered site surveys showing sq. ft, of lot, sq. R. of house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window saes; poured found design, etc.) • 1 set of Energy calculations • 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE oZ6d ?- - 67 SITE ADDRESS TYPE OF APPLICANT STREET ADDRESS . TELEPHONE #437- °/5Y E C RemodetiRegair Requirements • 2copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate d home served by septic system for additions / \,.?5 UY VALUATION /J iro-o LTI-FAMILY BLDG YY - N FIREPLACE(S) 0 -1 -2 ATEMAAP .5 f `FAX # PROPERTY OWNER ?r'clo/? !-t",vdr-C,/V TELEPHONE# A57 Zo; -Y333y ------------------------------------------ ---------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes. Mechanical Contractor: Mechanical system includes Sewer/Water Contractor: Water Softener _ _ Water Heater _ No. of Baths Air Conditioning Heat Recovery .System Fee: $90.00 I? ?? • t. "F&-, ' $70.00 AUG 0 7 2002 '•L-; ------------------------------------------------------------ ------------------------------------------------------ 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. +? 71.- lld? Signature of Applicant OFFICE USE ONLY Phone # Lawn Sprinkler No. of R.I. Baths Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex K18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn.(4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi X° 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation ?? UU Occupancy R. 3 MC/ES System _ Census Code Zoning City Water SAC Units Ci Stories Booster Pump Nbr. of Units U Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered _ Type of Const J ' Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) _ FinalfNo C.O. _ Footings (addition) _ Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof - Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final - Framing _ Siding _ Stucco _ Stone - Fireplace - R.I. -Air Test -Final Windows (new/replacement) Insulation _ _ Retaining Wall Approved By l 4*9-_ ' , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 3 3 651.681-4675 New Construction Requirement$ • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window saes; poured found design, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan it lot platted after 111193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE F - r7 - O,-a T -s '-10, o 0 Remodel/Repair Requirements s4Y- 1'"?v 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septic system for additions VALUATION SITE ADDRESS ILDQrl Dtgrtca..LA Cj-- MULTI-FAMILY BLDNY TYPE OF WORK K\ %O_t 0 C?oc I? FIREPLACE(S 0 APPLICANT - N -2 STREET ADDRESS I L?a r1 ,, ,,tCC? C CITYSTATEtfrly ZIP 55 TELEPHONE # b5I-Z1SCn-GA&4//CELL PHONE # FAX # PROPERTY OWNER OA4?g L k 21 n 1 TELEPHONE # - ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor. _ Mechanical svsten3 includes: Sewer/Water Contractor: Air Conditioning Heat Recovery System D 15 v Aug Pee: $90.00 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 Applicant `(?1 t 4 1 yYlY'??A 1_'? OFFICE USE ONLY Water Softener _ Water Heater _ No. of Baths Phone # Lawn Sprinkler No. of R.I. Baths Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage 13 10 08-plex AN 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or- N ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 EM. Alt - SF ? 36 Multi /, 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldgr ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy 0) MC/ES System Census Code Zoning City Water SAC Units U Stories Booster Pump Nbr. of Units C7 Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const V-10 Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. _ Footings (deck) _ Final/No C.O. Footings (addition) _ Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof - Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco _ Stone _ Fireplace - R.I. _ Air Test - Final _ Windows (new/replacement) Insulation _ Retaining Wall Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total A Block 1, CAMERON COURT according .o the plat Minnesotan file and of record ffice of the Cour.y Recor:er, Dakota County, t of Lot 20, Bl:xk 1 of :ai.: CA":?OW COURT whi.-h 1 ie$ East -rly of a line d as follows: be,:innit; at a point ?n the r-fh'sai: Lot 20; thence0 0.50 feet Westerly frog the ,Nortnea--t cor::e y to a point on the South line of said Lot :' Jistan` 32 feet 'Westerly, Southeast Berner of sai-- Lot 20 and said li e there terr^•inating. 3 Block 1, CAMERON rO'UR.T, accordina to the olat ther-c,f ?n file and of record ffice of the County RecDrder, Dakota Cou.1ty, 'i.nesota. Excrnt that part which lies East-rly )f a li'te descri,.ed as `o 11;:is: b^_:;inninq at a point orth line of said Lut 20, distant thcraoutholinePo{ eroheaL0` 90 ,hence Southerly f said Lot 20; e+ 2 0.32 feet Westerly, from the Southeast corner of said Lot 20 and said rite rminating. tr:s is a tr.:e and correct lecresental-on of a survey or the tocndanes o' the land at O:e tlescribed and ocatiDn of all buildings d any thereon. and all vsmre 2nroacnrnenis if any. irpm or on said !and This survey Is s " ma a. e o the hoi-er of Bcoy on Cernecltidy on that h a mortgage loan now be'tne eason of sucnFm p?yaaen' Scunde'tst ooe and agreed eP `nmonumen'; nave -Dr(gage or any other rr-lerest acquired oy me and -fQT -"- -aced for the nIIrDOSe of esta Dlishing9 lot ,n es or boundary careers 45 Surveyed by/ this 77 V lea M.....P,liln LrU: ?•: dli...f N.r 13057 . REVISIONS I DESIGNED Bl' 52.00 - 2550 - _ll i^u fq .24.0 a o . SIN O 24.-0 O.. I z D N o .-.- Ln P ^ - rW I Exi;nn•G ; Buicoav6 24.0 0 L 56 52.00 } bl\ 11uKn av1 Gordon Nerl? ren ulla5 DoroAac+_ T-_cx?a,lmtd sst:.l sslaIt MnRTGAGE SURVEY A 3lock 1, caMERON COURT according to the plat thereof on file and of record ffice of the Couc,y Recor'c,r, Dakota County, "innesota. t of Lot 20, Bl:xk 1 of -ai- 'NFt RON COURT vhi-h lies East r'.Y of a line d as follows: beainnii; at a point nn th•: North sali, , of Lot i: Lot 20; thence0 C.50 feet 'Westerly fron the Northea-t corn' 2r 3isn 32 feet 'Westerly, y to a point on the South line of said Lot Southeast corner of sai-, Lot 20 3nd said li e there terminating. 52.00 3 the olat thrr•.nf m file and of record -- - 2550 !FEW C i 20'?? a 3lock 1, MMERON COURT, acccr+inq to Exce Dakota Cou ty, •'i"nesot pt that part c . ffice of the County Reorder, descri: ed as full ::fs: ee ;lnnir, l i q at a poi t 24.0. e :fhich lies Easterly 3f a distant 0.50 feet b!esterl; from the t 20 L Northeast t 20 Io ; l , o pith tine of said id Lot 20; :hence Southerly to a 4'-oint on the South line t 20 id L f of sail Lo and said 1 le • • o sa from the Southeast coif r of sa t Westerly, 32 fee C O r i I o o ,- I . rminating. p , • 1 o N o' - rW : t' Ex r s rwG B vrconvr. and eoy certify that tr•is is a true and correct iepresental:on of a sur+ev of :he to Wtdanos of the land aTh,s sdL.ervscey a noed maa.,r ocanGn of all buildings d any thereon. end all %sro,e emoachments it any, from or on said land Tins connection W,!h a mortgage roan now being placed' on ;he properly and no IrabiI?lY is assumed axcePt 10 the odder of •ortgage o: any other interest acquired oy the reason of such mortgage It is unde,s;ooe an 5 agf a dQTd( nwmer.'s nave laced for!ne purpose of es!aol,shmig ot79 s or boundary Corners AS surveved try _Qcmaiew . --- 13057 O N to • I ?4.0 . I .ii 24.0 ..:. ..4•.. -c. ? 2 56 25.68 - 5E.00 }?11 E1tcV moYt Gordan Nert&ert lua5 porra.la.G+. llaa`1 -?t?Ct. Ecv?an,MtJ SstD. Gmcpr,rni 55 1.1 l RECISIONS DESIGNED BI' ' MnRTGAGE SURVEY For Office Us,.; yam} Clt of Ea Ull Permit 40D el I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 6-,26 Site Address: J t /BAa,1 C Tenant: 6O r%4 ~`/t? e/! Suite RESIDENT / OWNER Name: rt Ile K Je Phone: 35r1. Address/City/Zip: /(E12-5 L2o1t~/1 ('I_ X~e4lrt' Applicant is: Owner -Y Contractor TYPE OF WORK Description of work: /W a.c/c 9 W T 1J Construction Cost: `_/_507_ Multi-Family Building: (Yes / No ) CONTRACTOR Name: s L~ ~ - i ~LC License o265 fV-2-W Address: g-/o7 4- rl / rcc„_e City: S l h °u- State: llt Zip: 33_ / Phone: 915~2-V7_ M2 Contact Person: C' , 0.,-/ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category I Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted 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 maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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. x di, r 4CL ~ ~la. G,eK x JL;~= Applicants Printed Name Applicant$ Signature Page 1 of 3 Use BLUE or BLACK Ink I For Office Use I RECEIVED Permit City o Eapn MAR 0 3 .016 / Permit Fee. (X~ 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I ` I Fax: (651) 675-5694 I Staff: r 2Le-V 014 RESIDENTIAL BUILDING PERMIT APPLICATION ~j Date: 1 Site Address: 16"o 6a~ Unit ~ 3/•°'' Name: Phone: Resident/ Owner Address / City / Zip: /\Ak 4- Applicant is: Owner Contractor f Type of Work Description of work: J~L 0 t~ f'' S ~ r~ GI ✓~7' )4 ~otG L~ ~Z l~- & 0 Construction Cost: ty 0 Multi-Family Building: (Yes / No Company: Contact: r~ i2~[ti Contractor Address: /'~'e4t4 City: t t3~ State: Zip: ~.>d (o Phone: Cl _ O`.~ D l~y-us License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) ay-l;- r /,,;p -7 9 ~'7, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING I 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: -P-lans-and-supportin",ocumentss i nit a be-pub n.-Portions e# the information may be classified as non-public if you provide specific reasons that would permit the City to t 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.gopherstateonecall.ora 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 corn d within 180 days of permit issuance. X ~ t, kt Applicant's Printed Name Applicant's gnat Page 1 of 3 /(c~~j 'Ovl~atjq~ c--/- DO NOT WRITE BELOW THIS LINE 3) (9 SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous f 01 of I-Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition Move Building _ Reroof _ Demolish Interior Y Alteration Fire Repair Windows Demolish Foundation Replace _ Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION A^v 00 Valuation PAW- Occupancy t MCES System Plan Review Code Edition - AM7 SAC Units (25%_ 100%_z Zoning i~ City Water Census Code Stories Booster Pump # of Units f 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 4 HVAC _ Gas Service Test Gas Line Air Test Roof: -Ice & Water Final Pool: -Footings -Air/Gas Tests -Final Framing Drain Tile Fireplace: -Rough In -Air Test -Final Siding: -Stucco Lath -Stone Lath -Brick J Insulation Windows Sheathing Retaining Wall: _ Footings _ Backfill _ Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: , Building Inspector -44 It h^ RESIDENTIAL FEES *is ase ee Surcharge Plan Review Y7 MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Date C!ty of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651).675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Site Address: Tenant: 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 1 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 pI- s. x 1 'I x i it 0/ ftlihte-ACt--- / - Applicant's Printed Name Applicant's Signature �1' ,-ii-' Phone: Name: uvuc 1. �itrxe -'+ Resic�en e Qwne 1 Address l City / Zip: " . aa�.t-A l Milbert Company Inc dba Cullign Watel" Name: ucense #: WC643176 �r; Cif Address: 1801 50th Street East City: Inver Grove Hgts. Contra for 55077 651-451-2241 State: NI N Zip: Phone: Contact: William R Milbert Email: New /�/ Replacement Repair Rebuild Modify Space Work in R.O.W. _ _ _ rTY a 0 r /— _ Description of work: RESIDENTIAL Water Heater Water Softener Lawn Irrigation (_ RPZ / PVB) Add Plumbing Fixtures ( Main / Lower Level) _ Permit'T p Aw Septic System Water Turnaround _ New N:• Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or WaterHeaterand Softener (includes $5.00 State Surcharge) Turnaround* (includes $5.00 State Surcharge) and $5.00 State Surcharge) TOTAL FEES $ $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water "Water Turnaround (add $200.00 if a 5/8" meter is required) $115.00 Septic System New ($10.00 per as built) (includes County 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.Qopherstateonecall.orq 1 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 pI- s. x 1 'I x i it 0/ ftlihte-ACt--- / - Applicant's Printed Name Applicant's Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA121003 Date Issued:03/10/2014 Permit Category:ePermit Site Address: 1625 Donald Ct Lot:202 Block: 01 Addition: Cameron Court PID:10-16300-01-202 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fixtures:replace tub,tub faucet and drain. Alex Barna Po Box 188 Fee Summary:PL - Permit Fee (miscellaneous)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Us Bank National Assoc 200 - 6th St S Minneapolis MN 55402-1403 (612) 802-1865 Sowada And Barna Plumbing PO Box 188 Cedar MN 55011 (763) 444-0292 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA123327 Date Issued:06/04/2014 Permit Category:ePermit Site Address: 1625 Donald Ct Lot:202 Block: 01 Addition: Cameron Court PID:10-16300-01-202 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Heidi M Masanz 1625 Donald Ct Eagan MN 55121 (612) 802-1865 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature