Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1519 Clemson Dr
cIrr oF EAG?N . '. 3795 Pilot Knob Rmd Eagae, MN 55122 ' ' PHONE: 454-8100 BUILDING PERMIT Receipt # T.. h. .mA fe. . . .. Fea v..l..? . n.,.e . . :.. 1 e Site Address Lor ? Block Sec/Sub. ? . Parcel # W Norr?e z Address ? Gi Phone °C Norne o u? /lddress 1- Erect ? Alter ? Repoir ? Enlarga ? FAove ? Demolish ? Asseument _ Water & Sew. Police Fire Eny. Pionner Council Bidg. Off. _ APC QccupGncy Zoning Fire Zone Type ot Const. # Stories Le n gth Depth S4. Ft. Nome Address 1 hereby acknowledge that I have read this epplication and stote that the information is correct ond ogree to tomply with oll applicoble State of Minriesoto Stotutes ond City of Eegan Ordinances. Sipnnfure pf Permittee A 8uilding Permif is issued to: oll work sholl be done in otcordonce with oll oppliooble State of MIj Buiidirg Official Permit Surchorge Plon cfieck SAC Water Conn. Woter Meter Road Unit Total on the express condition lhat Statutes end Cify of Ea9an Ordinances. Permit No. Permit Holder Misc. Permit Na . Holder V ' l? sclput? 1? ? -? - Diso. E leceric TQ Y?0 z 3 Q??! -I L-?2_ InWectian bate Insp. . Other Footings Foundation Framiny Rouyh PI6g, .? 401 Rouqh HVA Inwlation P -., ? Final Plba ft G, ar Final HVAC , W 4 Final W ? Wamr Desc?ibe LocAtion: YVell ' Serner _ Pr. O"wp. CITY OF EAGAN =795 PilO Keob Rood Eagae, MN 55122 PHONEs 454-8100 BUILDING PERMIT Receipt # aWc Nome Z Addre, 9 _ o Nan,e [fiatherl V< Addreu ~ Cit Phone F Uw Nome this Sipnoture of PermieSee N Building Pe?mit Is issued to: oli work shall be done in occo Buiidiny Officiol Pe?mit ? I _ '? (1 Surcharge Plon check SAC Water Conn. Wnter Meter Road Unit Totol i g_ n n on the express condition thn+ Statutes ond City of Eepan Ordinances. Erect ?J Alter ?d Repotr ? Enlorge 0 nnove ?o Demplish ? 7'u7 a Occuponty Zoni ng Fire Zone Type of Gonst. # Stories Length Ft. Assessment Wcter 8 Sew. Potice Fire Enp. Plcrmer CountH Bldg. Off. Percel # ZU-7c1g50-nRo-fii Parmit No. Permit Holdor Misc. Permit No. Holdsr Plumbiny H.V.A.C. Wall Water Disp. Sewer Electric Inspeetion pata Insp. Other Footinqg Foundation Fremieg Rouyh PI6p, Rouyh HVAC Inwlation Final Plb¢ Final HVAC Final Water Describe Location: IMell Sewer Pr. D'np. cirY oF E?G,?N 79?:4 . . 3793 Mlot Knob Reod Eegen, MN 55122 ' ' PHONE: 454-8100 BUILDING PERMIT Receipt # 5ite Address Erett ? Occupancy Lot Blotk SecfSub. "-?-' :-)?Iter ? Zoning pamel # Repoir ? Fire Zone Enlarge ? Type of Const. w Home Move ? ,# Stories ; Address Demo(ish ? Length b ^ r i- A Nortu _ u' /lddreu 1- r:... Nome _ Addross I hereby acknowledge that I have read this opplication and stote thot the information is carrect and ogree to comply with all opplicabla Stnte of Minnesota Starutes and City of Eagon Ordinances. Assessmenf Water 8 Sew. Police Fire Eng• Plonner ' Council Bldg. Off. APC Permit Surchorge - Plon check _ SAC VNater Conn. Wafer Meter Road Unit - Totol Siflnature of Permittee ? A Bullding Permit Is issued to: on the express conditlon thai al) work sholl be done in accordorxe with oll applicoble Stote of Minnesota Stotutes and City of Euyan Ordinances. B14ng Officiol Permit No. Permit Holder Misc. Permit No. Holder Plumbing ??? H.V.A.C. b(3 wen Water Disp. 5awer Electric Inspection Date In . Other Fpotings Foundation Framing . . Rough Plbg. ? >>_g Z Rouyh HVAC 6 ? Inaulstion .f . 1 Final Plbq. Final HVAC .., .f Final Water Describe Location: Wall Sewa? Pr. DisP. . 3795 Pllef Ksob Road Eogan • PHONEs 454-8100 BUILDING PERMIT To be uad Foe ?r; Est. Volue MN sS1M Receipt # 1 7 61 SiM Addrcss Erect ? dccuponcy Lot 81otk 5ec/Sub. .*''Alter p Zoninq parcel # Repoir ? Fire Zone E t T f C n arge ? ype o onst. oWc Nama Move ? #k Stories ; Addres s demolish ? Length U r;.., Grode [-] Depth Sp. Ft. °f Name Appeorals ,O V? ?re? Assessment ~ Cit Phone Warer 8 5ew. Pol ite rc Z ? Name Fire u? AcWress Eny. Z. Ci Phone Plonner Council t hereby aeknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to tomply with oll opplicpbla ^PG Stute of Minnesotc Stotutes ond City of Eagon Ord'rnonces. Permit Surcharge Plon check SAC Water Conn. Woter Meter Road Unit Totol Sipnofure of Permittee I A Building Permit is issued to: on ths express condition thn+ all work sholl be done in accordance with all applicabie Stote of Minnesotu Stotutes and City ot Eoflon 4rdinances. Building Officiol Permit No. Permit Hotder Misc. Permit No. Holder 3 Dr ( V Electric d Z( ?Bf I l -! 2?$2 Inapection Date Insp. Othe? Footings Foundation Framing . Rouyh Plbg. .??. -1 _ Rouyh HVAC Insulation ? 6j Finsl Plbp. Finsl HVAC ? Final Waftr Descrihe Loeation: VYell Srwer Pr. Disp. ~! , cirY OF EAGAN . 379! Mlof Koo? Rmd Ee9ae, MN 55122 - PHONE: 454-8100 BUILDINd PERMIT Receipt ?qk Ts 6e wueA ie. F.? v..l... S1te Address ". Ercd [] OccuWncY Lot Block Sec/Sub. Alter p Zonin9 parcel # Repoir Q Firo Zone Enlorge Q Type of Const. W NarT+e ' Move ? # Stories ; Address Demolis h p Length b r:.., • ::: i a..,..? •- Grvde ? Depth Sq. Ft. ?? N? ? ?? Address F r:.., oL___ Nome _ Address I hereby ocknowledge thot I have read rhis application and stote that the infarmation is torrect and agree fo tomply with all applicabls Stote of Minnesoto Stotutes ond City of Eagon Ordinances. Assessment Woter 6 Sew. Police Firo En0• Plonner Council Bldg. Off. APC Permit Surcharpe Plon check SAC Water Conn. Water Meter Road Unit , Tofcl 5lpnotum of Permittee I A Building Pertnit is iuued to: on the express condition rhni oll woric shall be dons In occordonce with all opplicabl* State of Mlnnesota Stotutes and City of Eogan Ordinances. Buildinp Officiol ? Parmit No. Permit Holde? Misc. Permit No. Holder Plumbiny '? r?-- H.V.A.C. 30 I Z. u r ah /O-3-? Well Water Disp. Sewer EMotric qg0 Z Z- ?(( S-?2?$"Z Inspection Dato Insp. Other Footinps Foundation Frsminp Rouph Pibq. Rouph HVAC ? ? ? Inwlation Final Plbp. •sZ ?/• Finsl HVAC Final W?? Describa Location: YWII Sewer ' Pr. D'ap. _ CITY OF EAGAN Remarks Additidn Tf+omAe Lalr_e F Ie{ghte Addition Lot 7 Blk ? Parcel #10 75950 070 43 owr,e? h"("` f? 4zt-j- Street 1519 Clemson Drive stece Eagan, Mn 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 167.83 A011270 7-19-82 STREET RESTOR. GRADING SAN SEW TRUNK *SEWERLATERAL 1$$.47 A011270 7- 9-82 WATEFiMA1N *YVATER LATERAL JQRJ WATER AREA 19 7 STORM SEW TRK 270.73 A011270 7-19-82 *STORM SEW LAT Ct1RB & GUTTER SIDEWALK STREET LIGHT ROAD iTNIT 240.00 #29842 4-29-82 WATER CONN. 420.00 11 it BUILDING PER. 7207 snc 525.00 " " PARK CITY OF EAGAN Remarks - Additibn TTzQmas Lake He3Ahts Addition Lot 6 Rik ? Parcal #10 75950 060 03 Owner Streec 1519 B Clemson Dx'ive State Eagan, Nhl 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ' STREET RESTOR. GRADING SAN SEW TRUNK 1973 *SEWER LATERAI -09 62 -82 WATERMAIN *NfATER LATERAL WATER AREA STORM SEW TRK . *,STORM SEW lAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT #29843 4-29-82 WA7ER CONN, if i? BUILOING PER. 7208 SAC 525.00 PARK CITY OF EAGAN Remarks Additlon Lot 8 aik '-; Paroel #14 75450 L480 03 owrte?? street 1521 Clemson DTiVe State Eagan. Mn 55122 , Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, 167.83 A011281 7-23-82 STREET RESTOR. GRADING SAN SEW TRUNK *SEWERLATERAL 1$$.47 A011281 - 3- 2 WATERMAIN *WATER LATERAL WATER AREA 7 STORM SEW TRK " 270.73 A011281 7-23-82 ,STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGNT #29844 4-29-82 WATER CONN. 420.00 n +r BUILDING PER. 7209 SAC • 00 PARK C1TY OF EAGAN Remarks Additron lbamns, T-ake Heigbts Addition Lot 9 Rlk 3 Parcel #j,O 7595(] 090 03 o,,,,,,e? t' ' I ' - street 1521 B Clemson Drive scate Eagan. NAl 55122 Improvement Date AmounL Annual Years Payment Recelpt Date STREETSUAF. 1981 279.71 55.94 5 167.83 A011332 8-9-82 STREET RESTOR. GRADING SAN SEW TRUNK *SEWER LATERAL 1$$.47 A011332 8-9-82 WATERMAIN *WATER LATERAL WATER AREA ? y ? Q,6?.w STORM SEW TRK 1981 312.37 20.82 15 270.73 A011332 5-9-82 *STORM 5EW LAT CURB & GUT7ER SIDEWALK STREET LIGHT 240.00 #29845 4-29-82 WATER CONN. 420. OO BUILDING PER. 1 SAC PARK Receipt PLUMBING PERMIT Permit No, CITY OF EAGAN Fee fill in numbered spaces S/C ' Type or Prini /egib/y Tot. 1. Date ? 1 J b Z 2. Installation Cost I ??? • 3. Job Address •Lot ?-7 Blk. - ? Tract f , • _.. 4. Owner , . ?-r•:: , ?? ? ? ?, ? f?s. ? y, 5. Contractor Phone 6. Address ??OSG 7. CitY State Zip ") ? - % 8. Building Type: Residential E3 Commercial O Institutional O 9. Work Description: New 9---? Add O Alter ? Repair O 1 10. Describe 1 11. No. Fixtures Water Closet No. Fixtures Cesspool/Orainfield Bath tubs Se tic Tank t Lavatory p Softner Shower Welt ? Kitchen Sink Urinal/Bidet Other / Laundry Tray . , Floor Drains J ; . .. . Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all,ordinances and codes governing this type of work. .? SIgr1Bd : f0r %r' Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 10Zi, Receipt MECHANICAL PERMIt Permit No. ' CITY OF EAGAN Fee ? Fill in numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. Installation Cost y ,:: _• 3. Job Address Lot ? Blk. ' Tract 4. Owner 5. Contractor Phone % i 7 { 6. Address • • - 7. CitY / _L.. / State /-' - Zip >, f, / 8. Building Type: Residential CL--"Commercial 11 ?nstitutional ? ? 9. Work Description: New Ci"' Add ? Alter ? Repair ? I 10. Describe ??.?rs-t ?/ 1w? ??-?; Fuel Type i 11. No. EQUipmeni STU - M. Ea. Forced Air o, u' ? No. EQUipment CFM Air Handlin : Mfg. g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other _i Air Cond. _ "- Mfg. / Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : ! < < <r - ,, I : for Rough Flnal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-$100 Receipt -' - ? ! _ . PLUMBING PERM17 CITY OF EAGAN i •:?r Permit No. Fee FiJI in numbered spaces S/C Type or PrinL legib/y 7ot. 1. Date L 2. Installation Cost -'?1" L' 3. Job Address ??i ( LotBlk.--;r2 7ract Z , . _ 4. Owner ' jL,;r4t,2 ? i 5. Contractor Phone 772 ? 6. Address .41= 7. City „?.' ? :''.o.•c?! 5tate !'?1A- , Zip S 8. Building Type: Residential 9'' Commercial ? Institutional ? 9. Work Description: New CL/ Add O Alxer ? Repair ? 10. Describe 1 11. No. h Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? Bath tubs Septic Tank Lavatory Softner ? Shower Well Kitchen Sink Urinal/Bidet Other -x ? Laundry Tray ? Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets E 12. I hereby certify that the above information is true and correct, and I agree to comply with alliordinances arrd codes goveming this type of work. , Signed for Rough6? Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved C{TY OF EAGAN 454-8100 , - Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Ffll in numbered spaces S/C TYPe or Print legibly Tot. n 1. Date 2. Installation Cost 3. Job Address ?? ^? ? ?' ?• ?'' `• ° '? Lot 5 Blk. - Tract 4. Owner .? 5. Contractor Phone 6. Address eq&il? 4 7. City -'{ /J' 1-' j State fVt tik Zip 8. Building Type: Residential El-"" Commercial ? Institutional ? 9. Work Description: New G-* Add D Alter ? Repair ? t'4-'-t r Fuel Type 10. Qescribe u.'=ti_ i l 11. No. ? EauiRment STU - M. Ea. Forced Air No. Equipment CFM Air Handlin : Mfg. g Boilers ? Mfg. ._ Mech. Exhaust Unit Heater Mfg. Other Air Cond. - / Mfg. _L Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 o ?. Recaipt= ` - PLUMBINGPERMIT PermitNo.? CITY OF EAGAN • ? Fee ?. Fill in numbered spaces S/C Type or PrinL /egib/y Tot. f' 1. Date 2. Installation Cost f?"1 C J, v I; ? --? 3. Job Address ??4? c_ c< ?-• •_' :;?. - Lot 7 Blk. ? Tract ' K c ;? •: . 4. Owner 5. Contractor Phone . ? 6. Address ,='S 5`? L?h- ?????- ? c? • 7. City State %?A1.r-• Zip 8. Building Type: Residential ff-l-"Commercial El Institutional ? / 9. Work Uescription: New C7 Add ? Alter O Repair El 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield / Bath tubs Septic Tank ? Lavatory Softner L Shower Well _ Kitchen Sink Urinal/6idet Other / Laundry Tray _. / Floor Drains , ?; . Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN . Fee Frll in numbered spaces S/C Type or Print legibly Tot. ' iy. 1. Date 2. Installation Cost '-.. 3. Job Address Lot Blk. Tract i. 4. Owner %,. - - - --- ? 5. Contractor • '" ` ? ? ' r /?? Phone 6. Address 7. City ? ' ? ! ? ? • ? State ? Zip 8. Building Type: Residential ? Commercial ? institutional ? 9. Work Description: New L7 Add ? Aiter ? Repair ? 0. Describe Fuel Type No. 1 Eauinment 9TU - M. Ea. Forced Air No. Equipment CFM Air Handlin : Mfg, g Boilers ? ? Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mtg. i Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit Na. CITY OF EAGAN Fee ? - Pill in numbered spaces S/C - Type or Prini /egib/y , Tot. 1. Date L 2. Installation Cost 3. Job Address Lot ?B Ik. Tract 4. Owner J ? ? 5. Contractor ' • "i :' Phone 6. Address > 7. City State • %'' Zip 8. Building Type: Residential 2' Commercial ? Institutional ? 9. Wark Description: New D" Add ? Alter O Repair ? 10. Describe :fn: ??°U' • 4?} Fuel Type -I 11. No, I Equjpment BTU - M. Ea. Forced Air ? No. Eauiament CFM Air H ndlin : Mfg. g a Boilers ? Mfg. .?- Mech. Exhaust - Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Reoeipt - PLUMBING PERMIT Psrmit No.- -' CITY OF EAGAN - '? Fee Fi!l in numbered spaces S/C Type or Prini /egibly .ra? ??? ..sl • 1. Date 2. Installation Cost 3. Job Address Lot ? Blk. ? Tract Lo, - _ , 4. Owner e4z ., i 5. Contractor Phone I1 7 /.?L f 6. Address Jd S v w?'"-? lf?. A-; `,- / 7. City •' ?_??'? State Zip 8. Building Type: Residential M----Commercial ? Institutional ? 9. Work Description: New L7" Add O Alter Cl Repair O 10. Describe 11. No. .-? Fixtures Water Closet No. Fixtures Cesspool/Drainfield ? Bath tubs Septic Tank s?- Lavatory Softner ? Sh°wer Well ? Kitchen Sink Urinal/Bidet Other ? Laundry Tray ? Floor Drains R Drinking Ftn. Slop Sink ? Gas Piping Outlets 12, t hereby certify that the above information is true and correct, and I agree to comply with ayi ordinancesbnd codes governing this type of work. Si ned : 9 G`" 4 for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 i i PNOt Knob Road n; MN '35122 ?t9: :?.? • bss: Address: ?7 r} `-T i6er: . V - !r No.: No.. to tomply wifh the City of Eagan f Insp.. OF EAGAti Filof Knob Road MN 55122 Address: No.. Dr L7 B3 Tho=s Laka Hts Connection Charge: ' Account Deposft: Perm]! Fee: Surtharge: I Mfsc. Charges: Total: Date Paid: No.. to wmply wtth the City of Eagan of Insp.. F CITY OF EA A SEVNER SERVICE PERMIT G N 3795, Piloe Knob Road PERMIT NO.: CI3Y OF EAGAN SEVI/ER SERVICE PERMIT Eogon, MN 55122 DATE: 3795 Pilor Knob Roed PERMIT NO.: Zonin - DATE: 4: No, of Units: Eogon, MN 56123 O'"^Br- _ Zoning: No. af Units: Address: "^ Owner: Site Address: - - :c; _ '• " Address: Plumber: Site Address: Plumber: 1 ree M eom y py wM the City of Eagan Connection Charge: "?Bees• Account Deposit: i agree to aamply with the City of Eagan Connection Charge: Permit Fee: prdiep„ee16 Account Deposit: Surcharpe: - ,, Permlt Fee: BY Misz. CFwrges: 5urcharge: Dote of Insp.: Total: sy Misc. Charyes: Insp.: Date Paid: Date of Insp.: Tofaf: Date Poid: I nsp.: - -- WATER SERVICE PERMIT PERMIT NO.: DATE: - No. of Units: " Connection Charge: Account Deposit: _ Permit Fee: Surcharge: Misc. Charges: - Total: Date Paid: WATER SERVICE PERMIT PERMIT Np.: DATE: . No. of Unlts: ? •'r' - ? , .; . Thi, request void •?/Z L ? T C..J? 1T T. months from •?/ 74 6? - / '?, [/T? . 3bd0 ? 99023 30, o 0 Renuest Date Fire No. Rough-in InsUection ,?+ Required? ?Ready Nuv?l Will Natify Inspec- Y?'s ? No ?? tor When Ready icensed Electrical Contractar I hereby request inspection of above Owner : =et Address, Box or Route No. 1,52:k Pd '`11WYNIA DFb"K City v N TA ectron o. Township Name or No. Range No. v1 Count Y 1 OLV'44LJI-1?0 Occu nt IPFINT ? Phone No. Powe.r Supplier Address Elec ncal Contrector (Company Name) Contractor"s License No. Maiiing Address (Contractor or Owner Making Instailation) 6, C-ulf- 4W Authorized Sig ur (Contractor/Owner Making Installation) ? '? Phone Number o ,SSoS .-- ..• u ?rc nvAnu Vr [lCC.IMl1:117 Griggs-Midway Bldg. - Room N-191 1821 University Ave., St. Paul, MN 55104 Phone (612) 297_2111 Inls nvsNECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTIOIV FE£ 1S EIVC tOSED. REQUEST FOR ELECTRICAL INSPECTION Es-oooo,_oa T H023? QT) See in structions ior completing this form on back of yellow copy, Belaw Work Covered by This Reauest ,..c 1 Ne Add Rep. Type of Building Appliances Wired r Home Range Equiprnent Wired Duplex Water Heater Temporary Service A pt. Building Dryer ` Lightiny Fixttires Commercial BIc1g. Furnace E lectric Heatin Industrial Bidg. ir Conditioner 5ilo Unloader Farm i Other Specifyl Bulk Milk Tanlc Othtr (Suer_ify) C?mm?nr e;r pecify P Inenortrnn C,,., 0,.?,.... Other Olher # Pee ServiceEntranceSixe tf Fee Feeders/5ubTaeders #1 Fee ? t0 100 Anl S 0 to 30 Am s , Circuits 101 to 200 qnips 31 to 100 Amps ?l?+ to 30 Am 0 s Above 200 Amps Above 100 Am s 31 to 1U0 Am Transformers _ Remote Control Circ Above 100_Amps ' Signs . Special liispection . Partial ?ther Rein?rks $ 3v? TOTAL F ? ?• Rough-in - s=?-? I the Electrical nspector hereb Final , y ?2e certity that the above i spection has been This request void m ade. I ts nionths from a 7? 3 RECEIVaD CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 AMOUNT $ 1 a ooLLwRs ?oo ? CASH ? CHECK White-Payers CopY Yellow-Posting Copy Pink-File Copy ? f -3 ReceIveo CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 19 AMOUNT is I a, DOLLARS ?oo ? CASH ? CHECK Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy I Thank You J ?? . B Y ? WATER SER VICE PERMIT CITY OF EAGAN $795 Pilot Knvb Road PERMIT NO.: Eagdn, MN 33124 DATE: Zoning: - No. of Units: ?"'' i` 1 Owrter: Address: 5ite Address: 'I ('.1-_ :n? "z 1 - , ,.,, , •,? T 't. Plumher: ? CITY OF EAGAN WATER SERVICE PERMIT 3795 Ffiot Keob Road PERMIT NO.: Erigan, MN 55122 T.I,. DATE: Zoning: No. of Units: Owner: 77£!B3 "n"Cn Add1'eSS:. Site Address' 1": rlet.i3un Ih' i,'" oi?ss Plumber: ? Meter No.: Connection Chorge: Meter No.: Connection Chorge: "' 0 "1' '.) Size: Account Deposit: Size: Account Deposit: . „ Reader No.: Permit Fee: Reader No.: Permit Fee: I agree to comply with tha City of Eogan Surcharge: 1 agrea to comply with tha Cify of Eagan Surchorge: ' ;`?? ,;? .? ; Ordinonos. Misc. Chorfles: Ordinonces. Misc. Charges: ? • " ` r Total: Total: id B Date Pald: By : Date Pa y f I O : InsP Date of Insp.: Insp.: nsp.: ate o • CITY Of EAGAN SEVUER SERVICE PERMIT 3795 Oilof Knob Rood PERMIT NO.: Eagan, MN 55122 DATE: Zoning: - No. of Units: Owner: ` •> - _ Address: Site Address: -`y .'' "' y Plumber: . , - , ? , . t l(1 , '1t5 1 agreo to comply with the City of Eagan Connection Chorge: Ordinenees. Account Deposit: ey Date of I nsp.: I n9p.: ? CITY OP EAGAN SEVNER SERVICE PERMIT 1 37^S Pilot Knob Road PERMIT NO.: . ;j Eagan, MN 65122 DATE: ? Zoning: ' No. of Units: - - -- - Owner: a Address: ? Site Address• i ?30ri DI' Ls ^•.c?:^<, ' '-` a ., ? Plumber. ?ar. Permit Fee: 5urcharge: Misc. Charges: Total: . 01, ;::: 1 agree to comply with tba Cify of Eegan Connection Chorge: Ordinancat. Account Deposit: Permit Fee: - Surcharpe: gy Misc. Charges: Qate of Insp.: Totcl: Insp.: Date Paid: CITY OF EAGAN 3793 PIIM Knob Roed Eogan, MN 55122 PHONE: 454-8100 BUILDING PERMIT Receipt # Te M uaad hr DECK Est. Volue $350.00 Date 5-3 ,1 q 83 5ite nddress 1521 Clemson Drive E,et:r X occuuoncy $ Thomas Lake Hts 3 Lot Block Sec/5„b. qiter p zon„g Parcel # 10-75950-080-0 3 Repair ? FlreZone E i T Kdy Kassinger n arpe ? ype of Consf. z Name Move ? # STOries ? Addreas same Demolish ? Length_ Ci phone 452-9639 6rade ? Depth Sq. Ft.- ? 0 Name (father) - Aovro•al+ Fees ? ?u Address Ncme _ Addreu I hereby acknowled9e that I have reod Ihis applicotion and state that the information is wrrect ond ogree to comply with all opPlicable Stute of Minnetota Sfatutes ondgify of Eogqh Ordirwnces. Sipnoture of PermiRee J?? A Bullding Pertnil Is issued to: all work sholl be done in accorda with all op bl'e S?ta.te of Bulldirp Officiol Assessment - Water & Sew. Police - Fire Enp. Plonner _ Councll _ Bldg. Off. _ APC N° 7975 Permit 11 . JU Surchorge .50 Plan check SAC Water Conn. Woter Meter Rood Unit Total 12 - n n on the express conditlon thnt Statutes and Ciry of Eogan Ordinances. CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & ` BUILDING PERNffT APPLI(ATION 1 set of energy calculations. Zb Be Used For Valuation 0O Date /$J Site Pddress: I?5Zl &EAl-?OtiJ 7ap- Lot f Block Sec./Sub. Ezt. ," Parcel #: !,?j -' 7 S 9sa -- 0 d8'0 _ 03 ckmer: }iA 7'?(;? AS51nIca? Address: J5Zl GICF_.",5()A1 b?. City/Zip Code: ?? (?? ?( ?? ! 2 Z Prwne #: q,:;Z Contractor: IVA ' l- A7N Ec ? Address: City/Zip Code: Phone #: Arch./Eng•: hj IA ? Address: City/Zip Code: Phone #: OFFICE USE ONi,Y Erect X- OccuFancY Alter Zoning Repair Fire Zone Enlarge _ Type of Const. MDve # Stories DPnblish Front ft. Grade Depth ft. AePROVats FEEs f?0 Assessments Water/Sewer Police Fire Pertnit u Surcharge , r() Plan Check SAC ' Eng. Water Conn. Planner Watzr Nleter Council Road Unit Bldg. Off APC T7PAL ? y?A- ? ??a5 LaKL OUSE HEATING TEST RECORD ? H V ? ? ? ADDRE55 G 3.L? ??,??"y??? ? APT._PLOOR SUBURB _CITY OCCUPAN7 ` v OWNER -? ? HEAT lOSS DATE HTG INST TER BAD !: . ?. - GAS C0. ME ? SOLD BY f, 4 INSTALLED BY - - EI•chicol W k e, 0-9Cl Gas LIM By TYPE OF HEAT GA _FA.L_HW _ STEAM _SPACE HTR. A NIT HTR. _OTHER GAS DESIGN CONVERSION ? MAKE /V'1 ? MAKE OF BURNER . ModalIW C? M lv Model 1 Swiol Mex. BTU RaNnq INPUT ?L ;/JL7 D MAKE OF FURNACE Mod•I /CONTROLS o; THERMOSTAT ?i?f Heat Plu ? Vont Sl:a p Valvs L1-1 KINO OF LI R SIZE NONE Limit ?.le. ? Droh Nood ,?-Z? Ryulaior Limit Soniny FiIM: Si»,_Lid ?- um6or ? Fon $atting n- U Clilmney Loeotion Inaide 'Y Outside Pilot Type Chimnay Consirucfien rZ°^ ^ Pilot Make f?l• %Z. Pilot Medsl Smoke Bom6 2zo, Wiring Pilot TiminQ n? Drah Toof Tay ? L.W. Cut Off Daor Prassura 4u-"? Liqhtinp Insf. ? ? Pressure Peresnf C0 Dute Tes»d ' 2 I.put CFH frV 4901577 P•resnf - 02? 1?-L -- Company Tesliny f 4 $tack Tamp. ''/' ? Pxwnf CO iT?^ tl' d tte Nam? oi TesN? iAe &4 l' Af Form 235 ?' - AD RESS OCNPANT _E HEAT LOSS SOLD BY (!; Elochieal Werk TYPE OF HEA HOUSE HEATING TEST RECORD?"9?_3l _(k°'"'?a?? ?^(Ake I? CLP y,nJ,y .012, APT. -FLOOR CITY ?SUBURB rr?? ? uP/oP... hE712./ OWNER ? ;AS C0. METER INSTALLED BY _ FA ,A _MW -STEAM -SPACE HTR. -UNIT HTR. -OTMER ?/ ; n ?AS DESIGN t CONVERSION MAKE ? MAKE OF BURNER Mod•1 6 e. Medol Swial ? Mox. BTU Rariny INPUT o MAKE OF FURNACE _ hbd•I CONT OLS rF/ THERMOST9 T ? aat Plup Voni Sf:e Valre /%?C ? ?l?e- KIND OF LIN SIZE NO E Limit ?IO7 qti-°LU e? Drch Nood Rpulamr ? LimiT Settinq FilTwn Sise um6er ? Fan Settinp Chimnoy Location In? ?-- Outside Pilot Typs C ? Qimmey ConsTrudion i? Pilot Maks ' " Pilot Modsl g Smoln Bomb ?Wlrinp ?l e s Pflot Timinp r'?kS ' K ? Draft i L.W. Cut Off tA .4 Dow Preasuro ?Ad: Liqhflnq lasf. 1m ? _ I/ 4 .? - Praasurs . ? P areantC02 Date Tesf?d Input CFH ? Pwcent ? Company Tssflnp U?'J[ ? Stack Tem P?rc?nt CO Nam? ef Tsat L Fmm 235 . 4116? HOUSE HEATING TEST RECORDQ--3 -764,AS LaKF 44 i ADDRESS 152 112 Ln . le-J/1.ISO/A APT. _FLOOR CITY -Aw?SUBURB OCCUPAN7 410- P.+.. _ ^,0s/.p ¢ OWNER HEAT LOSS D LIE HTG. INST. 7-?GAS C0. METER BADGE SOLD BY Su r,?Q+ {?[TG- INSTALLED BY Ig /- Elechieal Werk 8;. Gas Lins By T TYPE OF MEAT GA _ FA X HW -STEAM _SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN CONVERSION MAKE MAKEOF BURNER Modal Model Swial ? Max. BTU Raeinq . . . INPUT MAKE OF FURNACE Modal THERMOSTAT Valvs u, Limlt -? Limif SsMinB- Fan Settin9- Pilot Type ! Pilot Make _ Pilot Model -: Pilot Timing - L.W. Cue Off _ PIu9 Von1 Siza g` i/ KIND OF LINER SIZE NONE Drah Hood R?yulomr -L?1 R_2 ?.1 ?_ Filtera Si:s ° _Numbar ? Chimney Locae{on Inside_X Oufside 0nfP? ChimnsyCons}rucfion PreasuraPsrcenfCO ?? Input CFH P?rtent OZ / /v Stack Temp. Parcent CO 0142%5 Fwm 235 Smoka Bamb i`( A- Wiring yeS Draft • Q's n4e;)C T?n Tap y`p S Door Prosawa Li 4= Liqhdnq Inst !/Ie!!g Date Tatad Compeny NamaofTs?t Q v"'Y" gy, _,// • ? T?L ?? . ?••. "• •••.t` ' ?il?.l.i.;l' ? 5l.':? Ui [i1rLl:i` site plan w/elevations 6 IIUIIDIix': P17;1-SIT pu^PLIGaTIGN 1 set of energy calculatian 'Io Bc L'sec: For AuqO u?1 tT Va2uation?*Jjm;a? Datc '- --- _ , Site 1ddre55: /S ZI L?LEM50?1 Y>21l1C Lot A_ Blodk 3 Sec. fSub:TiMNws utKC +Lsmt?Esect Paroel t: !f) 75 q ST!' 0 30 cs 3 Alrer Repair Dwmr: 1/fFAJ6 f(A&Enl / (an45s Enlarge - M7ve Addzess: 2as3 d, R(Ce SfeEET Darnlish City/2ip Code: ST',?AuL- rAnl, 155-113 Grade OFFI(E USE QMY Occvpa zonirsq Fire Zom A) A - 7ype of Oonst. A St,ories " Front D ft Depth RIP_ ft Fhone & : '?83 - oBol APPPOVAL5 CAntrciCtOr: A?5 A6Ed HOMES AddYe55: 2353 hI. RldE S7-0EET City/2ip Code: 5-r'.?AuL- wd• ss <<3 Phcabe fl: -483 -0801 ?? NoM?s Arrh./Et,g.:WIA& 114 Address: 2325-3 /?, 2rdE 6-1-REE7- Gi=y/2ip Cocte: s„PA?? Mnf. 55t?3 Phore #: $93 -o8oi Assessments Water/SeNer Polioe _ Fire En9 • Plarner Crnincil Bldg. Off. APC Pezmit Surchaxge / 7 ? Plan CheC)c ! O 7 SPC -5-? Water Conn, ya ? water Meter ? Roaa onit avo 7UTpl, T 1y ? ? ' -( S r - 1 site plan w/e]evations 6 BUIIDINC: PI:iZ?iIT A,^[?LIG1T70N `` 1 set of er?ezgy calcvlativn t ? ??-? 4 ? 1/ t , `` ? - 7b BC USCC: FOZQUAD o AIIT V3Il]aL1.ofYry"j!@V?46W- L D3t.C ----- --- Site Address: )52/ 8 ?Le?nSon/ D2rc/E OFFICE USE ONLY lot &I_ Blodc 3 Sec./Sub.Tknnks ifiKs AEitAt3Erect g_ OccLpancy !13 Parcel p: /U 759 s-U 0701 O-S pepair Fire Zonc ?V?J l?Ak(5 f?i?GFJ? ?OMES E.tilarge Zype of Const. ?TL Nbve A 5tnries ft Address: 2353 Af• 1?1(CE Dm?nlish _ Front City/2ip Code: ST,?Auc. nnr+(• s?ri13 Grade Depth le Z ft Phore 0: 483 -080! APPFOVAIS Contractnr: Ar?L 9AG?A? W,11V-676 fYlcress : 23 5 3 Rte E S7-REE7- City/2ip Code: sT. ?A?L ". ss 1 f3 Phar d83 -OSoi Arch./Eng.: I?A?S tFAhh? fla4nes Address: 23?3 al Rtee 57XEE', Cit;//Zip Co'c.,2: 51-, PAc;(- e(AA(, 55-113 P:lcne 0: 4?03-68D! Assessments Wster/Seaer Police Fire II'e9 • Planner Council Bldg. Off. APC Pennit c2/5-'ie Surcharge / 7 -,?' Plan Check o 7 -y' sac sas- Water Conn. yg?o = water Meter Go Road vnit vyv ?t [ S 'ICri'AL -J 1 S ??S k .. zO ' ?? ?q 1 sitc plan w/clevations 6 ? IIUII1)I!9c: PF??ktTT A,^I'L7GITTCN set of e;r_rgy calculatioi - 7b IIc Us(x: For 4L)A0 vnlr'f Valua;iorv'3k;= patc -- -- SILC Add7CSS: /5-19 C'LEM50,1 `Ll2/?IE OFI'I(F USE Q,TI.Y Ivt '7 Dlodc 3 Sec./Sub.WNAs 41eE*4TS Errct X OmIPvw7' /( ? P.1T'CX'L M: CL 7S7 SC L?'iIZ C: 0:3 AlYL'Z Z(X11IKJ /'/J Repair Fire Zone ? C.wner: PAn15 dA6ERl 90nnES E.ilarge _ 1Ype of Oonst. ? Nbve A Stories Adc..ress: 2353 ?RldC 57'4GE7- Dcrnlish FYont O f ? Cit /Zi ?AUL rT Cole: ST 5113 G=ade Depth f . y p . 5 , Phom e: 483 -os or APPRLr.ALS FEES Contractor: /JAl?S llA&Er? J?annES Ftssessments Pezmit a/,Sf° Adc:ress: 23s3 1.( RrcE 57-4EE7- Water/Scwer Su:charge . Police Plan Chork /O 7 Cirf/2ip Code: Sr, b'4UL itnn/. 5-5'113 Fire SAC SaS? Fhone Y: ?4 3-o8a? ?3. Water Conn. .vsa ?- .,_ Planner hater Meter /a Arcr,./eng• : l/AWs dAC?,/ Nannes council RDad onit Bldg. Off. Address: 7-3 S3 d. RleE 512EE'r APC Citi/zip coe": 5?-?. P?ol_ run/. 55/0 Phcre #: ¢83-0S01 ZO? ._._ ?_.. v. ._....?"f??T.J ? X.IJ.:t' ? k':..? Ui f.i1?Li:i? ?. 1 sit l l 1 c p an w/c cvations 6 J DUITDM Pi:sIiIT pPPLIG1T70N ` 1 set of enezgy calculatior sr, c 'Ib Bc L, Foz i& ? , . Rub u N rr Valuat iOn fa R]tC A?l R?L 22 , ?R82-_ - ? Sitc 73dress: i519 3 Ct-EiASO„/ D,p«(E OFFICE USE (XILY LOL (D E310CJC -3 SCC. /S . TNonnAS IAKE }\E161F15 EI'CCC QCC17?k3fK:Y Parcel A: %v ?5c(.?0 L?o G3 Alter 7aning Pp Ftepair Fire Zone J R.aier: \k0.a6 Atavs?l I?orr.ES Enlarge -'jYFe of Wnst. hbve A Stories Address: 23s-3 tS, `R?eE ST2Ee-r Desnlish Front O ft City/ZlP CD?lC: ST. ?AUL n?.A. ss 113 ? Grade Depth o2_a ft Fho:ie k: 4-9 -z, -oBoi APPF37VALS FT.15 Contractor: AptyS NA6?4 FloMts Pssessnents Permit '-2 /s-? P[3dr255: 23 53 Rke? STRELT W3tft/SEt.er Surcharge / 7?- Polioe Plan Check /a > ? City/2ip Code: s,-, ?AuL- nnn1. 5'57113 Fire SAC 6-As- -*II Pha?e ?S3 -6$D7 F]?g. Water Conn. y,?0 ? plaruier Water Meter (oa ? Ar-ch./En,.: AArSs KA6e? \?onnES Council Finad Unit a S?D Zl'- Bldg. Off. Address: _23'S3 rS. '2?? s-72F-ET p,13C Citf/Zip Code: ',7,TA0t-- Mnf. s51t3 Phorz #: =AI, ?(-::; K5t -1 .;. BUILDINCa PERMIT CITY OF EAGAN 7795 Pibt Kaob Read Eogan, MN 55122 VHONE: 454-8100 4 PLEX N? 7209 Receipt Site AddreSS 1741 UlEUMO[1 IJr1V2 Erect M Occuponcy R 3 Lot 8 Bixk 3 $ec/Sub. IhCMS 1-*2 Heig}ltAlrer ? Zoning PD Parcal # 10 759 50 080 03 Repolr ? Fire Zone NA E V nlarga ? TYpe of Const. W Name ?g ? ? ?S Move Stories z Address 23$3 N. R7.C2 St.. Demolish ? Length4O- ci St. Pat11 55113ph,,, 483-0802 Gmda ? Depth-22_Sq. Ft.- p (y Aoororals Faes o Name _ ??H Address h r?w. Name _ Address 1 hereby ackrwwledge thot I hove read this opplicotion and state that the informotion is correct and agree to comply with oll opplicoble Stote of Minnesoto Statutes and Cify of Eogan Ordinonces. Assessment _ Wafer & Sew. Police - Fira Enp. Planner - Council _ Bldg. Off. _ APC Permit _ $urcFwrqe _ Plnn check _ SAC - Water Conn. Woter Meter Road Unit _ rocol $1585.75 Signature of PermiMee v,. I A Bullding Permit is issued to: ? 1°Ken Hmes on iha axpreu Caditlan thnt all work sholl be done in accordnnce with oll oDPlicoble State of Mirftsoto Sfatutesqnd Ciry of Eogen Ordinances. , Bulldin9 Official CITY OF EAGAN 5795 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 BUILDING PERMIT T. 6e wed {er 1 of 4 PLEX VW N? 7210 Receipt # Site Address 1.7L1 t5 (:leII1SOR llL1vE Erect N OccuponcY R 3 Lot 9 It Blxk 3 $ec/Sub. lhcmas lak?'' ?'`b"tS Alter ? Zoning PI) Porcel # 10 75950 090 03 Repoir ? Fire Zone NO. E l f T V arge n ? o Const. YPB W Name faL13 ?'13gfi1 ?E3 Move ? # Stories z qddreu 2353 N. Rice Street, Demolish p Length 40 p St. Paul 5511A0„a 483-0801 Grade ? Depth 22 Sq. Ft.- z ?1? Avvrorels Faea p Noma f ?u Address f r:.., e, "' Name _ Addresa 1 hereby acknowledge that I have read this application ond state thaf fhe intormotion is correcf nnd ogree to comply with oll apDficoble State of Minnesota Statutes and City of Eagan Ordirwnces. Assessmenf _ Woter 8 $ew. Police - Fire Eng. Planner _ Council _ Bldg. Off. _ APC Permit G1J.JV Surcharge 17.50 Plan check 107.75 snc 625.00 Water Conn.420.00 WoterMeter 60"00 Road Unit 740-00 Taoi S1595_75 Signotum of Permittee I A Building Permit Is issued to: HaI1S H3g.Q21 HQneS on the express condition thm oll work sholl be done in acmrdonce with all applitable Stat Minneso Statutes and Ciry o4 Eopon Ordinances. Build7rq Offlcial ?-s? „ CITY OF EAGAN No - 7208 . , 3794 Pilof Kno6 Rood Ecgan, MN bS122 - ` PHONE: 454•8100 BUILDING PERMIT Receipt Te bs wee ra 1 of 4 PIFX Est. Value $35,000 oore _ Apri1 7_9 _, i 9-B2- Site Address -151I B ClHi60i1 DL"].VE E,?t (I Occ„pa„cy R-3 Lot 6 Block 3 Sec/Sub.??s T?k? N°ightSAlfer ? Zoning PD parcel # 10 75950 060 03 Repuir ? Fire Zwne NA l E f C T V n orye ? onst. rPe o w Name H31'tS H22p11 FQma Move ? ?! Stories z Address 2353 N. Rice St., Demolish ? Length 40 ci t. Paal 55113 phom 483-0801 Grode ? Depth M Sq. Ft.- p 0 Nome Q"1C1flT Approvols Fees :kr ? Address Nome _ Addrese Assessment _ Water & Sew. Police - Firo Eng. iW I City phone Planner _ Council - I here6y acknowledge that I have read this opplication and stote that gldg. Off. _ the inlormotion is correct and agree to wmply with all opplicable APC $tate of Minnesoto Statufes and City of Eogon Ordironces. $Ignafure of PermiHee Pertnit 41J.JV SurcFwrge 17 - Sn Plan check 1.07.7 S snc 525.00 00 Water Conn. 420, WoterMeter 60•00 Rood Unit 240-0 n Tot,i $1585_75 A Building Permif is issued to: Hin5 Ha$en Hmps on the express condition thnl pll work shall be done in atcordonce with nll applicoble State Minnewro St es ond Ciry of Eapan Ordinonces. Buildinp Officiol ?`??P ? BUILDING PERMIT N? 7207 Receipf # -? gs? ?? Site Address 1?17 IJ.CII1SOi1 1JL'1Ve Ered (N Occuponcy R 3 Lot 7 Blak 3 Set/Sub. 7holiiiaS 1?o BeightSAlter ? Zonirg PD parcel # 10 75950 070 03 Repolr ? Fire Zone NA Enlorpe ? Tvpe of Const. V W Nome T7?,. ? •"Gen Homes Move ? # Stories = 1 Addross 2353 N. Rice St., pemoltsh ? Length 40 9 r,«. St Pa111 SS71 ?.___ L.R4_(lftll7 6rode n Depth 22 Sa. Ft.- a Noma _ r ,? Address r n.., Name _ Addren 1 here6y acknowledge that I hove read this opplicotion ond state that the information is correct ond ogree to comply with all oDPlicable $tote of Minnesola Statutes and Ciry of Eogon Ordinances. Assessment - Water 8 SeW. Police - Fira Enp. Planner _ Coundl _ Bldg. Off. - APC Permit L17.71/ Surcharge 17•50 Plun check127.75 SAc 525.00 Woter Conr42.0 .0.0 _ Water Meter60 - 00 Rood Unii 940 nn Toeol $1585.75 $ignofure of Permittee I A 8uilding Permit Is Issued to: IlanS Hageri Hmie$ -- on the express condition thnt all work shall be done in accordonce with all oppli le State of Myir ewta Stotutes ond City of Eogon Ordinances. Buildhq Offidat cIrr oF UcnN 7795 Pllef Kno6 Rmd Eagan, MM bil'!!' PHONt: 454-8100 1hiz ue4,,e?: '.o j 1;16 Is mowms fiou, T 93280 j.?1 p? 3, 11,.L K, 4 ?- 5 ) 2 " 3<a .e-"7 0 Rapues Dac 1 Fre No. Ruuuh-i InsuecLOn Rred, ?Feadv Nol NoUfy Inspec- t Wh E y" 94. or en Ready censcA Electncal Contracmr I hereby request inspec<mn oi above owr,er electrical work installed a[. S111,1ef Atldress, tlox or Rou[e No. Ciiy ??? o?? ?w.? U'd..7'0? e?uon No. Township Namo or Na. Range No. Co???y ?}T^ Occu PftlNTI ant( G Phone No. . ? t 1+'?? 1'_ Power Supplier ?% Address ?t?ir?e?'br Hec cal Contracmr (COmpany Neme) ?t L ,. r-,.? GonV.ctor's Lirense No. A:szs-z Mailin g AAdress fContraj,fnr or Own sr Makin8lnsta ilauon) ? ] p [ ??J?7?i?.1.?,.4"' Auth ied Sign t?re ( ntte}'?tor?Ownar Making Installation) Phnne Nwnber y..:.. MINNESOTA STATE HOAflD OF ELECTRICITV Gri99s-Mitlway Bltlg. - Room N-191 1821 Univarsity Ave.. Si. Paul, MN 55104 Phone (612) 297-2111 TNIS INSPECTION REQUEST WIIL NOT BE ACCEPTEO BY THE STATE 80AFD UNLESS PAOPEN INSPECTION FEE IS FNCLOSED. EB-00001-03 ( ?l( T REQUEST FOR ELECTRICAL INSPECTION ? i` ? i,? ??/ y? ?r' See insvucbons for complelin9 Uhis form on back af yellow -1PV ..v, ?.,_. L V.v ?_.,...,..i 1... TL„c R-uocf .. uc iv.. . ..,,............. _? ... BuJdin9 ._ ..__, ApUlmnce,s Wved Eqmpment Wued Ranye ervi ce Wa2er Hea2er tures dinc? Apt. Dryer aLnc W ial Bldg Fumace er WM l8ldg uCnoner ank OLncr V ifyl ( IIY y OAhCl LOIlIpUIe !/lSpc'?u?n i ec uw.i- Y Fee Servicg EnlranceSize 7 Fee eders/5u1dfeede11 Fe !t wts m s c 0 to 100 Am 5° Y' 0 to 30 Arn s 31 to 1 UO Amps Am s & , 101 to 200 Amps Above 200 Ainps Above 100-Amps 4 0-Am?s , - Remote Control Grc. thei Fee p [Transrormersr. ? ? l JSigns' Special Inspection S?C u ?r T OTALF E koiiHh-iiI ?`,,*? ' ?• tD? 1. the Electncai yecto, hnreby cervfv ihal the above -y Dan,?? , von has been Finol d' /' ? .,r). made. rh- . , inin r 18 'onths hom Thic requesl voitl ?? ?/ Z ,mot,,, t«,m ? 034b ucensen eiecincai "nvacmr 3000q 30,00 1 hereby request inspection ut above electrical work mstalled e<' r t Atldress, eox or Ro'uAte No. V ?? ?rY500 Ciry ecLOn o. Township Name or No. Rango Na_ Cou Occ ant (PflINT) s3 4wS ' Phone Ne. MS 6a?. Power SuO[D?lier Atldress • I ?%P+Vt? Electncal Contracmr (CompanY Name) ' ?tLl' C ?? knn r ta?or's L?cens)e No. ?L Mailtiny?gtAddreLss ICOntractor or(? O^wner Makinp Instailabon) ? 1 ii? F. , l'?"{?' P. Autth?onzed Sie wre ( traGtor/Owner Making Instailatwn) ? Phone Num?erc ?? 6 r ^-? . ? MINNESOTq STATE BOAND Of ELECTPICITY Griggs-MiAwaV eldg. - floom N•191 1827 Unrversity Ave., SL Paul, MN 55100 Phone 1652) 297-2511 THIS INSPECTION PEQUEST WILL NOT BE ACCEPTEO 9Y TME STqiE BOAND l1N1E55 PROPER INSPECTION FEE IS ENCLOSED. ? ? 0346o EQUEST FOR ELECTRICAL INSPECTION ,?.x Ee-ooooi.ea Un See mshucryons for cumplehng [his form on Fack of yellow mpy. "X" Below Wark Covered by Thls Reauest N. Add flep. TypB 01 BW IdiOg Appli:InCBS Woxtl EquiprtlBM R4r¢d Home Range Temporaiy Servicc Duplex Water Heater Lighting Fixtures Apt- Building Dryer Electnc Heatin Commarcial Bldg. Furnace Silo Unloader lndustnal Bldg. Air Conditioner Bulk Miik TaN< Faim ome...ooi,iN) om«:,ISpe??rvi ther SpecitY Othor Oiher °r? ?r??•????• ? cc u vvv W Fee SerwceEn4ance5ize # ppq Fenders/Subteednrs N Fee (;ircoits 0 to 100 Am s 0 to 30 qm s 0 tn 30 Am s 101 to 200 Amps 3I m 100 Amps 37 m 100 Am s Above 200 qmPs Above 100-Am s A4ove 100_Am?s Trarsrormers Remote Control Cvc. ParLal' Othe Siyns Special Insyection ? Re?„ks roraL F Ruugh-in 1 Date I, the Elechiwl ns0ector, hereby Final , -v- " ? ?f 4'i.. . Y.i'i?i j :./M??•??? G'?-e cerirty that the above mspecuon hes baen 18 manths from.?. ? S? B3, ?GwM < Lk, N", Thi< request void 919021 L 7/ 3 3, Tho?, L k, 300o Y ' 30, o a Requcst Date ? 5? Nre No. Finu{?h-in Insuertion R ?pwrc<f? ? ?-y' ? ReaAy No°? JWill Nulify Inspc?- ? ?es ?No ??? W??en Rendy V Licensed EIecUical Gontracwr ? I hereby rrquest msnecfion ol abnve Owner electncal work installeA et e[ Address, Rox or Foute No. 11515 C1l14Mix0;4 CitY 1*0W ectron o. Tuwnshin Namn or Nn qanuc No. Cnx1 ,n y 4?? Ocr RINTI ?Pii R?F?S FWS li% Phmle No E., ruwe?:r CsuPplier o°?!?y 'R'? r ?+_ Address Elyck icJl Contractor ICompany Nxmal ? ?"P Con tor'S Licen,p No. Id ' •,,... xSZ s-? M pailinq[ AdJress (ConhFaLclor or yO?w?ner Makmg Installatronl 1'S i6 ?. G ?Ct P ?P1E' . Au[hnnzed SiB a ura 'onhactor/Owner M.ikiny Installduon) Phone Nu m bor i r ' V .?zs, MINNESOTA STATE BOARD OF ELECTPICITY Griggs-Midway Bldg. - floom N•191 1821 Univarsity Ave., St. Peul, MN 55104 Phone 1612) 297-2111 THIS INSVECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOAND l1NLE55 PROPER INSPECTION FEE IS ENCLOSEO. REQUEST FOR ELECTRICAL INSPECTION EB-OU001-03 y?llow couv. ? -d90210 See inshuctions fm r.omulhting ihis form on back ot "X" Below Work Covered by Thrs Request New Atltl Rep. Type uf Bwldin9 Appliancas Wiretl EpuiUmenc Wiretl Home Range Temporary Se.rvicc Duplex Water Heater Lighhny Fixtures Apt. Bwldinq Dryei Electnc HeaLn Cpmmeicial Bldy Furnace Silo Unloader Industrial Bldq Air Condihnner Buik Milk Tank Parm atnoi oeary, otne, (Snec.ifv? Othor ,Si Oti CI[hpr COOIOtlIE I/]SUBCIfO/] FPP RP.IOW # Fee ServmeEnVanceSae a Fee Fexdens/Sabieaders u Fce Qrcw[s U? 0 to 100 Am s 0 to 30 Amps D(n 30 Am s 101 to 200 Amps 31 to 1 UO Amps 31 to 100 Am i Above 20i Above 100_Arnps Above 10i Tianstormeis HemoteControl Crcc. 77- Partial.0 Sic?ns Specil Inspeion r,_e? ) T Riv?4??ks > 3 ? OTAL fiJC7• Rough-in ? ' Datc I, the Flecvical ? y-f nspei herebV ce lil tl t th h Fuial ? ??d°? r y ia ovA e » pettwn has haen made rnis rrque,t vnia `" - - - • -bLl 1y mon[hs from Th,s,em,rst ?.,d 300oy IB mnnths Gnm 3o?ob ? q?,np? Renucs? Daf? Fire Nu. Rouph-in Insprclion Feq ired? E)Rqady Nnw WrII NutiH Inspec '5W 162,,. ?ya. ?Nn «orWhenReutlv ?.,L?censed blecineal Cmnractor I hereby rnyuest mspecbnn ot above ? Owner electncal wurk insialled at rt AAdres?. eox re Route No. 5fib CajhSzM D CIIy (AG ecimn o. Tuwnship Name or No. R,Inya No. Con??y D?c Vdnt (PflINTI '` l ? Phune No. 9 . ; Pawer Suooher kQa Address ?-4?,kf??O"-tAM Ne??1(I? oal ConVar?todf ICopmpany Name) ?/? Cl.i.?1-0L CunV?@ac'?toy`r?enso No. IQ S? 7(s L¢; 4 ? ?`-- Mniling AdJiess ICOnVar,tor or Owner Making InsT.illalmn) it1 k . (L uff- P4a) Authonzed Sign rx (COnVnv[odOwner Meking Installavunl • ? Phon/e 0Numb?e-ry ' ' ?, ( -+- J Jl MINNESOTA STATE BOAPp OF EIECTRICITV THIS INSPECTION ftEQUEST WILL NOT GriA9s-Midwey Bldg. - Hoom N-797 BE ACCEPTED 6Y THE STATE 80AHD 1621 Un,versay Ave., SL Paul, MN 55106 UNLESS PflOPEN INSPECTION FEE IS Phone 16121 297-2111 ENCLOSED. ` REQUEST FOR ELECTRICAL INSPECTION EP-00(101.03 IIISIlI?LLI0O5 IO, co??pien„e t??iz fo.?? on bac o? venuw cunv. J/' SEC k L 3000 Y "Y'" RA/nui Lllnrk Cnvered bv Thls Request _ Ne AAd ReP Type ot Bwldin9 Ho mF; AVOrianc25 WveA Range ment Wired .SP.fVICtl Duplex W2ter Heater -ixwies l1pt. Bwldin[? ?ryer eaLn Ir Cnmmercial Bldg Furnace adei Industrial Bidg. Air Condiuonei lank Oi??Nr SPei.iry ?'ifyl fa?m ??her c.Urnpule inn?ir.?uvn r cc ??,? .. ServmeEnvanceS¢e d Frte FeeACrs/SuMeetlers 41 Pee circwts p Fee 0 ta 100 Am>s 0 to 30 Am 5 0 ?0 30 Am )s 1?1 to Z00 Amps 31 ro 700 Amps 31 to 100 Am Abwe 200 Amps Above 100-?m2S la6ove 100-4mps RemUte Control CirC. Partial Other Fee Transioiinery \ Speaal InsPecvon . ?• S- v TOTAL B• Reniark•. Rnuyh-m `a"' p I the Electncal nspnctoq hareby certdy that the. ebuve Fi„al /n nms nopn This ie411est vo'd 18 months 6om CERTiFICATE OF SURVEY For: HANS HAGEN HOMES, INC. ? ' E/ew?/.ms s6vrv o.r ? ??red ? ll V RECE"ff APR - p i&82 ?? /? ? 9 • , , , p °s qL v?b i ?- ,.`__ . ' ---`._ -:,- ?, ? f V ? ?'\ q16 O ??o / O '/ ?4?? ?v Lots F Yhrc;ueh 9, incLnsive, B1nck 3, THON[:1S LAKE HEIGHTS, Dpkc+t2 Crnintv, Minnesrta. C-.,oge k5 se -11 D,o ?O/7p SCALE 1 Inch= °O Feet o Denotes Iron Beanngs shown are on an assumed dotum. Job No.9'sa-677 gook= Poge_ We here0y ?certify thoi }his ie o frue and Correct represenfafi0n o} a survey of fhe E. G. RUD a SONS, INC. boundories af fhe above deacribad lond end of ihe location of all buildinqa, if any, ?qND SURVEYORS thereon, and all visible encroachmBnis, if any, frOm or on said land. E. G. RUD & SONS, INC. 9560 Lexington Avenue N. oated tnis??? doy or A°-/ g?fz. ?"3?f -) ,? New Brighton (Lexmgton), Mmnesota i bY ,?'x«o? 55112 Minn Req. No. 9e0g Telephone. 766-5556 CERTIFICATE OF SUItVEY For: HANS HAGEN HOMES, INC. ? i . ? Qenoi?r o ca?n?v s.Nra'e a a.?+?. N feYOfiev?s s?ivw. ? e P a?s•ro? ^ ?l ?I 1/.9 41OS ? - \ 9 Un„' 9u.?o'. 1 \\ V Go-?tii ° ? " 'noi? ? s? ???`?.??2? .? ? ? ?? P \? J 01 +I w Z. O= , ' -- C-D i ? Uv ; Trts F through 9, i_nclusi.ve, Blc,ck 1, T'H(`"1:15 LAKE ITEIGIITS, U,-knta Count5', i Minnesnta. y Cnii.Og< Har.re S_' G%o - ??! 9D SCALE 1 Inch ='O Feet o Denotes Iron Bearings sFawn are on an assumed datum. Job No 9'?'P ?'' Book- Page_ we ne.eby certify tna+ this ts a t.ua and corroci revresemation ot o survey of rhe E. G. RUD & SONS, INC. Doundaiies of IAe above destribed land end of ihe location of all Euildinqs, if ony, LAND SURVEYORS thereon, and al1 visible ancroacnmanis, if ony, from or on said land. E.G. RUD a SONS, INC 9560 Lexington Avenue N . Dated mis?/r7oQY o} New Brighton(Lexington), Minnesota py ,cY 55112 Minn Reg. No. 9828 Telephone: 786-5556 ? ENEBGY REQUIREMENTS `Thie form to be completed and submitted with building permit applications EXTEAIOR ENVELOPE AVERAGE "U" ClaMPUTATION OWtiER _}1AhI S 1,'-r6c,cl /?ON?ES SITE AODRESS i CONTRACTOR 1)Ar1 S }(qE,?l ??Vt?? DATE PHONE 4,?'3 •GSo? ' Determine working square footage of each. ,t 1. Total exposed wall area ..... 12 ?G?.' sq. ft. x .N" = Z3E?,2& .od• 2. Total roof/ceiling area ...... (oll sq. ft. x OEr = yq. Total exposed wall area above floor = 1-2 40 a. Tntal wall window area ........................... -7 q h. Total door area ................................. x a c. Total sliding glass door area ................... ? d. Total fireplace wall area ........................ Ib e. Total wall framing area (average lOX)...:........ iOt f. Total net wall area above floor ................. g,!? q+Z g. Tota] rim jaist area ............................ 92 Total exposed foundation area = 4-,4 h. Total foundation window area..................... i. Toa7 net foundation area ahove grade ............ st.g Determine "U" value of each wall segment. a. 7ci X „ult ,s=> b. ?c) X ,luff c. 40 z "u" d. I !a x "U" ,47 = 5? e. t t71 X NUli . i 3 = i? ! 3 f. q1Z X "U° y. -7 z x °u° oc• = 4, 32 . . h. ?' A y ftll pV X tlu,t 47 a 2 l. S 1? 3 .....................................Tota1 ' i79 TT771 If ftem A3 is the same as, or less than item fl, you have met the lntent of SBC 6006(c)Z. • e'f?/?!?cKr ? ' {F,? ' L?l?l? r Total exposed roof/ceiling area _ k. Total r of/ceilinga framing.area(average 10%)... 1. Total net insulated roof/cei'.ing area........... _ • Determine "U" value for each rocf/ceiling segment. f ,-----_ X null -?- ----?_ X »Ull : o4 _ ? ?•_ ssc x ilUti ' 03 ------- = / 4.. ......................... •••....Total 1f total of #4 9s the same as, or less than fl2, you have met the intent of 5EC 6006(c)1, . Alternate Building Envelope Design , io utilize the tctal envelope system method, the values established by the sum of items #3 and #4 shail not be greater than the sum of items #1 and S2 l. 23o .2P> + 2. 2-f 4¢ ° 2_&2,_?2 3. /-29.82 + 4. 1qg 76 . a CITY USE ONLY (, ? g? ? RECEIPT #: SUBD. DATE: `/'Co 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos whEan permits are required for each unit FIXTURES Shower EACH 3.00 x Waier Ciosei 2•00 Y Bath Tub 3.00 x Lavatory 3.00 x Kitchen Sink 3.00 :c Laundry Tray 3.00 x Hot 3.00 :c j ater Heater 3.00 :c Floor Drain 3.00 x Gas Piping Outlet * minimum -1 3.00 x Rough Openings 1.50 x Water Softener 5.00 x Private Disposal ` Dakota Cty. license 65.00 (new and refurbished systems) U 'nkler " home under const. 3.00 Alterations xdsting 20.00 Water um Around 20.00 STATE SURCHARGE TOTAL SITE ADDRESS: °ovLE rv+R7 1521 B CLEMSON DRI4E EAGAN , 55122 OWNER NAME: H 45z-5391 w INSTALLI STREET T14. TQTAL .50 • SU CITY: STATE: ZIP: PHONE #: ( ) ? -X) . City of Eagan 3830 PILOT KNOB RD EAGAN, MN 55122 (651) 681-4675 Permit Type: Building Pelmit NUmber: EA034783 Date Issued: 03/23/1999 Site Address: 1519 Gemson Dr Lot: 7 Block: 3 Addition: THOMAS LAKE HEIGHTS Description Sub Type: 04-plex Work Type: Reroof DescripCion: Census Code: AddiCion/Bsmt fin/Decks/Porch UBC Occupancy: Construction Type: Zoning Square Feg,t:.,%,, (yR ?:- .. ,?N:" 'Mly?`;P.iFai{_.vi:?m ? -ygo Remarks: I„cluaes: 1519s,1571,and1521R. Fee Summary: State Surchazge 6.00 Valuation: $12,000.00 BaseFee 209.25 $215.25 Contractor: - Applicant - SELA ROOFING & REMODELING St. Lic.: 4100 EXCELSIORBLVD ST LOUIS PARK, MN 554160000 ' 6128238046 Owner: Thomas Lake Home Owners Association 1535 A Clemsan Dr MN 55123 651-688-8245 0 I hereby acknowledge that 1 have read this application and state that the information is conect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ApplicanUPermitee: Signature PERMIT I Issued` : Signature . 1999 BUILDING PERMIT APPLICATION (RE$IDENTIAL) 3830 PII.OT IQNOB an ssiaa (651) 661-4676 New Construction Reauirements RemodeUReoair Reauirements ? 3 registered site surveys ? 2 copies of plans (inGude beam 8 window sizes; poured fnd. dosign; etc.) • 7 energy wlculatians • 3 copies oT tree preservaGon plan iT Wt plaUed aRer 7/1/93 requir Yes No DATE: ? DESCRIPTION OF WORK: ? Name: ? /J , T/??e ?w'v'PVS S N < Phone #: Laat First - 1(2 hSv ? ° \ J STREET ADDRESS: C-leh^ S D-? ?IV?P- LOT: ? BLOCK: ? SUBD./P.I.D. #:l.1'kQ-'VV1Lt,Q. AL, PROPERTY OWNER ? 2 copies of Plan ? 1 efte surveye (exterlor edditions 3 decks) ? 1 energy calculatlons lor heated addkiona CONSTRUCTION COST: /??3 67v?.•-N.y ?nesL. ??m ?L?ana o?.??s 1 / _ StreetAddress: 11- C? 7 CX ? StM Vd--1 Ciry ??/l i? State: /f= '+,-*' Zip: ? Company: FING8c REMODEldNG.INC. Phone #:,od3 CONTRACTOR 4100 LK ' Street Address: . IAU[S PARR+MN 55416 License #Of)0) a-'T(D Exp. ID City #UUUIUDV State: I?rcLt St?Q?eaN ?9l+osrv Zip: ARCHITECT/ ENGINEER Company: Phone Street City Sewer 8 water licensed plumber (new construction only): _ change and lot change is requested once permit is issued. t hereby acknowledge that I have read this application, state that the State of Minnesota Statutes and City of Eagan Ordinances. Signature of OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No Registration #: _ State: Zip: ition correct, f? 9?. - Not Required Penaity applies when address to comply with all applicable 03/18i99 TSU 03:48 FAS 612 806 6705 SiPLS PAYROLL DEPT RFC a a a - PHONE .? UNIT N?II? PHONE NUMBEI3 ?b f?-A S *5t3A-- RP MANAGEMENT 378-0595 RICK JOHN50N 887-9410 3i3bEF- GEftlU.01NE ?RESTIOGE 686-2965 -4517A JANET MCCI)RMICK 805-1987 ?c?xo ?rsYU?EN C:ASIL.F 45d?1 IsIen OIANE EFTA 4S+-7954 15188 ANNE TEMPI_EMIW 68141361 15i9A SORAYA R05HAN 406-6893 15198 GREG DANGER 688-3467 1520A PATRICUIRINGf3ENBERG 687-9269 1$$p8 WILLUIM LE:iCH 681-0368 1521A DEBRAOYSI.IN 686491e 1521B MARY DOYLE 452-6391 1523A JOHN QUICi. 68fi-63Z5 15238 PETER BOCK 6864M 1525A JANEIVERSWd 687-0933 15258 ARLENE PAiJNER 686-%W 1526A KAREN BAR BER 4543783 15266 JASON lILL1E 696-7193 1527A KAREN COH OES 456-0388 15278 ANGELA KPNOOF 4054i77 1529A ROBER7A ELLIOTT 681-0373 1528B NANCY HAF PER 452-7842 1528A LAUREN FIbIL.EY 683-1116 15298 DEAN NEISON 452-5847 1530A NICOLE PALMER 40545M 153pg JEAN BESEIAAN 40S41861 1531A RICHARO WVUPT 4524598 15916 AAARV POOR7VIET 686-7540 1532A JIM MCDONNLD 405-0577 15328 KAREN OISON 6954= 1533A OENNIS BE1lNIER 686-6524 t5338 SANDY WNrIVER 6884383 1534A 61LL FL•Alll]rlf 888-7488 15348 BETTYOAVIS 4544891 1535A DICKSWEOgAN 6OM46 15356 PAM SCHMITZ 6834M2 1536A LEE ANN 6i VME RuN u r,UQr 4543194 15369 ARIENE NIpJU 4524808 1537A MUHIEDINE CHAABAN 454-7281 15378 PAULJUNG 4544220 la 002 ? osu ? "o ,?..?, `'•5 IN Y'D? 0' ? zg?J ? ,/(S :5 -,?Y5 A a ? - Is-a 4 ?s,9 _1S,a?0- ?7,??3 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651•687•4675 New Construction ReaulremenN ? 3 regisfered sMe surveys showing aq. R. of loT, sq. R. of house and all roofed areas (20% ma:lmum lot coveraae allowed) ? 2 copies o1 plans (show becm 3 window slzes; poured Ind. design; efc.) ? t set o1 energy calculotions ? 3 copies W free presenaNon plan M lot platfed aHer 7/1/93 DATE: ? .14 ' q? DESCRIPTION OF WORK: ? ? WL, ???•j? ? STREET ADDRESS: ),r- n t"* ? ?e LOT: ? BLOCK: v SUBD./P.I.D. t?: ? t3 - ? P?4 .t r"t Phone #: PROPERTY ?ost OWNER Street Address:. Firsf s ).fA { . A 0-.? City tN• Aw State: /?`?? •V Zip: ? Company: PR Phone #: J)T> > (area code) ?.?. CONTRACTOR Sheet Address: License 4k°1? ?J ?Exp•?4S1/-100 City G4? ?`a?e G%?^°? State: ? Zip: ti.kjw L' ARCHITECT/ ENGINEER Telephone #: area code ( ) Name: Stree't Address: Regisiration #: Ci}y State: Sewer 8 wafer Itcensed plumber (reauired for new eonstructlon onlvl: Penalfy applles when address change and lot change is requested once permR Is issued. Zip: I hqreby acknowledge thaf I have read this applicatlon, sfate thaf the informafion is co t, and agree fo compl wNh oll applieabl State of Minnesota Statutes and City of Eagan Ordinances. O Signafure of ApplicaM: OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received _ Yes _ No _ Yes _ No _ Not Required Remodel/Reoair ReaWremen}s 2 coples oi plan 1 sef of energy calculaHOns tor heafed addNions 1 aXe survey for exterlor addMions 3 decb CONSTRUCTION COST: VwDo.? CITY USE ONLY LOT ? BL ? PERMIT #: susn. RECEIPT #: RECEIPT DATE: O CJ 2000 MECHANICAL PERMIT (RESIDENTIAL) CZTY OF EAGAN 3830 PIIAT IQtOH RD EAGAN DIII 55122 ? 651-681-4675 Date• Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under consfruction and not owner/occunied. • HVAC: 0-100 M B T U ADDITIONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) $ 30.00 6.00 State Surcharge .50 Total $ Complete this section onlv if you are remodeline, addine to. or re airin an existing single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. _ New _ Alteration ? Repair _ Other Fumace _ Air exchanger Reminder: Call for inspections SITE ADDRESS: ! 5a?I OWNER NAME: _ INSTALLER NAME: STREET ADDRESS: CITY: ? Airconditioning ,G"? _ Other Fee State Surcharge Total $ 30.04 -.5.0 $ 30.50? Ci PHONE#: bs(- 'I S?• ? sJ"l ) (AREA CODE) ? - ' rA, PHONE #: ?? (AREA CODE) GAS .WORK ORDER 1082 Payne TANDAH FRo' 410 W. Lake St. J ' D St. Paul, MN Minneapolis, MN 55408 651 /772-24 H'EAT I N'? O 612l824-2656 ? A Blue Dof. Service Co. FOI IIPMFNT INFORMATION LAST :T411e' FIRST mOj? ADDRESS /So11E eMSOn D2' CITY &'Aqan ZIP 551 t Z HM PH?GSf) 615a-5-7 9/ WK PH TECH TM DATE lllelW TYPE kat MAKE <- MODEL 3?o?oavoayoLl???f4- SERIAL ,?19Gb7,4?2 -76 INPUT ? I ORSAT TEST RECORD C02 G' y °k METERED INPUT ? Cfh CHIMNEY TYPE 02 % LIMIT SETTING C'?'cks ah ° FLUE SIZE ? in. CO C) % PILOT OUTAGE ASf S2C CONNECTOR SIZE y in. NET STACK TEMP TOTAL CHIMNEY INPUT btUh ? COMMERCIAL 2002 BUILDING PERMIT APPLICATION CITY OF EAGAN 651-681-4675 o -? Foundation Onl New Construction Interior Im rovement • Structural Plans (2) sets • Architeclural Plans (2) sets • Architectural Plans (2) sets • CivilPlans (2) • StructuralPlans (2) • CodeAnalysis (1)" • CertificateofSurvey (1) • CivilPlans (2) • ProjectSpecs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • ProjectSpecs (1) • CodeAnalysis (1) " • Master Exit Plan (1) . Spec. Insp. & 7esting Schedule • CertiFlrate of Survey (1) • Energy Calculations (i) not always" • Soils Report (1) • Spec. lnsp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always" • Meter size must be eshablished . Meter size must 6e established • Meter slze must be established - if applicable • Project Specs (1) L • EnergyCalculations (1) 1 • Eleclric Power & Lighting Fortn (1) " d b . Master Exit Plan (1) y 1 • Emergency Response Site Plan (1) ! • Soils Report (1) i • MGES SAC deteimination letter . MCfES SAC determination letter • MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 call 651-602-1000 Food & 6everage or lotlging tadfities - submit plan to MN uepartment ot hearcn. cau oo-i-z-ia-v7v6ior ?em!u. Contact Building Inspections for sample. Permit for new buildings or additions will not be processed without Emergency Response Site Plan. Ask Building Inspections for requirements. I?1 9GS? DATE: Z WORKTYPE: _ NEW _ REMODEL CONSTRUCTION COST:? ? SITE ADDRESS: I S Z TENANT NAME FORMER TENANT NAME, IF APPLICABLE: DESCRIPTION OF WORK? Name: PROPERTY Last OWNER Street Address: City: Company: CONTRACTOR ARCHITECT/ ENGINEER Sheet Address:"1 v v City: T?T Cornpany: Name: Sheet Address: City: State: Zip: Phone#: 4-Z Z3-a2?)? ? Phone #: Zip: Registration #: ? State: Zip: ` - - -1 Licensed plumber Installing new sewer/water service: Phone #: I hereby acknowledge that I have read this application, state that the information is correct, and agree t? comply with all applicable State of n . i State: SUITE #: -1- #: ?c S( ? &81- $2C(S First Minnesota Statutes and City of Eagan Ordinances. D I' 1 i n ?/,, y,( ,? Signature of Applicant: ? ?1 Updated 7/02 ' 75950 THOMAS LAKE HTS 2ND 1515 10 75950 030 03 1515B 10 75950 020 03 1517 10 75950 040 03 1517B 10 75950 050 03 1518 10 75950 020 02 1518B 10 75950 030 02 1520 10 75950 050 02 1520B 10 75950 040 02 1519 10 75950 070 03 1519B 10 75950 060 03 1521 10 75950 080 03 1521B 10 75950 090 03 1523 10 75950 110 03 1523B 10 75950 100 03 1525 10 75950 120 03 1525B 10 75950 130 03 1526 10 75950 060 02 1526B 10 75950 070 02 1528 10 75950 090 02 1528B 10 75950 080 02 1527 10 75950 150 03 1527B 10 75950 140 03 1529 10 75950 160 03 1529B 10 75950 170 03 1530 10 75950 100 02 1530B 10 75950 110 02 ] 532 10 75950 130 02 1532B 10 75950 120 02 1531 10 75950 190 03 1531B 10 75950 180 03 1533 10 75950 200 03 1533B 10 75950 210 03 1534 10 75950 140 02 1534B 10 75950 150 02 1536 10 75950 170 02 1536B 10 75950 160 02 CLEM50N DRIVE 5 (PAGE 1 OF 5) CITY USE ONLY PERMIT #: ") L 6 U ? RECEIPT DATE: 2002 ftESIDENTIAL MECHAIVICAL PE$MCf A#'PLICATAONf CITY OF L'AfiAN S$SO PILOT KNOB $D ERfiAN MN 55122 651-6$1-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unil Date: 1 ?0 ?L? SITE ADDRESS: OWNER NAME: O TELEPHONE #: A(o_ INSTALLER NAME: TELEPHONE #: STANDARD HEAIING 8 AIR CONOITIONING . STREET ADDRESSM 410 WEST LAKE STREET 612-824-2656 CITY: STATE: ZI P Place a check mark next to the permit work type 2(\ Add-on, modification or alteration to existin dwelling unit $ 30.00 • furnace replacement • air exchanger • air conditioner • other Nature of work: ("o `aF/ j ? 2r?? . ,..? , State Surchar e $ 50 Total $ SGNATUR- P R T ? vQ ` I ciaa COMMERCIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Foundation Onl New Buildin Interior Im rovement • Structural Plans (2) sets . Architectural Plans (2) sefs • Architectural Plans (2) sefs • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) " • Certifcate of Survey (1) . Civil Plans (2) • ProjeCt Specs (1) • CodeAnalysis (1) • LandscapingPlans (2) • KeyPlan (1) • ProjectSpecs (1) • CodeAnalysis (1) " • Master Exit Plan (t) • Spec. Insp. & Testing Schedule • Certifipte of Survey (1) • Energy Calculations (1) not always" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power 8 Lighting Form (1) not always" • Meter size must be esiablished • Meter size must be established • Meter size must be established-if applicable ! • ProjectSpecs (1) 1 . EnergyCalculations (1) d • Electric Power & Lighting Form (1) " b d . Master Exit Plan (1) 1 1 • Emergency Response Site Plan (1)'*" 1 1 • SoilsReport (1) 1 • SAC determination • call 651-602-1000 • SAC determinaUon - call 651-602-1000 SAC detertnination - call 651-602-1000 Call MN llep[ oFHealth at 6S l-Zl5-U /UU Tot tletails 7egaitling f00p &beverage 0r lotlging IACIn[t03. Contact Building Inspections for sample and iFraquired when it states "not always". *** Permit for new building or addition will not be processed without Emergency Response Site Plan. Date ?/ 2 9/ v"3 Construction Cost 'L ? UC19• KV Site Address j.S'/ Cf - Z r -1'43 Ck.,n+5 ?-r? /} >' ' UniUSte # Tenant Name O rr+sp ?V L r} ke- Former Tenant Name p?L` 1.vc , c...v Description of Work S Property Owner n'-L Ir Telephone #( ) Contractor S Xic. Qov?r? S 12,rnm ? A1--- ? Address 1-t/ U-U 15:t ?e 15tv-11 0/- v ? City S/ ' Ln ? s State Zip s'S 4L < Tetep6one # ( ) (}GO/?S? ? -lt Arch/Engr naaress Registrat city AN 3 0 FJ) State Zip Telephone # ( Licensed plumber installing new sewerlwater service: Phone #: I hereby apply for a Commercial 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 Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. L, Z r ApplicanYs Printed Name Applicant's Si e THOMAS LAKE HEIGHTS 75950 PERMiT DATE & TYPE a/s2 8/82 6/81 4/81 LOT BL ADDRESS 4-PLEX 060 03 070 03 080 03 090 03 4-PLEX 100 03 110 03 120 03 130 03 4-PLEX 140 03 150 03 160 03 170 03 4-PLEX iHO 03 190 03 200 03 210 03 10/80 4-PLEX ZZO 03 230 03 240 03 250 03 1519B/ CLEMSON DR 1519/ 1521/ 1521B 1523B/ CLEMSON DR 1523/ 1525/ 1525B 1527B/ CLEMSON DR 1527/ 1529/ 1529B 1531B/ CLEMSON DR 1531/ 1533/ 1533B 1535B/ CLEMSON DR 1535/ 1537/ 1537B PAGE 3 OF 3 30 (p () ? a L/ RESIDENTIAL BUILDING Permit Application City Of Eagan °3830 Pilof Knob Road, Eagan MN 55122 " • Telephone # 651-675-5675 -: FAX # 651-675-5694 New Co'nsWction Reouiremenfs Rem6deVReoair Reouirements OKce Use Onlv 3 registered, srte surveys showing sq: (E;of IW, sq. ft of house; and all roofedareas 2 copies of plan Cert of Survey Reed (20°h maximum bt coverage all(yHed) 1 set of Energy Calculatbns for heated additions Tree Pres Plan Recd 2 copies of plan showing 6eam & window sizes; poured tound'deSign, etc. isde survey foradditions 8 dedcs Tree Pres Not Reqd i set of Energy Calcula6ons AddAion -indicate Non-site sepfic sysfem _ On-site Septic System 3 copies of Tree Preserva6on Ptan if lot platted after 711193 ' ? " •' ' Rim Joist Detail Options selection sheet (hldgs with 3 or less unAs Date ' Construction Cost ?"? I 3 a t/ ress / Site Add ._? ` b4-W, S JvN UniUSte # p Description of Work J ',/lC O W ? o o j r r-oloftic-evvietif Multi-Family Bldg Y ? N -?? Ftireplace(s) 1 _ 2 Property Owner I O 1MQ.?6 Luk Q 14 0m20_ti-ef < SSOC ijid 1Telephone #(rp5j) CA <9,3 ` 1 rp QA Contractor pn t A-A-P [ G C0 v1 ? '} 10 C1 Vn `c) ..11 N C _ Address kp City I.MJoddr? ?F11 State M /U Zip ,' • ' t ` Telephone # (y ? s q 3 COMPLETE THIS AREA ONLY IF ,. ; Energy Code Category Minnesota Rules 7670 Cateeorv 1 • Residential Ventllation Category 1 Worksheet (ysubmission type) Submitted . • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING Minnesota Rules 7672 ' . New Energy Cade Worksheet Submitted Telephone # ( Telephone # ( Telephone # ( 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 Statutes; I understand this is not a pernut, 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 approva] of plans. ? rc ? ? (??,,?r ? r s Applicant's Printed Name Applic Ys Signature MECHANICAL (RESIDENTIAL) Permit Application City Of Eagan C) O--I 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when pertnits are required for each unit 'U 30. t? Datez.?/ / ?2-0 / 0'?!> SiteAddress 4Ll Unit# Pro ert Owner T l h # ?isO - l p y e ep one ( c'ontractor STANDARf; .:?::;TING 8AIF CONDITIONING C0. 4i;: 'IE5T I,AKE STFIF-hi Street AddrelAINNEAPOLIS, MN 55408-2996 City 612-824-265 State Zip Telephone # ( ) The Applicant is _ Owner ?Contractor _ Other Add-on, modification or alteration to existing dwelling unit $ 30.00 ? fumace replacement air exchanger ? air conditioner ? i A,1G 2 other - I-? BY - - - - --? State Surcharge $ .50 Total I hereby apply for a Residenrial Mechanical Pernut and acknowledge that the information is Ue in conformance with the ordinances and codes of the City of Eagan and with the Mechai permit, but only an application for a pemut, and work is not to start without t; ai approved plan in the case of work which requires a review and approval of p ns i curate; that the work will ,; that understand this is not a will b in aceordance with the / Applicant's Printed Name ApplicanYs 651zl,?) 2004 RESIDENTLAL BUII,DING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 C) C, . la-? New CansWction Reauirements RemodeVReoair Reauirements 3 reg'stered site surveys showmg sq. ft of lot, sq. R of house; and all roofed areas 2 wpizs of plan (20% maximum lot coverage auowed) 1 set of Energy Calculations fw healed addillons 2 copies of plan showing 6eam & window sizes; poured found desgn, etc. 1 sile survey far additions & deccs 7 sel of Eneigy Calculations Add'dlon - indicafe iI on•srTe septk sysfem ME 3 copies of Tree Preservatbn Plan if lot plattetl after 717193 Rim Jast Delail Optlons selection sheet (bldgs with 3 or less unRs Date ? /20 / Construction Cost 3,09 / (J-CJ Site Address ? C, !i UniUSte # Description of Work ? C ,-- C,? k C?/ Multi-Family Bldg YY _ N Fireplace(s) 40 _ 1 _ 2 ert P o Owner -? r hone #?1 ) o'?? ?/ U Tele y r p p Contractor Address z7- C? c- City /i/? G_? 0? State e Sa Zip J G Telephone #( 7 7.?` 1 2 ?.? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUlLDING - Ivlinnesota Rules 7670 Cateeorv I Minnesota Rules 7672 Energy Code Category . Residenfial Ventllation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Su6mitted SuhmiUed . Energy Envelope Calculations Submilted Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Telephone #( Telephone # ( Sewer/Water Contractor Telephone #( D -_ I Y' I I hereby apply for a Residential Building Permit and aclrnowledge that the informatjon is complete and irate; that the work will be in conformance with the ardinances and codes of the City oq,agan and the State o MN Statutes; I understand this is not a pernut, but only an application for a permit, and workis rio?f'"o"sfa`it'vvitP°iout a permit; that the work will be in accordance with the approved plan 0 ?4e case of work wXch requires a review and approval ofplans. ? ApplicanYs Printed Name Ap ' 's Signature -40? 2 I 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 -J?r- ?7-0 . a-ll New ConsWClion Renuirements RemodeUReoalr ReauiremenLS Office Use Onlv 3 regislered site surveys showing sq. ft of lot sq. tt. of house; and all roofed areas 2 copies o( plan Cert oi Survey Recd _Y _ N (20%maximum lot coverage allowed) 1 set of Energy Calculatlons for heated additions Tree Pres Plan Recd _Y _ N, 2 copies of plan showing beam & window s¢es; poured found design, etc. 1 site survey foraddHions & decks Tree Pres Requlred _Y _N lsetofEnergyCalwlations Addition-indicateifonsResepticsystem On-siteSeplicSyslem _Y _N 3 copies of T2e Preservation Plan tl lot plaHed aRer 717193 Rim Joist Detail Options seledbn sheet (buildings wAh 3 orless unils) Date Construction Cost Site Address UnitlSte # Description of Work /N3/ ftl_. 645 Multi-Family Bldg ? Y _ N Fireplace(s) _ 0 k1 _ 2 Property Owner /°?(?'?- ? ?1 L L? Telephone #(61-?) y^ ? Contractor Address /Y3S9 /??i?^? /h/GS City 5/9?/t(G'? State Zip Telephone # ( 00:;) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Workshael • New Energy Code Worksheet (J submission type) Submitted Submitted . 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 plan8 _ Y _ N If yes, date and address of masTer plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( 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 Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved pl in the c e f work which requires a review and approval of plans. ' ?q 0 Applicant's Printed Name Ap licant's Signatur r________________- For Office Use Permit vb6 City of EaEd~ I v I Permit Fee: ~ C/ 6D 3830 Pilot Knob Road I I j Eagan MN 55122 Date Received: 0go Phone: (651) 675-5675 I Fax: (651) 675-5694 I Staff: I I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: U Site Address: / / l Tenant: Suite ry RESIDENT / OWNER Name: Phone: J1 Address / City / Zip: 6 Applicant is: Owner Contractor TYPE OF WORK Description of work: m Construction Cost: i~(p~. ~C~ Multi-Family Building: (Yes /No CONTRACTOR Name: License Address SEI.. AROOFING & REMODELING, INC. 4100 City: 81, tTI$ PARK, MN 55416 State: Zip: & ~ -0 10001 I Phone: Contact Person: l t- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted N 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 may be classified as non-public if you provide specific reasons that would permit the City to conclude that the 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 art with perm ; t the work will be in accordance with the approved Ian in the case of work which requires a review and approval of plans. x~ x Applicant's Printed Name Applicanti's nature Page 1 of 3 Oct, 19. 2009 8:54AM Sela Accounting No.8161 P. 3 AM R CAN F~R11~ American Family Insurance Group /f/~O NOAfFW30KSd NFAtINlNT" THOMAS-LAKE-HOM EO'WN4 Building J - 1 Exterior Roofing, Description ~ast placement Actual Cash t r Taxes Total Depreciation _ Valuo rb- elated damage found to the building roof at the time of inspection e Furnace vent - rain cap and storm collar, 5" 4-00 EA $8.88 $0.00 e Furnace vent -rain cap and storm collar; 5" 4.00 EA $35.67 4.7b $4.76 Siding Description Base Service Qt Unit rice Char & Taxes This is a repair to the front siding and no depreciation applies 2a - Remove Vinyl outside corner post 8.00 LF $1.04 $0.00 $0.00 n_ 2b - Replace Vinyl outside corner post ~,A 8.00 LF $3.78 $0.84 $0.92 3 - Replace Metal or Vinyl siding - Detach & reset 100.00 SF $1.42 $3.99 $0.27 \ V Totals $4.83 $1.19 Fascia Description Base Service Replacement Actual Cash Qt Unit rice charge Taxes Coat Total Depreciation Value Fascia metal between condo units and chimneys-1221f Front Fascia metal, window fascia metal= 166.51( Front fascia at garage door areas =17.5 if 8" Right fascia, patio door fascia, and window fascia metal =143.251f Privacy wall fascia is 10" entry for 191f of 6" and 4" Back Fascia, window fascia metal =1511f This is a repair to these areas and no depreciation applies 4a - Remove );aseia - metal, 4" 19.00 LF $0.28 $0.00 $0.00 4b - Replace Fascia - metal, 4" 3 19.00 LF $3.07 $1.64 $1.38 5a - Remove Fascia - metal, 6" 601.75 LF $018 50-00 $0.00 5b - Rcplaee Fascia - metal, 6" 601.75 LF $3.33 $56.24 $50.78 6a - Remove Fascia - metal, 8" 17.50 LF $0.28 $0.00 $0.00 6b - Replace Fascia - metal, 8" THOMAS LAKE HOMEOWNERS 0022114927$ „L•,",a, , "sue ASSOCIATION Use BLUE or BLACK Ink for Office Use I I j Permit Permit Fee: 41 city of Eap I 3830 Pilot Knob Road ~ Date Received: I Eagan MN 55122 I I Phone: (651) 675-5675 I Staff: Fax: (651) 675-5694 I 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 1'51 / I r fe a l Soh U V Unit r- Js ram /a -7 O 74<310 Name: J kilma-~ l(a &A Rioltu/ 060h4afS Phone: r~ RESIDENT / ~SI ~Sra1 C.~~2/7iSOr>, IE.} r' h 5 S/~2 OWNER Address / City / Zip: Applicant is: Owner X Contractor TYPE OF WORK Description of work: `ol ~ Construction Cost: l~ / Multi-Family Building: (Yes / No Company: lQ 1~0~pa 6 ~nA Contactui~: +.~ct~Y1K1cs~ Address: 440 E.WAL ifilr° City: S~ • `©t aPL3LO- CONTRACTOR State: 11 -Zip: Phone: CV5 R\.S- License e~~o1 bS0 Lead Certificate Wf -'a. (TICA--1 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? -Yes _No If yes, date and address of master plan: 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Xs c/ee x Applicant's Printed Name A41ric 's Sign ature Page 1 of 3 1~l°l A 151° I521~ .15218 C U"kon W Use BLUE or BLACK Ink For Office Use 1 City of Eap I Permit I 3830 Pilot Knob Road ~ Permit Fee: Eagan MN 55122 Date Received: Phone: (651) 675-5675 1 I Fax: (651) 675-5694 1 Staff: - - - - - - - - - - - - - - - - - 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: IL Site Address: 1 l I~ I Y Unit Name: I I I l11 1 ! ~ ~ 1~ 1~ f 'C~ yl ; I I~Phone: ;t w~ I VU' Resident/ ' Owner Address / City / Zip: Ell 2- Applicant is: Owner Contractor Description of work: ld V,~L~ " (A Type of Work Q Construction Cost: V Multi-Family Building: (Yes X / 'No . ) Company: 154 a QicccI yy1 C'_,n d &gied~~ ~n4 ntact: ''J? V Contractor Address: t-h Q r )~L=PIs/0~ PJ(u~ City: , S4 Lock SoZ- State:h 'Z`ip:~~ f° Phone: License #:C~2 v01 U Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.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 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x Ja 2lk. Ih T_Ik~ - oA S x- Applicant's Printed Name App ' is ig ature Page 1 of 3