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1255 Dunberry Lane Use BLUE or BLACK Ink r For Office Use City O1 EPermit#I C,f `b 11 I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 9 A)(y @Ck2 Site Address: La.S'. DUA b ~s✓ Catir2. &MA 14P Tenant: Suite RESIDENT/ OWNER Name: { y0 fi N 5 S Phone: IT Address / City / Zip: z ass Le fry L &vt c--, Applicant is: Owner Contractor TYPE OF WORK Description of work: E~t r-asS Vj F nA%.v elk-, A, Yh Construction Cost:4l1(Pgn C)o Multi-Family Building: (Yes / No ) CONTRACTOR Name:~,'~ e vi 0t - License . Address: W6 City: State: Al Zip: -%S t ozo Phone: ©a Contact: ~o h t~ Email: 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 the 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.goi)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 appro I of plans. x Applicant's Printed Name icant's Signature Page 1 of 2 ?• . , _ _ ? .i CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 ! oarE RECEIV6D ? -- / RROW ?? r AMOUN7 $ 1 f • - ,? ?r?.4 . .. ?.-z r; _? & DOLLARfi ,ee E] CASH '---Qt':ti6CK r FOR..... Af [" [ ??. .. -? fl? .` ? .i'?•, - l FUND COUE AMOUNT %l. . z / • } ?J ! . Than You , , B Y i ? 13512 White-Payers CoPY Yellow-Postin9 CoPY Pink-File Capy CITY OF EAGAN /3 8/ k )t 2 Blk 2 Parcel 10 17104 020 02 257 Dunberry Lane stateEagan, MW 55123 Improvement ` Date Amoun[ Annual Years Payment Receipt Date STREET SURF. S7REET RESTOR. GRADING SAN SEW TRUNK 1973 172.92 8.65 20 * SEWERLATERAL a $ 3285.41 328.54 I5 ' -41 17006504 -8-6-79 - WATERMAIN * WATER LATERAL 19$0 WATER AREA 1977 172.92 11.53 15 36 138 Services 980 . * STORM SEW TRK 980 tr STORM SEW LAT 1980 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 150.00 13512 -8-79 WATERCONN. 500.00 13512 -8-79 BUILDING PER, #5117 SAC PAR K cirY oF E?G,nN 3795 Pilot Knob Roed 6egan, MN 55122 N4 5117 PHONE:464-8100 BUILDING PERMIT Receipt # ' Te be aud fee Est. Volue ^'r ^ Dote . 19 . Site Address rI rjp x?zY 1.,?re Ered Q Occuponcy Lot Block . Sec/Sub. ?'t? T?r ?t?l NC?x=. Alter ? Zoning Parcel # Repoir p Fire Zone E l of Const T n orpe ? . Ype W Name Move p # Stories Z .. , 'Yl:?,.r? Address Demolish ? Front t i-:... ;.o V17 ? cn' 4rA-6873 Grade rl DeDth r ft. °C Ncme . . L? . ?. ..? '? ,o o? ?? Assessment _ v ~ Ci ph? Water & Sew. ? W Name Police F i re ?? Address Eng. q W Ci ph? Plonner Counci I I hereby acknowledge that I have read this opplication and state thut the informotion is corred ond ogree to comply with all applicoble State of Minnesota Stntutes ond Ciry of Eogon Ordinonces. gldg. pff. _ A? Signafure of Pe?mittee A Building Permit is issued to: cll work sholl be done in occo Pertnit Surciwrge Plon che,tk. _ SAC Water Conn. 1 'n Water Meter ' Totol ' on the express condition that State of Minnesota 5tatutes and City of Eogan Ordinances. Building Official P?nak # Oeft loued 'undttN Plumbing I3S`$ ?'.;L3- ?9 Mechonical INSPEGTIONS DATE INSP. Rotqh-In Finoi FOOtI?KJS dats INSP. DCfe InsD. Foundation Plumbiny ? - Frame/ins. j Mechanicol Finol I ? Remarks: 2 !• ? ?- L CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612)681-4675 SITE ADDRESS: I ' . 1 ANt C PERMIT SUBTYPE: TYPE OF WORK: lir 1;rr?irf tON 0041 f 1NQ a oN R?coRn PERMIT TYPE: Permit Number: Date Issued: APPLICANT: i :1 i,,;1.t 1 fF,1 ,1 f 4r.4--2410 t41? i i n ?No; ?it?s?.• N` S t?:i 1?I Ft REP A rrz t RclnF.rN?i ! ? Permit No. PertnR Holder Date Telephone A ELECTRIC PLUMBING HVAC Inspaction Dete Insp. Commenta FOOTINGS FOUND FRAMING ROOFING u/ ROUGN PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TES7 INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAI PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG DEGK FINAL - r i I I I CITY OF EAGAN 3830 Pilot Knob Road I Eagan, Minnesota 55122-1897 (612) 681-4675 ? SITE ADDRESS: i rtral i PERMIT SUBTYPE: TYPE OF WORK: v . n ? INSPECTION D. . .• ? ? PERMIT TYPE: Permit Number: Date Issued: APPLICANT: Pertnft No. Pertnk Holdar Date Tslephone # ELECTRIC PLUMBING HVAC Inspaction Date Inap. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL (3YP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG z - ? DECK FINAL ? ? L CITY OF EAGAN ? ON RECORD 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 I SITE ADDRESS: { i,hc PERMIT SUBTYPE: PERMIT TYPE: Permit Number: Date Issued: APPLICANT: TYPE OF WORK: 14r . ;: i; , i ,iH #3U{i I1fNfi 01 16 14 0 '3f .'q I<) r3 RF {'ATR l tl0OF i Nft 1 irni+f" 1 Ni PermR No. Parmft Holder Date Telephone N ELECTRIC PLUMBING ? HVAC ? Inspectlon Date Insp. Commants ' FOOTINGS I' FOUND Ii FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC 7EST INSUL t3YP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ` ORSAT TEST BLDG FINAL i -- --1 BSMT R.I. BSMT FINAL DECK FTG dECK FINAL I 1 - ?--?? CjTy 00 EAGAN 3795 p;w Knob Roud Ecgan, MN 55722 Zoning: , Ovrner: Add, ess: ' Site Address: ,Plumber: Meter No.: t Size: ? Reader No.: ? Ea9pn I agree to eomply wit6 the C+tY Ordinaetes• • BY J Qote of Insp.: -?` WATER SERVICE PERMiT PERMIT NO.: DATE: _ No, of Units: ? _ Connection Chargec _ Account DeP°sit; _ permit Fee: Surcharge: . ? Misc. CFwrges: Totol: Date Paid: , lnsp. SEWER SERVICE PERMIT CITY OF EAGAN 3745 Pilot Knob Rood PE4tMlT NO.: Eogon, MN 55122 DATE: Za?ing. No. of Units: Owner: Adoress: , . - Site Address: . Plumber: ', '?,^• , - I ngree to compfy with the Ciry of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: Misc. Charges: BY Date of Insp.: Totol: Date Paid: , Insp.:- GAN WATER SERVICE PERMIT CITY QF El? 3795 Pilot Keob Roed PERMIT NO.: - Eagon, MN 55122 DATE: r No. of Units: Zoning: -- - .•r - Owner: - Address: - ' Site Address Plumber: Connection Chorge: Meter No.: Atcount Deposit: Size: Reader No.: permit Fee: - I agree to eomplr wilh the City of Euga^ Surcharge: ? ---.- ? -, Misc. CFwrges: O?dinanees. Total: Dote Paid: By ` Date ot Insp.: Insp.: fER SERVICE PERMIT CITIf Of EAGAN SEVI , ? 3745 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: , Zoning: No. of Units: .i,, Y . , _ . . _. . Owner: _ Address: 155 Dunf:,erry . . . T.cm-• _.., Site Address: r7yt?'1 Plumber: - 157% 7, 1 agroe fo eomply wifh fhe City of Eagan Connection Charge: osit; t De A Ordinances. p ccoun Permit Fee: Surcharge: r : i Ch BY ges a sc. M T t l Date of Insp.: a : o ,___ . Date Paid: CITY Of EAGAN cr-'T"PUC,: 1177 t rm ,1TrX?)-7?M . 3795 Pilot Knob Roed ' Eagan, Mienesota 55122 Phone: 454-8100 7;. r: T 447 _ r: 1r,4 " PERMIT No . 5-22-79 ].3913 Dote: Receipt No.: y 255 & 1257 ?? ?" ? T'?' T? 5ingle I Site Address: Residentiol C"??f'f' 161c'ir 1@X I ? X Lot Block Sub/Sec. _ Multi Res., Comm./Ind. Name `ef ? BUDAer-, /Repair New/Alter ? . . ; Address Cost of Instollotion O City ;-p"'La S1A?ley Phone: em+it Fee 4? [? .'?! ? Na e ? Surchorge Address e 0 • . .. City ` . ?_ ` Phone: ` Total .. This Permit is issued on the express condition that all work shall be done in accordance with all applicable Stote of Minnesoto Statutes ond City of Eogon Ordinances. Building Official CITY OF EAGAN . 3795 Pilot Knob Road ? Eogan, MinnesoM 55122 Phone: 454-8100 PERMIT Dute: 5-23"79 Site Address: ' 755 t 1257 ?`?41?2Zy 7aTx- Lot ' Btock Sub/Sec Name °s Address C??L ?7 CIYY `)Y"'?ii? ! ' _ Phone; Na e . Address e City Phone: This Permit is issued on the express condition that oll work shall be Minnesoto Stotutes ond City of Eagan Ordinances. No. 1358 ??? r• t Receipt No.: Single I Residential Multi Res., Comm./Ind. New/Alter./Repoir Cost of Installation Permit Fee atn Surchorge ? Total t done in accordance with all applicoble Stote of Official cIrr oF 9AcnN 3795 Pi1M Kneb Rood Eagan, PHONE: 4548100 BUILDING PERMIT APPLICATION MN 55722 N2 5 117 ReceiDt # X--? To ba utad ior DuplEX Est Volue 79,000. Dute 19,2-- Site Address 1Z55 &12$7 DLll7bPSYY L3ne Erett 7m OccuPencY R 3 h Alt Addn p Zoning R 2 Sec/Sub. C Lot z Block2 P er • - air R ? Fire Zone 3 parcel # 10 17104 020 02 ep Enlorge ? TYOe of Const. V Tollefson Bldrs. Nome Move sm.ies Z 3 HOlyOk2 Av2. pemolish p front 72 N• Address Q 6 p Name $?e z? ?? Address ?- fiw P6one Nome _ Addreu I hereby ocknowledge that I have read this applicatian and stote that the fnformotion is mrrect and agree m comply with all applicable Stote ot Minnemto Statutes and City of Eagun Ordirmnces. Signature of Permittee _ A Building Pertnit is issued to: all work shall be done in acco Building Official Grade ? DeDth 5 ft. ApProvcla Pees qs,essmem Permit 1t54.UU _ woter & sew. Police surcnorge 39.50 Plan check 92.00 Fire SAC 1,050.00 Eng. planner Councii Woter Conn.500.00 Water Meter 120. 00 Road Unit150.00 Bld Oft . g• APC Total 2.135.50 on the express condition thct Stote of Minnesota Statutes nnd City of Eagan Ordinances. This ?ques-4yoid 18 months from ? / ?y Date of this Request__?r- Zf-AZf'7 9 R 66276 I, as picicensed Electrieal IContractor OOwner, do hereby request inspection of the above electri- cal wiring installed at: ? ? ? -), CAAo5?0- (L,4? Street Address or Route No. Section Township Range County Which is occupied by AZ'i?S'?rr? Is a roughin inspection required on this job? No ? Ye&7Pk, Ready Now ? Will CaIIX Powei Supplier ,p ,?A 7? S ?'9'?'P'67 1?3P.?oc9K LANE ?7Ddf1 Electrical Contractor r'9?1fh.110±Uni ` ?+a?cas?¢a4r'Y?di1?l?L?i ?2e 5036 Mailing Address (ElectYltal Contlactol or Owner Making Thls Instaliatlon) Authorized Signature Phone No. (Electr?ical Contractor or O?wpner Making This Installatlon) SV?VE RO??;;rD ??? p? This inspection request will not he accepted 6y tbe uU ? State Board unless proper inspection he is enclosed. Minnesota State Board of Electricity 954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 ^'100"11E0UEST FOR ELECTRICAL INSPECTION CHECK BELOW WOAK COVERED BY THIS REQUEST R 66276 Type of Building New Add. Rep. Check pppliynces W'ved F gk- Check Equipment Wired Fot Home ? ?] ? Range Tempoiary Witing ? Duplex ?? ? er Heate ? Lighting Fixwces ApL Bldg. ? ? ? Electric Heating ? Commercial Bldg. ? ? ? r Silo Unloader ? IndustrialBldg. ? ? ? co BulkMilkTank Farm ? ? ? t ? Lisi Othec ? ? ? R[hers ere Others? flere 1 COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Fceders&Subieedera: # Fee C'vcuits: # Fce 0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eres 101 to 200 Amp . 31 to 100 Amperes 31 to 100 Am res Above 200 , A ps. Above 100 Amps. Above 100 Amps. - Ttansformets Remo[eConUOlCvc. Paztialorotherfee S' ns Special lns ction Minimum fee 55.00 Remazks TT - TOTALFEE ? I, the Electrical lnspector, here,}fy??rtify?fj(?ti abov i spection has been mad .?p?ctJ (Rough•in) Date -? `' - (Final) ? ? •? ? ??? Date This request void 18 months f m- v , . BUILDING PERMIT APPLICATION Telephone 6 & 73 Inalude 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations. 0-_r, -0,7% To be used for Valuation -1 G? site nddress: /"r:;:i"? ,'-?,?7 Lot aiocx sec. /su? Parcel ruwnver /D I J/D ? D?D o a- oZ a ?91? 1 Oamer Address ? y J Contractor nddress ' Arch./Eng. Address Erect Alter Repafr Fnlarge Nbve ' Ilemol3sh Grade .OFFICE USE Aate of Approval & Initial Assessment Fdater/sewer Police Fire Eng. Planner oDuncil Bldq. Off. A.P.C. Telephone Telephone 01 PATE o2 /,3 7 ? . \f OFFICE USE. Occupancy W13 Zoning Fire Zone 3 Type of Const. 7/ # of Stories Fron t 7? Depth FEES Pexmit Surcharge PZan Check SnC ';? r• 5?? Water Conn.,Pff,? S°Iater Meter;V,,,?,' ( O TOTAL ??3s? . ?--- -_ -?5 ??y Tollefeon Buildern Inc. , F. C. JACKSON LAND 6URVEYOR t' R[GIfT6RHD UNC[R LAWB OP 6TATi O/ MINNEfOTA _ LIC[N![D SY ORDINANCC OF CITY OR MINNCA!'OLO 9818 EAST 83TN STREET554II 727-3494 ?.X/'flFt4 ?It'V, ./ i ; t *urbepor'sc QLectiticatr , e Or.10906-' 183 37 A ,lI ? ?' ' '-__ .- _._?• _- ___ . __ _ _ __ ?s . , I ? I a r ? 1 ?. ? ? ? ? - - - - ? ?, . ? ? - --- , r: ? -? jr?`?? --- --- ? _ --,-?^,? _ ? I HER[OY CaRTIFY TNAT TME ABOVE IB A TRIJE ANO CbRRlCT RAT OP A SURV[Y O! 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Cn? s Y I ?C 0 F,t S•f1) A#p ?Jy q??Y rV+?-?++?rr?w ' ? ? •?-.e?--?..•-.-.-?.-. ?? ,,......,:..-.-w- *'^^""-"---"--•..-.,..:...-._...,._..m,??_...._._ , ?..--.... A.........,'a•?..: .:?....d,?..t+.:, ..-'..:. .?.Y,-.?.«?..-?..:d„-?.?-.e-_•:-'..+.a.?. i?.. '-_.?.:.--?--T•-«Y%-..,?..-? ,?-*?E . -,_•.. ???...-...-..'.?.....r. -.-..-ra-.,?...«u.:?._. ri.w?v?ws?wMrw?-, '^.^^y? Y„'ea-:r ? . Fw-t?+v-•+??? , - v?A?....?rr;orw.?.< \ ?20SaO BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EACAN 3830 PIIOT KNOB RD - 55122 $60.50 851-681-4875 NaW co„trucn«, ReaWreffm? Rertadel/Reoair Reaulremenh Calkd 3 1 pp a 3 replsferea alfe wrveys ahowlnp tq. H, of lot, sq. ft. ol houae 2 copies of pian 7 o d antl gff rooletl areas (70X mmclmien bt coveraae allowed) 1 set of energy cdculallons tor MWed adc9HOns > 2 coples of plans (show beam & window slzes; pouretl fnd. deslgn; efc.) 1 alte survey for extedor addiflons # decks > 1 !af ot eneryy CqlCUlallOna > 3 coples d hee preservatlon plan B lof plotted aMer 7/1/93 DATE: _ J -as -'acOQ DESCRIPTION OF WORK: STREET CONSiRUCTION COST: CsJ n7 jUXm, eD LOT:w W- BLOCK: SUBD./P.I.D. A: PROPERiY OWNER lfy Phone g: (1-1(N- Sheet Address: ciy stafa: zIp: 553371 Company: Phone M: (area code) CONTRACTOR Sheet Address: lkense # Exp. CNy tate: Zip: ARCHITECT/ ENGINEER Company: 1?- Name: Telephone M: ( ) p I ?-- Sheet ay stare: Lp: Sewer/water licensed plumber (if insWllina sewer/waterl: '?R°.n0(&?dYi0 &;?YCUf]IM Phone #: /,P- 9Pb -JZ4/ / I hereby acknowledye Ihat I have read this applicaHon, stote Ihat Ihe Womwtion is cortect, and agree to comply wiTh ap appOcable SfafE of Minnesola Stahites and City of Eagan Ordinances. , (? Signafure ot Applicant ?M0. ? M A?CQYI S (\j OFFICE USE ONLY Certificates of Survey Received _ Yes _ No ' ? !J?r? Z$ Tree Preservation Plan Received _ Yes _ No _ Not Required ?4D RegbhaHOn Jf: OFFICE USE ONLY BUILDING PERMIT SUBTYPES .- •, , ? 01 Foundation ? 07 05-plex ? 13 16-plex 0 21 Porch (3-sea.) ? 02 SF Dwelling ? OS 06-piex ? 17 Garage ? 22 Poroh/Addn. (4-sea.) ? 03 01 of _ plex ? 09 07-piex ? 18 Deck ? 23 Porch (screened) ? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Stortn Damage ? 05 03-plex ? 11 10.plex aie9 Y or_ N O 25 Miscelianeous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg. WORK TYPE ? 31 New ? 36 Move Bldg. ? 43 Reraof ? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding )< 33 Aiteration 0 38 Demoiish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors " Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code No. of Units No. of Buiidings Const. (Actual) (Allowable) UBC Occupancy Zoning O? # of Stories o Length t Width Basement sq. ft. Main ievel sq. ft. sq. ft. sq. ft. MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building Permit Fee x Cl.s o Surcharge Plan Review License MC/ES SAC City 5AC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies ToWI: JT 60.5o sq. ft. sq.ft. Footprint sq. ft. Census Code MC/ES System City Water Booster Pump PRV Fire Sprinklered ?(-? Engineering Variance Valuation: $?.'.U0U ? 31 Extan - nnuni O 33 F_xt. AR - S F ? 36 Mufti SAC Units % SAC CCTV i)F [=AGf?N CA':Illf:Ra S 71_Iii1.T.NFi_ N0u r.;!?i. IiATG.;: 03/23l98 l']'.P?F.E: 15r.9.f:,::L2 ?u" PdhM'L-" ? L'Af?OL'r'N ft F'I_U'POIdSK: 32:10 ')(JO:L :i.255 DlJMf+ERG'Y L. 74.75 205 9001 1255 nuNtjr:_,;,v L. 1..50 ; 70'fc?`.:l Rt.Cn7.p` AiTiGlan'I;: 7605 00874[.)1 LI6Efi :CD;i NANCY PERMIT ? y G''1TY OF EAGAN ? 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: BUILDING 031642 03/23/98 SITE ADDRESS: 1255 DUNBERRY LANE LOT: 21 BLOCK: 2 CHES MAR 5TH P.I.N.: 10-17104-021-02 DESCRIPTION: - (ROOFING) ,8u3Idi'n4'°,Permit Type "'reuildi'ng WB=r-;k Type ? Censue G,pd,e -? ,.,.? , ;s . SF (MISC.) REPAIR 434 ALT. RESIpENTIAL ? Ct ?{y` 1 ? p U?*( llwJ REMARKS: FEE SUMMARY: VALUATION Base Fee Surcharge Tntal Fee $74.75 $1.50 $76.25 $3,000 CONTRACTOR: OWNER: _ Appl3cant - ' PLUTOWSKI J03EPH 1255 DUNBERRY LN ? EAGAN MN 55123 (612)454-2470 ? , . ? • _ ? ` '_ ? . I hereby acknowlectgs that Z have read t h i s,application and'sta'Ce that?ih"s information is correct and agree to cQjnply.w:tth'aIf applic'ab`I 6"'St a`ie°(if htrs: -'" n. . ,. Statut,es and City of Eagan Ordinanoes L. APPLICANT/PERMITEE SIGNATURE ISSUED : SI ATU 441 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) -?'? ? • ?.J CITY OF EAGAN 3830 PII.OT KNOB RD 66122 681-4675 New ConsWetion Reavirements ? 3 registered ske surveys ? 2 copies of plans (inGude beam & window saes; poured fid. design; etc.) ? 1 energy caleulations ? 3 copies of tree preservation plan 'rf lot platted after 7H/93 required: _ Yes _ No DATE: ? I ? g ? RemodeUReoair Reauirements • 2 copies o} plan ? 2 site surveys (exterior addkions 8 dedcs) ? 7 energy ealculetions Tor heffied addkions CONSTRUCTION COST; DESCRIPTION OF WORK: R t= ('? oc (= STREET ADDRESS: LOT: ' _ BLOCK: ? SUBD./P.I.D. #: ?Jpd]TJi? , PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Name: PL U Ict-j 54? o- 0 Phone #: 46,q-01 Y?o 1-ast First Street Address: I a S!S N a E JQ-kV I._ +G1 CnY F-i+Es W N State: V"L rv Zip: !?:L 3 Company: 661F Phone #: t-(Sq a LI 7 ? Street Address: <iF} v+,7 §? License # ciIY State: Street City State: r Zip: / Phone #: Registration Zip: Sewer & water licensed plumber (new construcfion ony): . Penatty applies when address chang and lot change is requested once permit is issued. I hereby acknowiedge that I have read this application and state that the infortnation is correct and agree to comply with all appiicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes - No - Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging O 02 SF Dwelling ? 07 4-plex O 12 Multi RepaidRem. O 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-plex ? 14 Fireplace 0 05 SF Misc. ? 10 = plex 0 15 Deck WORK TYPE ? 31 New ? 33 Alterations O 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq.ft. sq. ft. sq.ft. Footprint sq. ft. Building ? I ? ? 16 Basement Finish ? 17 Swim Pool ? 20 Public Facility O 21 Miscellaneous MGWS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance ? Permit Fee 7?• ?J` Vaiuation: $ Surcharge ? Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S!W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units AY. X 1$ $: X( :d<*3$'k C< Y,t ?C >n k iX YF Yn %k ?t: X': rY:;t ?:7k 96 r_rrv or• r:::FlGraN f:ASH:f.E:l;:e S T'EFM:iid!aL. NO: 891 nnri-: 03i24?9E; "(J:NiF_': 16s0058 iLi;; NAtf[:;; WESLIE f3r_'FiNA:CL?f 321(] 9001 1257 BIJNE;rIiF:V 45.75 205 9001 057 DUNLil::RRY 0.70 fai;ai F{ecci'.i.p4, AInUun't: 46.45 CR(:)(37430 UG;[i:P: :I:il;: NANC•/ •k, w;'r#%t:YF)k!Fm?:t7??CX,t?XY„'M'$o%)k`?h4?Y??Y>;?X<.?y>k%F)kritY,C;?%;;YFX( n)k? PERMIT ? CITY OF EAGAN PERMIT TYPE: ? 3830 Pilot Knob Road B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 031684 (612) 681-4675 Date Issued: 0 3 J 2 4/ 9 8 SITE ADDRESS: 1257 OUNBERRY LANE LOT: 22 BLOCK: 2 CHES MAR 5TH P.I.N.: 10-17104-022-02 DESCRIPTION: (R00FSNG) ,$uildino--.Permit Type SF (MISC.) i?Bui?.dimg 'bJ'c;r{c Type REPAIR Cen;sus C.ode 434 HLT. RESIDENTIAL > ? ?. •?? _ .`?>. ? r `.. t' a?.r_... .?. .`??"• REMARKS: FEE SUMMARY: Base Fee Surcharge Total Fee VALUATION $1,400 $45.75 $46.45 CQNTRACTOR: OWNER: - Applicant - SCNNAIDT WES 1257 DUNBERRY LN ' EAGAN MN 55123 (612)890-5935 : e . t .. . . 9 .w... rap .'. o I hereby acknowledge that I have read`th-is applicaCiun a?hch sCat? $ha??he `informatio-n is correot ar1d agr'ae to' camply with° sl`1 appliceble State:- afi Mn. „. ? Statutes and City_o#.Eagan 4rdinanc'es.;? APPLICANT/PERMITEE SIGNATURE ? ISSUE BY: aIG?NPTURk ? ? 1 L5 4 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNOB RD - 65122 681-4e75 mort3-t0 New Construttion Reauirements ? 3 registered ske surveys ? 2 copies of plana (inUUAe heam 8 window sizes; poured Md. design; etc.) ? 1 energy calwletions ? 3 copies oi tree preservation plan if bt platte0 aRer 7/7/93 requireO: _Yes _ No DATE: _cSQ- WKs? 3-2b `1$ DESCRIPTION OF WORK: STREET ADDRESS: RemodeVRecair Reauirements ? 2 mpies of plen • 2 site surveys (exteriar addRions & dedcs) ? t energy caleulatians tor heated addkions CONSTRUCTION COST; ?•?yC?' I vo c t LOT: ?z BLOCK: Z SUBD./P.I.D. #: C??` PROPERTY OWNER Name:SC-`\yv0.iC'.?k- Q d-c?+l tVe Phone #: Las[ First '- Street Address: 12 L?o CONTRACTOR v . City State: Zip: Street Address: City ARCHITECT/ ENGINEER Company: Street City Phone # License # State: Zip: Phone #: Registration #: _ State: Zip: Sewer & water licensed plumber (new cons6vction only): . Penalty applies when address chang and lot change is requested once permit is issued. I hereby acknowledge that 1 have read this application and state that the iniurtnatlon is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. . Signature of AppliaV OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes _ No _ Not Required OFFICE USE ONLY BUiLDING PERMIT TYPE ? 01 Foundation 0 06 Duplex ? 02 SF Dwelling ? 07 4plex 0 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex O 05 SF Misc. ? 10 = plex WORK TYPE ? 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) _ (Ailowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS h ' . ?u ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace O ? 15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Engineering Variance Permit Fee Surcharge Plan Review License MCMIS 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: $ 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit % SAC SAC Units INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: LOT: 22 BLOCKc 2 1257 DUNBERRY LANE SCHNAIDT CHES MAR 5TH (612) 890-5935 PERMIT SUBTYPE: TYPE OF WORK: pECK WES NEW BUILDING 025276 03/30J95 e , r ? LL ,. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-17104-022-02 DESCRIPTION: PERMIT PERMIT TYPE Permit Number: Date Issued: 1257 DUNBERRY LANE LOT: 22 BLOCK: 2 CHES MAR 5TH B%uilding`-P.ermit Type Building Wor,k 7ype .`. y -? . DECK NEW . ,., . ? ._ v.. REMARKS: c:'?.A90x V i Iu BUILDING 025276 03/3@/95 FEE SUMMARY: Base Fee $30.00 Surcharge $.50 Total Fee $30.50 CONTRACTOR: OWNER: - Applicant - SCHNAIDT WES 1257 qUNBERRY LN EAGAN MN 55123 (612)890-5935 I hereby acknowledge that I have read this infioxmation is correct and agree to cornply L Statutes and City ofi Eagan Ordinances. application and staCe that tHe with a11 aPPlioable Statg o.f Mn._ na?n ? 1 rn..? APPLICANT/PERMITEE SIGNATURE 'I ED B: SI ATUR { CITY OF EAGAN ?J??• ??J 143830 PILOT KNOB RD - 55122 LRECiR ?_ 995 BUILDINGPERMIT APPLICATION (RESIDENTIAL) ? ? 681-4675 ..: New Canatruction Reauirements RemadeVReoair Reauirements ??`?I??? ?_?_r ? 3 registered site survays ? 2 copies of plan ? 2 copies of ptans (inUude beam & window sites; poured fid, design; elc.) ? 2 ske aurveya (exterior adddions & decks) ? 7 energy eakulations ? 1 energy cakula6ons for heated additiona ? 3 copies of tree preservation plan H lot platted after 7/1l93 required: _ Yes __ No DATE: _3-6 " q S CONSTRUCTION COST:' /?Go DESCRIPTION OF WORK: Re.'co-2 o1& ze- nL ; i-?I4C-g- axA ?? ??? t??51-`1 STREET ADDRESS: q-0? IlZ O Z' 645Vroas SY`F?Si? ! OT 7-?1 .z- BLOCK Z SUBD./P.I.D. #: PROPERTY Name: 4SIc?nvQb,AA' *37L,1? Phone #: t9Q0`593S OWNER As* FI^a* Street Address:_7 257 T`I",eexv,_ 2-1u City: 54s?QL? State: YF\'Il-?' Zip: CONTRACTOR Company: Phone #: Street Address: License #: City: State: Zip- ARCHRECT/ Company: Jc?o,r Phone #ENGINEER Name: Registration #Strset Address• City: State: Zip: Sewer & water licensed plumber. Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowtedge 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 USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservatlon Plan Received Yes No OFFICE USE OyLY BUILDING PERMIT TYPE Ai 7?; ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish 0 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool 0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility 0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 _ plex af 15 Deck WORK TYPE $r 31 New 4~?? is' ""°- "-- ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) r)dgo.of Basement sq. ft. MCNVS System (Allowable) Main Ievel sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length 7' sq. ft. Census Code. < Depth 19F4 Footprint sq. ft. SAC Code o i Census Bldg _L Census Unit o APPROVALS Planning Buil ding Engineering Variance Permit Fee Valuation: $ 200 ? Surcharge Plan Review License MCiVVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. Road Unk Park Ded. Trails Ded. Other Copies Total: % SAC 5AC Units - -.? - - - -- aa?? ?adwd -. ?p o? . 464 RESIDENTIAL BUILDING PERMIT APPLICATION ? City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Consiruction Reauirements 3 registered site surveys shaxing sq. ft, of lot, sq. ft. of house; ard all roofed areas RemoCHlRMair Reauirements 2 copies of plan f3ffitai3se?v (20% mmimum lot coverage albwed) 1 sel of Energy Calculations for heated additions & d k ddi i 3s?cPt?s Fre9 PresfieqUU2t? 2 copies of plan showing beam & window sizes; poured found design, etc. lsetofEnergyCalwlalrons ec s ons t . 1 sile survey for a Addifion-indlcateifon-sitesepiicsysfem CStr'Si1E?aeiic?ysl0m p 3 copies of Tree Preservation Plan if lot platled afler 711193 Run Joist Dehail Options selection sheef (bldgs with 3 or less uniis Date(Z) Construction Cost lf?? • Site Address UniUSte # l- 1?? 1.1. SSl2 - E?o ?`l Description of Work ^aCC?t(?- Multi-Family Bldg ? Y_ N Fireplace(s) _ 0_ 1 _ 2 ProperlyOwner Telephane#((Gk) Contractor , t ?'?"c1-? ? V ?@?. ?• ? - - Address State City &..2jt?A? Zip 64:F;A lk Telephone # ( 1?,QW&A/o 3?2 ?2 _ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category t Worksheet . New Energy Code Worksheet (J submission type) Submifled Su6mitted • Energy Envelope Calculations SubmiKed Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 257o plan review fee applies. Licensed Plumber Mechanical Contractor SeweNWater Conhactor Telephone #( Telephone #( Telephone # ( n? °i?. ..SZ?? ra?-??a_n? 1" 31•c?s I hereby apply for a Residential Building 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 the State of MN 3tatutes; I understand this is not a permit, but only an application for a pernvt, 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 uues?-a?7-reuiew and approval of plans. 1f 1? ? U?F?lI [r-rS,d L?,.?l?pc?•.- Applicant's Printed Name Signature JAN 2 7 2005 OFFICE USE ONLY Sub Types 4. ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? D8 06-plex 0 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of_plex ? 09 07-plac ? 17 Garage ? 22 PorcNAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 L.ower level 0 24 Storm Damage ? 06 04-plex ? '12 12-plex Plbg_Yor_N p 25 Miscellaneous k T W 1111?4t'IL JJ111rli4 6r- ? iZ?•dYi F/Zo'Z or ypes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Add'Rion ? 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 appiicant Valuation Occupancy ]Z - ? MCES System ?1 Census Code y 3 Zoning ?- ? City Water SAC Units Stories Booster Pump # of Unds Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) ?p FinaUNo C.O. _ Foo[ings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final ?O Framing _ Siding _ Stucco _ Stone _ Brick Fireplace _ R.I. _ Air Tes[ _ Final _ Windows ? Insulalion _ Retaining Wall Approved By: rl l ? ? , Building Inspector ------------------ -------- Base Fee ------ °----- ------------------- ---------------------- -------- --------- -- - - - -- Ct? a? --- Surcharge a U ? Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Searoh Copies Other Total al "i "?-S? Storm Sewer Trunk Ches Mar 4th Block 1, Lot 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17- 18 19 20 S:ock 2, Lot 1 2 3 4 5 6 7 8 9 Ches Mar Sth Block 1, Lot 1 2 3 ' 4 5 6 7 8 9 Block_21Lot1-1 ??? 3 4 5 6 7 S 9 10 : 345.67 346.45 3G1.68 301.02 1118.88 934.10 494.29 455.49 364.05 59].58 397.59 328.56 693.81 327.37 290.39 490.78 805.84 1631.79 1908.97 2512.98 459.47 545.87 624.55 577.04 478.66 422.66 488.72 553.46 423.54 467.30 369.51 601.09 468.55 506.35 403.00 416.03 546.00 443.09 390.00 390.00 390.00 733.75 603.69 331.45 325.00 325.00 600.68 1021.18 . s. OG?bB Council !7inutes Apri1 21, 1981 A11 voted yes. Smith moved, Parranto seconded the motion to accept the request of the develeper for the pr=parstion of the feasibility report for street and utility improvements in tf:e rirst Addition subject to subaission of an applicatioa by the developer. A11 vote yes. R 81-22 C91tL TOLLEFSON YdI9ER OF PLAT Carl Tollefson appeared on behalf of his application for waiver of plat in order to subdivide six duplex lots for single ownersF.ip located in various lots and blocks in Ches Mar and Cedar Grove ACditions. The Planni.^.g Comais- sion recommenCed approval on March 24, 1981, subject to certain conditions. Mr. 'tollefson indicated that Dave Gabbert and he are going to fora a,join*. heneowaer's association for existing double bunga:ows in the Ches Mar area. E3an moved, Parranto seconded the moticn to app.^ove t!:e application subject to the foraation of a homeowner's association with the Gy-Iaws and articles to be revieved by the City staf: and further subject to the folloWing conditions: 1. All prope^ty sha11 retain the existing drainage and utility ease- ments. 2. Each of the newly created lots must meet a11 applicable ordinance requireaeats. 3• That the hoaeowaer's association by-laus shall be subJect to staf£ reviex and approval. All voted y=s. R 81-23 BRIdXffiLL ?OTiNHO0SB TPSMPOHAR2 dD9FR2ISINC SICN The application of Carl Tollefson for temporary advertising sign to advertis? 2riarhill Tocrnhouses located on Silver Be11 Road was next con- sfdered. The sign wouZd be at the soutY:west quadrant of the new Trunk H43hway #13 and S11v>r Bell Road. Smith moved, Parranto seconded the motion, all voted in favor, to approve the application subject to compliar.ce with the applicable ordinance. YILLZAM lEADE tiAZ4ER OF PLAT The application of Williaca Meade for Kaiver of plat to subdivide a five ac.^e parcei Was nex: conside.^ed. Because of lack of appearance by the appl:- cant, Par^aato moved, Wachter seconded the motion to continue the application ur.til the next regular meeting. All voted yes. SIi.I_i BEAQCHFMIA REZCAIAC The application of Sally Seaucheain for rezonir.g from R-1 to Agricul- tu^al of a parcel in the Wilderness Retreat area on Cliff Road uas next considered. Ms. Eeauchemia va9 preseat a.*.d indicated she preferred to rezone to Agricultural rather than to acquire a special use perait as recommended by ? . ?. ?. ' C:-Y oF ?.v 3795 F_'ot Kncb Road ' Faqan, >linnesota 55122 - L1AK0'TA CO()NI'Y TRSBUZIM 420 THIRD STREEP FAFdRINGICxT MIIQ 55024 ? ??? Re: City of Eaqan - Leg C,entleren: L? I am here,aith enclosing 1 copy/ooPies of Notioe of Public Hearing in the follaaing matters: Carl R'Ibllefson for waivex of plattina for 8 dimiPx lo ? ? which please publish for 1 week(s) in Your 19 gL_ and , 19 edition of the Tribwie. Please forwaud to the City of Eagan your Affidavit of Publication•. Thank 1ou• Very trulY Yours g.?; panOvpsbece, '?C ty Clerk City of Eagan Telephonea 454-8100 ,-- ?? r?LUnq regulations to split ei.ght duplex lots for Cinnle ?......?.._s..?. ' of proper[y located in Dakota County, `tinnesata descriSed as follovs: Lot 1, Block 1, Ches fAar Sth Acldition I,ot Z. Hlock 3, Ches t4ar lst Prkl.ition Iots 1 & 2, Block 2, Ches Piar Sth Addition Int 1, Block 1, Cedar Grove 11 Lots 1 & 3, Block 4, C'hes Mar lst Addition 7nt 2, Block 1, Cedar Gxrne 17. of the NM; of the NNbd of Section 14, Township 27, RarxJe 23 • . Dated: 3-6-81 Advlsory Planning ConnlSSion City of Eagan By: ?0n ?. Clty C1 k CITY USE ONLY PERMIT #: RECEIPT DATE: it£SIDENTIAL MECHANICAL PEftbIIT APPLICATION CffY OF &kfiAA 3830 PaoT xaos P.n EAfiAP EfA 551 EE 651-6$1-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: ? '-) L'? ci \ SITE ADDRESS: OWNER NAME: INSTALLER NAME: STREET ADDRESS: *4 6 J L4?? \ CITY: TELEPHONE #: TELEPHONE #: W • P• 0 1 \ r?J ?.?f ,L ! STATE: ?„(?J ZIP: ,?.?j'v`- 7 Place a check mark neYt tn the narmit wnrk tvna _ New residential dwelling unit under constructionand not owner/occupied $ 70.00 _ Add-on, modification or alteration to existin dwelling unit S 50.00 urnace re acem • air exc an ir conditioner Tb er Nature of work: State Surchar e $ 50 Tota I $, 6-je5cJ Re»eiuder: CaU for inspections. i ? ? ? ? • Updaied 1/01 CITY USE ONLY PERMIT #: APPROVED BY: RECEIPT DATE: INSPECTOR COMbIEftGIAL MECH4N1CAI. PEftMIT APPL1C!lTION CIY'Y oP' £ASi4N S$SO PILOT KN08 $D fAHAN,INN 5518E 651-681-4675 Please complete for: all commercial/industrial buiidings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: - (AREA CODE) TENANT N,A.?IE (IMPROVEMENTS ONLY): VY'AS THERE A PREVIOUS TEA'ANT 1N THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: C1TY: WORK TYPE: New conshuction Install U.G. Tank _ Interior Improvement _ Remove U.G. Tank _ Processed Piping Specify Nature of W ork Whera installiug/removing underground tank, call 651-681-4675 for inspection by Fire Marshal axd Plumbii:g Iinspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removaUinstallation = minimum fee Contract price: $ x 1%= $ (Base Fee) State surcharge calculate at 5.50 for each $1,000 Base Fee TOTAL $ SIGNATURE OF PERMITTEE PHONE #: - (AREA CODE) STATE: ZIP: Updated 1i01 h , CTTY OF EAGAN S[J67ECT: FIIUVER QF PZAT APPI.ZCANT: CAFtL '1C)LIEF501V IC)CATION: I17P 1, BIOCfC 1,CfE5 MAR 5TH,Ll7f 2,ffi1)CK 3, CE?'S MR 1ST, IL775J&2,BIL)CiC 2,C[]ES MAR STH;IA'P 1,BIpCK 1,CMAR GRC7VE 11,I(yPS 1&3,BLOCiC 4,C!-IE'S MAR 1ST',ILYP 2,B7ACK 1,CmAR Q3'n1E 11 OF THE NW4 OF THE NW4 OF SECtION 27 AfID SECTIODI 20 EXIStING ZOJING: R-2 (RESIDENTIAL O[JPLFX) DATE OF PUBLIC HEAFtING: MCH 24, 1981 DATE OE' REPORT: NkRCS-I 18, 1981 REPOFtIED BY: KURTIS G. i7I12ICH, PIADIIdING ASSISTANP APPLICATION STJBMI'I`I'ID An application has been sutani ttecl for a waiver of plat to allaw for the sub- division of 8 duplex lots for separate ownership of each duplex unit with lot. 1. The lots in question cuirently all mntain one auplex upon a single lot. The proposal is to split each lot tn allaa for separate v+mersliip of each duplex timit with lot. 2. £ach of tYie newly-created lots would meet all ordinance requirements applicable to the R-2 zoning designation. 3. The proposed lot splits wvuld not negatively in-pact the character of the neighborhoods azxd wnuld encouraqe owner occupancS' of the dwelling tmits. ' 4. In the past, other similar waivers of plat have been grantecl in the Ches Mar and Cedar Grove rreighborhoods. 5. Separate utility lines are currently provided to each unit. If approved, the waiver should be subject to the followi.ng oanditions: 1. All praperty shall retai.n the Pxisting drai.naqe and utility easeffenis- 2. Each of the newly-created lots nwst meet a11 applicable ordinanoe re- qtxirements. KGU/jac ;. t .S.l?ii?'• '- :83-;n F. C. JACKSG %1 LANO 9URVFYOR R[6iST[P[D l1MD[R "W! OI *T4T[ OI MIMNfWTA LIGiNf[O Ct ONOiNANC[ 0I CITY OI MINJI[AIOII• ae+e cwsr sarH srReer 55417 ,?---?- . 7 21- 3r.84 *.`. . , , burbcpoc'fc Ccstiticaft ,.. . . =. .:.:: . ? . /X ?•, ?_ ` / ?M dj V's`/ I p ? ?j lvV \qj .01 r ? \d?y? ?-:- `? . ?:. , ? I M[R[S'I C[RTI?Y TIIAT TN[ A6DVE 18 A TpU[ ANO CORptGT PIAT Or A$URV[7 OI JcTI?./?=J,) ? •=z rokI . --= nrd?Hqyet7;"i??? i? Lnt 2,Hlock 3,Chen Mar Firat Addition, Dskota Caunty,Ninneeota. wa suwvzreo sv ri rNis 23rd. 1918 [OHTMTI ON, NO. 3600 F. C. FACKSON. MIM71! ti) ..._... ..._.... .t.t'. F. C. JACKSGN uNO suRVeroa ? .. . 11901tT[N[D UND[R LAW/ O/ IITAT[ OI MINN[Wi4 - •: .f r0 ?7 LIC[Ni[D BY ORDINANCl OF C1TY OI YINN[A/OLIf - ' 3616 EAST SDTH STREtT 55417 727-3484 ' , .. *UTblp0i 9 (dtttlGtdt[ - i i ? 2 L' j' . .i 34. ? ` I + I ? t ?? od i r;- 0 I, . s ? 1 ru t, . :.;, V . i . o ; ; ? rr? L y ?? .:r 1 MLR[BY C[11TIIY TMAT TX[ AYOV[ 18 A TI1U[ ANO ODRR[CT RAT 01 A SVRV[T O? Lot 1,91ock 2,Ches P1ar Plfth Add![lon, Dakau County,Minnesota. i? ? ? ? v AS iURVEY[D 8Y ri rMIS-80h_oAr 0r-•?4V• w_o. 1973 ? . SIGN[ ? t? ? • -d .C?-"?? - , -. . F. C. J CKSON. MIMn T R[oIsTruTloN. No. 9600 ,. ? . . . . . . . . ' ''?..: ..;..;-r.., .. . . ' ' - . , . . ?. ? F. C. JACKSGN L iND SURVEYOR ? n z P[GIfT[N[D UNO[R UWt 0/ *TATt OF MINN[SOTA . lIC[N"D /t ORDINAMGt OIP C]1N O/ YINM[A'Ollff - •= 1. rvN 3616 EAST 57TH STREET5541I 127-3484 . `J . :; . ::.. .. _? d ! ;: i. hZ / so.? -.-- 'A.:,.. ;:: r??- ? ?? . ? . •r ' 1 Y v ? i ? ln' N /qY. ? ? • L L Z8 I ;I ?. ? i ? • ._? ._ ?- f I .? t .? I N[R[OY C[R71A' 7NAT iN[ AOOV[ If A TRU[ ANO CDRN[CT RAT W A SURY[Y Or Lot 2,51ock 2,0hee Mar Fifth Additioo, Dakota C:Iunty,!llnneeota. Aa auav[no mr Uc rHIa-2ad.i_owr a Aug. 1978 Revieed .7an. 19tn. 1979 V(^ / r F. C. JACKSON, MINry[soTA ? ??. ? ? \ v r i _-- qm, No. 3A00 l.i? SMC:. .?iSOix ...,.?. - F. C. JAC.KSCN . LANC 3URYfiYOR RItOIOT[R[D UMD[A LAWt OF STATi OI MINNRpT,\ UCiNMFO INV OIIdMAMCi p? CIT7 001 YIMMGIW.O ---3616 EAST 63rH 3TRCET 55417 727-3484 . '. _ oancrpot'g Cx6tatt . " . /74:J+aa? < `v -- ... .'_ 1, _'. - 7iii - .. .. .... , .. . . - , _. o , - ' - - ?---?': ? ??=- - - - ` ; ?-??eP osc d . ' ?.' •o•? Y H _Su 6 ?/?vi s ??on . _ ? rk?G?t.tt.e.ll -• z? ? . ,o `. - - i ?? 9. ZZ'-? ` . . ?f oI . a i -? _... .?_ ?._ .? ._v -: ....__:.,,_ _ . _ :,.. „ ,......., x...?..._. M[ROY C[RTIIY TMA TN[ ABOV! If A f11Y[ AMO OORR[Q RAT 0/ A BURV[Y Or L3t I,Black 1,Cedar Grove N3. 11, Llskota Ciunty,Minnesata. As su*vcvm mr w[ TwIs ZOth. o,r . Dec. A.o. 1977 Revlsad Jrn. 18th. 1978 S16N[ F. C. JACKSON, MiHH[sorR', no. seoo ' .:t3..:. . ..'.?'. .. " I Hcw[sr , a ' ` F. C. Ji4.CKSON LAND SURYEYOR wccieriaeo u»ocn uw¦ o? IIrArE or MiHnEw*• ! ? lIC[NS[D BY OpDINAMC[ 0/ QT? W YtNN[AMI.IS % r $818 EAST $SrH $7REETj _?417 727-34144 iburbcpor's Crrri4cate ? _.> G y /ec /..__ ?. ; • ?Y?-..?2-?! -/.. ; 7? I c? i? ? ? ?,rof'D,y•??si°?' - G?r S? TMAT TNC AlOYE 16 A TRY[ AMO ? / ? ? \ \ \ PLAT 0/ A SUAV[Y OF Lo; 1,Block 6,Chee !ier Firet Addlti,3n, Dakota C3unty,4inneaota. As aunvcvco w wc rNU_9th. _owr o. APril 1979 • Siaweo? F. C. L v :)N. Mawwswr"k/q ?nruiror. No. 3600 _. _ V .. . • , . ?J?..?.. ... . ???44?1.. ...?. • ? ? ro;t F. C. JAC?,:S0N LAND SURVE`:OR R[GIBTiRlD UNOCq (AWi 0I lTAT[ pI MINNEOpTA ?. .'.i??? .. ? L!C[NB[O Q1' OROINANC[ (/ C1TY 0I YIMN[ArOL19 5816 EA37 SSrH STREET55417 727-3484 fouibcpor'g QLcrfiticate i-.• : ,ry ?2 ? 1 \/ \ I H[R[pY G[RTI?Y TryAT TXC AlOV! 10 A TIIU[ AiiO OORR[CT RAT 0/ A$URV[Y Ow Lot 3,Bl:)ck 4,Chea Har,First Addition, Dekau Caunty,Minneaou. ws suavcvro w rc rMja--_9[n_o,r w_Aug. . p. 1978 Revised Peb. 7tn.1979 F. C. Jf(CKSON. . I . . -.?? .. , . ? , ? . ? / _- . M? _?- ? ? ? ? • ' /?? , ??? :;'i 4 + rwr. No. 3600 " ?Cari ':?ilei:oa F. C. JACKS09V LwHO surrvcrort ? 11[GIfTERLD UNDLR LAWO 0/ GTAT[ OI YIXNClpTA ' ?/'-• ',- ?J UC[Ni[D RY OROINAIIC[ p' nTY p/ MINNdIRxiB • = Z ro n 727-3484 9616 EAST 35TN 3TREET55417 ,-P?m - , .... ? . .. . ' - /G o. /B ? --- ?7 - 3 ° T4 I 3 231 ? . .. :? ??• ? ? ? ?•-V ? ti ?i c:.;uf.: I7b-u t ? \ I v.\ `? r ??voPose? J ? . 4 ,o 'h f ? / J ? ? N ..54lJ :1 / ? / S/,D 17 ?L'A . I' \ i 2 2.3j ? ----------------- .... - . .. ? _ . _. MiR"Y C[RTI/r t1iAT TM[ AlOV[ t{ A TqU[ AMp ppRR[CT PLAT W A SURV[Y OI Lot 2,Slock 1,Cedar Grove No. 11, Dakota County.Minaeeota. At fVRV[1'[D Bv rc rHU-_4th_wv a Npv. ..o. 1976 20-27-23 .. . swMC -ll.-?---r. c. JAKSON. MIMMtaoT isr¦wrwu. rw. aaoo ; . ... .; . . ? p • + r.•.??,: „ ? Ci?? , ? m?? _ ( , -: ? 1:- , ; o, z, ..?I! y? ...<...•= . , .,. .,. ?f - ?i • . ? ' . ? L?kGRiv r ,.t': •; ",-;,]??' i - - ? `;, . .: -1 ,... .?': :??:r •. h ? '` -?.-?? y . ?? ; , ??_.^ _ RK; ' ? ti ;,,, , , .• A. H. # 30 . . . Q: ?t . ?' ? ?-•?- ? ? ? .? • ? , , ... 767 P D UTIUTY ?X E eS pM I I ? ? L,_'tRK ?9??` = (. ?.?. . _>• ? l !. ? ; .'.1 r? i i ?? 1? LL,, ? t? ??? `; ??? ?„-t?:•• 3' ?.,. 1 ? \G ?, : ?• '? _,,? ,.,.? ,..•. t7TTT r. " . : ?;. Y.•.ti'.'.' .:? V?? ? "r_,d • ? ? '?.`:?:;: T-A ?' ? n?' ?• C? t?''>C !FG i I . I ?A , ?RcELS .r?{:%?•rr,.,? ?.?. h6L •,c'?r?!•'{ C r•i '_ 10 8p2 \ :?' „t '^?-: C4C; ,;??".?t•?7,,,< ,:, - * ? ; - ?,, ?:3?.,.; ,•,? ' '••? •rr=?c?,?? ;,::? •??,,,?-y,•.:x?- ? w i' i? ?C < IGH i , ?,. rr• ?yL ? %.p.k ? .' ??.:.r??, ? .t-.I: ? ' • ,. Y?.`? .Y' . . ?r ? . ? ? {? .??{:!;:;::.•? . / ? -t TT- .,: . "' : -. : . -- . . .__... TaUK ;.?'-_ ?,1 ? \ / ?'. . .. .:>::::::::::: ?.LA 1=;..1. •. ? . . {.:. i/. :.. ? •.,... ..... ?:?? f:=: : ????? :?:?:?? SuBTEtr , ? 2 aaac ?'4 n ? ? . .??j".t ? . Jl'? ?? ?? q'Tr. ???/?IGZ ? ;? ` ? ? ?'7'7 ? •1 •???Y ?.. .,. ?`-7 ? . . . . . ?.}P;4 ? . ... _???a ? :,...::_:;i: ?:;? ?'?`•' / / ''. i: ti ' ... . .. . . . : .?. . 34ALLANflAiE ? 7 ". .'.1 -l/,? ,a ..1:..?11'^f' ?'i'.•.:?? (?>:.:.:_::;::;: • -'-T ' ? i?.. . r.::........ ' i-- 1 ? ??.-:..i....l? '1qb3( 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements 3 registered sRe surveys showing sq. ft. of lot, sq. ft of house; and all roofetl areas (20°k maximum lot coverage allaxed) 1 Soils Repodif proposed 6uiltling is to be placed on disturbed soil 2 copies of plan showiftg beam &window sizes; poured found design, e1c. 1 set of Energy Cakulafions 3 copies of Tree Preservafion Plan if lot platted after 711193 RimJoistDetailOptiom selection;heet (buildingswith3oriessunits) Minnegasco mechanicai ventilation form RemodeUReoair Reauiremenis 2 wpies of plan showing foohngs, beams, jdsts 1 set af Energy Calculations fa heated additions 1 sile survey Por additions 8 decks Addifion - incgcafe if orrsife septic system 14 7, 5::?? (1, 4 ?la -7,- ? t t the are trade secret and tfie reason. Plans are considered upuc intarmauon uniess uu s a e ? Datez11l 07 ConstructionCost 2-000 Site Address f Z-S 7 r u n'? C F'r ul?1 ? Unit/Ste # Description of Work ? 6-re s s LJ i+v Do LLJ Multi-Family Bldg _ 1' _ N Firepiace(s) _ 0 2 wner Lir.?aR ?NUTS??v Telephone#??mS/) 6ff? C-SD ? ?es Pe -?, ?- Co 0s-??.C--, 0 ^? r ( 2?° ? DLk ? 6? r r`') e rAddress State Zip S..?1 Z _ City L/t V-R u Telephone #(b ? I) ?5-y? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEw esvll-uOr..S Minnesota Rules 7672 - Minnesota Rules 7670 Cateeorv 1 -- code worksheet Energy Code Category . Resitlential Ventilation Category 1 Worksheet • New Energy (J submissian type) Su6mitled Submitted . Energy Envelope Calwlatlons Su6mitted In The last 12 months, has ihe Cify of Eagan issued a permit for a similar plan based on a master plan? Y _ N If yes, date and address bf master plan: Licensed Plumber Mechanical Contractor Sewer/Water Coniractor Telephone #( Telephone #j Telephone #( I herehy apply for a Residential Building 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 the State of MN Stazutes; I understand this is not a permit, but only an app]ication 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. .,??r" P S. 19,e rr? ApplicanYs Printed Narne DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ?RL 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3sea.) ? 31 EM. Alt- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo/pergola) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 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 x- 46 W?ndowslDoors ? 34 ReplaCement •Demalition (Entire B4tlg) - Give PCA handout to applicant r??? .-5s D@SCflqtlOfl: Water Damage _ Yes Valuation Occupancy MCES System Plan Review 100% or 25°/a Census Code ?, u Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const ? Width REQUIl2ED IN5PECTIONS _ Footings (new bidg) _ SheeVOCk _ Foofings (deck) _ Fina]/C.O. _ Footings (addition) ? FinaUNo C.O. Foundation HVAC Drain Tile OCher Roof Ice & Water Pool - Ftgs AidGas Tests Final Final _ _ ? Framing _ _ Siding _ Stucco Lath _ Stone Lath _Brick Fireplace _ R.I. _ Air Test Windows _ Final ? Insulation _ _ Retaining Wall r` Approved By Building Inspector ---- ------- --------- -------- -- ------------- ------------------------------------ ------ Base Fee - ----------- ---- Surcharge ? ?jlj Plan Review ? T 1 ? MC/ES SAC ,., ' _ U-" ? City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other ToWI City of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 95c019( - Use BLUE or BLACK Ink Permit #: / f/'` Permit Fee: F9695 Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATIOLAA Nv- l) Date: MA a0 ( ( Site Address: J J J) v h erry Ln RESIDENT / OWNER Name: E t I i© Ne-6-cPhone: 6 F I7V--eg/T Address / City / Zip: I o `1 C 2 LA 6 R.r-rY C. Applicant is: Owner X Contractor/ TYPE OF WORK Description of work: e--3 �-,5-s- (ovw d w Construction Co D,!Oa® ,.6G Multi Family Building: (Yes / No ) CONTRACTOR Company: k-vl'1-e-t G,, 1 d�W Contact: Dytr/\. Address: IA. CrQ e -'� lititeiJatel vl `FS City: t` State: 1A0 Zip: S5 t ad Phone: 6( — S cg S 362 License #: D L 30/S Lead Certificate #: Q-1- " 3 a `3S$ ` (I - 0056 ( Does this project require Lead Remediation? ❑ Yes 'A No n (see Page 3 for additional information) If no, please explain: 4 I) 7 f In the last 12 months, _Yes No If cCt'f COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of - n «- Af.Iicant's Printed Name icant's Signature Page 1 of 3 cD(Al-bbrj tal\Q DO NOT WRITE BELOW Ms LINE 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 06019 Occupancy „2',26. A MCES System Plan Review AO Code Edition t2'%'7 SAC Units (25%_ 100% ) Zoning 2-2 City Water Census Code 4 3y Stories Booster Pump # of Units .— Square Feet PRV # of Buildings "' Length — Fire Sprinklers Type of Construction Width ---- REQUIRED INSPECTIONS Footings (New Building) Sheetrock 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 Meter Size: Radon Control Erosion Control Reviewed By: R-7-1// , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 ,?ai2aYSaa 3u?;.??tn Lrx _.. •.st?•n'??- . F. C. JACKSON LAND 6iJRYHYOR . . .. , SC T I? ?/'= -3 D? . . RWIiT[R[G I1N001 LAMIN OP t1ATt 0I MINNtfOTA . .. . LiC[Nf[O OV ORWNATICE pF dT OR MIMMiArOW , •_ ,z'ro N . ' 3616 EAST 83TH STR6ET55417 727-3484 l.. • t, 1,_.?1 *urbcpoc's dCntificatt } ? .. i ?-77?1/7 ? ! 0 ?. ,.. ? Z7- --?? o O/Od SG'? ? ( • ? ? .Su 6 di 0 a ? 1 • • . `• . t JDII N /pr I" V ? ? . z Z ZS : . , ? -?--_- ---, _%4?- r --- -? ,??.?- - - ? I NtR[6Y C[ATIfY TXAT TX[ hOOV[ 16 A TRiJ[ AND Cib11RtCT PLAT Ow A BVRV[Y 0/ t' La[ 2,Bluclc 2,Ches Mer Fifth Addicion, ;. Daka[e Couaty,lllqnesota. >- r AS fURY[V[O ar M6 THIl--ZOd. GAY OR A!±B• .o. 1978 / Heviaed Jan. 19[n. 1979 / ?- 516N[D ' ? . - F. C. JAC 30N. MINN[fOTA.R[ 1fTnwTlow. No. 3600 1 EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694 bui Idi nains pections(rD.citvofeagan.com For Office Use Permit* /6 WC, Permit Fee: J2`O '� 6 Date Received: Staff: 2020 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Cc Resident/ Owner Name: Dave L n de ‘,' Phone: Address / City / Zip: %a SS 0 berry Imo^ h ` �d, ( Applicant is: Owner / KContractor Type of Work Description of work: ketecoo P - a d Rio (( +his Sc d( 5C daft Construction Cost: Multi -Family Building: (Yes / No ) Contractor yy Company: OL/ P� Y �-!�ln_ J.vl G. Contact: Ih jcJPeL Y ,4,4-Icv'1 Address: 3 ri SC ' 54 • kJCity: WC'n 5f ev State7Yltll Zip: 5e2 Phone: ?5?' Li- "/0Email: Adel y p /(di'er(a tau: ( • 1'1 t° `1 License #: AR Si 7 70 Lead Certificate #: If the project is exempt from lead certification, please explain why: yeS, vim"i�� t In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan Issued a penult for a similar plan based on a master plan? If yes, date and address of master plan: Licensed Plumber. Mechanical Contractor: Sewer & Water Contractor. Fire Suppression Contractor. Phone: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.comisubscribe. 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. CALL BEFORE YOU DIG. Call Gopher State One CaII 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.nooherstateonecali.orq I hereby acknowledge that this information Is complete and accurate; that the work will b in conformance with the, Jdinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, a •rk is not to st- y'r a permit; that the work will be in acc ance wjththe pproved plan in the case of work which requires a review and ap of plans. x f-141/4 v rl� Applicant's ranted N me x Applicant's loc