1538 Clemson DrCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1538 Clemson Dr
Lot: 1 Block: 1 Addition: Thomas Lake Heights 2nd
PID:10- 75951- 010 -01
Use:
Description:
Sub Type: e - Fumace & Air Conditioner
Work Type: Replacement
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Contractor:
Haley Comfort Systems
122 West 3rd St
Hastings MN 55033
(651) 437 -0338
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Mechanical
EA077775
05/16/2007
ePermit
equirements should be directed to Mark Anderson, State Electrical Inspector,
$50.00 0801.4088
$0.50 9001.2195
$50.50
Owner:
Keith C Hill
3260 Mathers Ave
West Vancouver BC V7V2K -5
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
INSPECTION RECORD
( CITY OF EAGAN PERMIT TYPE: '; "' I t" N##
! 3830 Pilot Knob Road Permit Number: 4y =? 76
?
Eagan, Minnesota 55122-1897 Date Issued: ?0 q
(612) 681-4675
SITE ADDRESS' • APPLICANT:
tf M;nN Illi Wi.''ta, P1 Illi
, f II??MF1 , ? ;?t1 Ilf 1 !iN i`i "NI,l t '. J.' ? q.'0
PERNIIT SUBTYPE:
, ',. I . .
TYPE OF WORK:
fi l •?iCR 1 F f It1N
S? a
?• ! ? li I
( R F f'1 ??a ? ??° ? r ?
?
`
i? Mfi1-# . t" M fi(s ?qr,i,? pt?? 1 I I
I ?
Permit No. Parmit HolAer Date Telephone N
ELECTRIC
PLUMBING
HVAC
Inapsctlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GVP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDQ FINAL
BSMT fl.l
BSMT FINAL
-
DECK FfG - -
, ?b1314 4 I
? -
-
DECK FINAL I -
?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
! {I j
?• ??i r I I!1 .i:f? ???Z
PERMIT SUBTYPE:
3i
I I , ; I I r* I r,F,..,
F
L
8#1 T I!z 1 Nr,
N;' ? t t r•, A
p r, ! I 1 / `16
h1 t?110- 0 t
N
:CORD
PERMIT TYPE:
Permit Number:
Date Issued:
! APPLICANT:
;li" I f?
i i,
TYPE OF WORK:
tll '.f l? l i i 1itPS
t l NA1
?:-
? ''
Permit No. Permit Holder Date Telephone N
ELECTRIC
PLUMBING
HVAC
Inepectlon Date Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
RdUGH
PLUMBING
PLBG
AIFi TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAI
v
6SMT R.I.
BSMT FINAL
DECK FTG ?? /•??F j N?
DECK FINAL ?
? - - -
rwrqre*wm?
E T.H.
D 1
BUILDING PERMIT
Receipt #
N° 32743
7o be usedlor 1 UF 4 PLEX Est. value $60, 000 Date rx1'OBER 8 , 1g 86
Site Address 1540 CLF.IMSON ll'rt Erect ? Occupancy R3
Lot 4 Block 1 Secisub. THOMAS LK H TS Remodel ? Zoning Pp
Parcel No 2ND. Repair ? Type of Const V..[1
. Addition ? No. Stories
NEW HOR I Z ON EiOMES I P!C Move ? Length 46
W Name
; P. O. AOX 1367 Demolish ? Depth 24
° Address
MPL
420-3900 Int Impr ? S Ft
Q
Ci? S Phone Install O
o Name SAME APProvah Fees
?°, Q Address Assessment Permit ? 313.00
? ciry Pnone Water & Sew. - Surcharge 30.04
? Police Plan Review
'
156.50
WyWj Name
t Fire SAC 575.00
n Address Eng. Water Conn. 500.00
g W City Phone Planner Water Meter 63.50
Council Road Unit
,
290.00'
I hereby acknowledge that I have read this application and statethatthe 9/30/8 6
Bld
off
9 Tr
PI 156. 00 {
information is correct and agree to comply with all applicable State of .
. .
. ?
Minnesota Statutes and City of Eagan Ordinances. APC Parks ;
Si
nature of Permittee
Var. Date '
Copies 2 08 4
0O
g Total .
NFint HORIZoiv riUlAWS ,
;
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesot a Statutes and Ciry of Eagan Ordinances. ?
Building Otticial
CITY OF EAGAN
3830 Pflot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
PormR No. Prnnft Ho1dK Daa TdephoeN A
Plumbinp ?
H.YA.C. / C D
eleeWc C'_ 7 5 ? w, r? ic .3 ?5 . G c',
sonen..
l:sopectbn Dde Insp. Commenb
FooUnysl
Footinys 11
Foundafbn
Framiny
Roofiny
Rouph P16p. O-a ,g . w•
RouYh Htg• X17 6 IVfl ///Sf/PF
Imul.
Fireplses
Ffnal Htp. /?/?
Final P16y.
i
Bidg. FinN
Cert. Occ.
Deck Ftp.
Deek Frmp.
Wdl
Pr. Dbp.
PERMIT#
-?• * MECHANICAL PERMR RECEIPT # 2 ?
• CITY OF EAGAN
- 3830 PILOT KNOB ROAD, EAGAN, MN $3121 DATE f?47
j?-
CAIdTRACT PRICF• PHAAIF• ASA.A1A11
Site Address ?,'/ •
Lot " Block
m Name
? Address ___7
c City? Name , . . iL
? Address
O CitY
TYPE OF WORK
Foreed Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outldts #
Other
? v M BTU
M BTU
M BTU
M BTU
CFM
/
BLDG. TYPE
'
Res. ?
Mult
Comm.
Other
WORK DESCRIPTION
New _
Add-on
Repair.
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M 8TU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $50 5/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FEE 5 ? i ; > ,? ??? ?..l?t?•
S/C: J?= SIGNATUREOFPERMI'FTEE
TOTAL•
FOR: CITY OF EAGAN
PERMIT #
' PLUMBING PERMIT RECEIPT # "
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55721 DATE:
CONTRACT PRICE PHONE 454-8100
Site Address BLDC. TYPE WORK DESCRIPTION
Lot Block Sec/Sub
Res. New
m Name + Mult Add-on
? Address Comm. Repair
c Ci
Ph Oth
r
ry
one e
NO. FIXTURES TOTAL
? Name W
t
r Cl
t -$3
s
00 t
a
e
o
e
.
3 Address Bath Tubs - $3.00
p City Phone Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
FEES Urinat/Bidet -$3.00
GOMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - $3.00
MINIMUM - RE5IDENTIAL FEE -$10.00 Floor Drains -$1.50
MINIMUM - COMM/IND FEE - 20.00 Water H?ter -$1.50
STATE SURCHARGE PER PERMIT - .50
Whirlpool -?.00
(ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets - $1.50
BEYOND $1,000.00) Softener - $5.00
Well - $10
00
.
Private Disp. - $10.00
Rough Openings - $1.50
31GNATURE OF PERMITT'EE FEE
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL•
T. H. CITY OF EAGAN
' L 1 N? 12741
? 3830 Piiot Knob Road, P.O. Box 21-199, Eagan, MN 55121
' PHONE: 454-8100
BUlLDING PERMIT
Receipt #
To be used tor 1 OF 4 PLEX Est value $ 61 ,000 Date OCTOBER 8 19 $6
Site Address 1538H CLEr1SON DR Erect 13 Occupancy R3
Lot 1 Block 1 Sec/Sub. THOMAS LK HTS Remodel ? Zoning pp
Parcel No 2 ND Repair ? Type of Const VA
. Addition ? No. Stories
w
Name NEW HORIZON H?OME5 Move ? Length 46
=
p• O. BOX 1367 Demolish ? Depth 24
o Addre
Citv ss
XPLS Phone 420-3900 Int. Impr.
Install ?
? Sq. Ft
Z o Name S?F'
0 ? Address
1- rrin, oti....e
F W Name -
x ? Address
:
< W City -
Assessment _
Water & Sew.
Police
Fire
Permit v Jl ° . ""
Surcharge 30.50
Plan Review 15$.00'
SAC 575.00
Water Conn. 500 . 00 1
Water Meter 6 3. 50 j
Road Unit 290. 00!
Tr. PI. 156.001
Parks
Copies
TOtal $2,089.00
Planner
I here6y acknowledge that I have read this application and state that the gldg.
information is correct and agree to compiy with all applicable State of
Minnesota Statutes and Ciry o( Eagan Ordinances. APC.
Var. [
Signature of Permittee
A Building Permit is issued to: nLw nvcc t 4vn nvrma on the express condition that
all work shall be done in accordance with all applica e State ot Minnesota Statutes and City of Eagan Ordinances.
Building Official ? ` ?- .? ! .
I _ I Pe?mit No. I Permit Holdw I Date I Totephono k I
IN.V.A.C. I ) C1 Gi ? I. • I???/?`!/
Mtq.
Plbp.
FMaI
Oce.
Ftp.
F?mp.
PERMIT #
• ? MECHANICAL PERMIT RECEIPT #
° CITY OF EAGAN
3830 PI LOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address gLpC
npE WOAK DESCRIPTION
,,
Lot Black Sec/Su ?='y
Q rMaliAlin k ?
Res. New
? Name M
l
G.1.??p u
t Add-on
S Address C
R
. omm.
epair
c Ciiy $PW Ot
, . her
Name
FEES
?
c Address RES. HVAC 0-100 M BTU -$24.00
p City phone ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
! TYPE OF WORK . ?S OUTLETS - 1.50 EA.
Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
BoiJer M BTU MINIMUM - RESIDENTIRL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
' (ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM ? BEYOND $1,000.00)
Gas Piping Oudets #
Other
FEE ?
' J- SIGNATURE OF PERMITTEE 6
S/C:
TOTAL ?
FOfl: CITY OF EAGAN
77 -7
' .?t%-'l, .. : . . . 4 :. :.. . { . . . • , . . -
. PERMIT # ?3S
PLUMBING PERMR RECEIPT #
" CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
Site Address
Lot Block Sec/Sub
m Name
? Address
c City
? Name -
3 Address _
O CitY
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(AQD $50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL:
T. H. CITY OF EAGAN R, a
f?
i E
r, }? = y, B 1 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
-
PHONE 454-8100
BUILDING PERMIT Receipt # '
To be used for 1 Or 4 PLFX Est Value $60,000 Date uCT03ER $ 19 86
SiteAddress 1538 CLEMSON DR Erect C? Occupancy K3
Lot 1 Block 1 Sec/Sub. THOtRAS LIC HTS Remodel ? Zoning L'a
Parcel No. ZND Repair ?
Additi
n ? Type of Const.
i
N
St V IN
W
Name NE?"? o
HORIZON HOMFS Move O o.
or
es
Length
46
z P.O BOX 1367 Demolish ? Depth 24
o .
Address
city MPLS p Int Impr. ?
none 420-3900 Install ? Sq. Ft
o Name SAME Approvi
f
i Address Assessment _
j
w
City Phone
Water $ Sew.
b-
?
F
Name Police
Fi
=
?
n
Address re
En
z
? W
City Phone g.
Planner
1 hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City oi Eagan Ordinances.
Signature of Permittee
A Buitding Permit is issued to: `•''''
all work shall be done in accordance with
Building Official
on the express conditlon that
City oi Eagan Ordinances.
Bldg.
Permit $ 313.00
Surcharge 30.00
Plan Review 156 . 50
sAC 575.00
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290. 00
Tr. pi. 156.00
Var. Date I Copies
1
Total r • 00
. WrmN No. WrmN HoIdK Dab TNsphone N
Plumbiny " , - ,. ` j i ? -- C
H.V.A.C.?
EIlChiG ' r. / r r SG ( f>r f 3 - • l/ l',
SOIIlflN
Inspmtlon Date Insp. Commenb
FooUngsl ?c
/
?fJ
FoorinQall
Foundatfon
Framinq
Roo(inq
Rouyh Plby. ` _
Rouyh Hfy.
laaul.
Finplace -X17 - "
Final Htq. ?
FMaI Plby.
&dq. Final
Cert. Occ.
Doek Ftq.
Doelc Frmp.
WNI
Pr. Dfsp.
?"?.'>if . ' , °' " ? , .
".T-?k'?? , , • PERMIT #
ti.?• ` ? MECHANICAL PERMIT
? CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: _
iAl_T DOICR• DHAIJC• d4d_01M
Site Address
Lot ' Block
? Name _
? Address
c City -
L Name _
c Address
O Cib -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
,i --
BLDG
TYPE WORK DESC
RIPTION
Sec/Sub ` 'W t° .
.
, . .
N
R
? ew
es.
n
M
lt Add
-o
u
R
i
C
& , omm.
epa
r
M O
_
?
P ther
d#EAP
`
FEES
RES. HVAC 0-100 M BTU -$24.00
Phone ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
M BTU
M BTU
•f "`? GAS OUTLETS
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 1.50 EA.
- 10.00
M BTU
BTU MINIMUM - COMM/IND FEE
STATE SURCHARGE PER PERMIT - 20.00
- .50
M
CFM (ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000,00)
FEE • a ; ,. z?. •? _ r' ?x .?.?1,-.i/'
S/C:
? SIGNATURE OF PERMITTEE
TOTAL• -
FOR: CITY OF EAGAN
• ? PERMIT #
PLUMBING PEFtMIT RECEIPT #
CITY OF EAGAN
3834 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: -
CONTRACT
Site Address
Lot Block Sec/Sub
m Name
? Addre
c City _
_ Name _
3 Address .
p City
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMMIIND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
Res. A New y
BLDG. TYPE WORK DESCRIPTION
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 t
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
Sottener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
FOR CITY OF EAGAN
STATE S/C:
GRAND TOTAL•
.??P CITY OF EAGAN : ?? ? u??8 ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
*
' k"
PHONE: 454-8100
BUICDING PERMIT Receipt # -
To be used for DECR Est. Value ;1 ,000 Date APR 29 . 1991
Site Address 1539 CLZ!lSEW DR
Lot -1 _ Block _I SeciSub. Z'HO!!A9 I.AICE H'tS OFFICE USE ONLY
Parcel No. ? Occupancy _ FEES
Zoning _
Z Name COPiNIE ?ASBY
1536 CT
?$? D (qctual) Consl _ Bldg. Permit ?QQ
o .
Addf@SS
R
City AACAN Phone
452-9612 (Allowable)
# of stories - Surchar e
9 .?
lZ ' Plan Re
ie
Lenglh v
w
Zo Name S? oeotn ? snc, cay
?? Address S.F. Total -
i
Clty PhOfle
S.F. Pootprints
_ SAC, MCWCC
F On 5ite Sewage _ 1Naler Conn
?u W Name
On Site Well
-
Water Meter
? ; Address MwCC System
< W City PhOne City Water _ Acct. Deposit
PRV Required - SNV Permit
I hereby acknowlege that I have read this application and slate Ihat the
i
f Booster Pump - S/yy Surcharge
n
ormation is correct and agree to comply with all applica6le State ot
Minnesota Statutes and City ot Eagan Ordinances. Treatment PI
Signature of Permite? APPROVALS
qoad Unit
A Building Permit is issued lo: ?ai? ??Y Planner - park Ded.
on the express condition that all work shall be done in accordance with all Co+ncil
applicable State of Minnesota Statutes and City of Eagan Ordinances.
gldy. ptt.
_
Copies 1•oo
Building OMicial Variance - TflTAL 26.50
?
?
. Permh No. Permit Holde? Date Telephone N
WATER
SE4YER
PLUMBING
H.VA.C.
ELECTRIC
InspscHon Date Msp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orstat Test
Fin21 Pibg. Plbg. Inspector - Noti(y Plumber
ConSt. Meler
Engr./Plan
Bldg. Fnal
Dedc F(9•
Dedc Final
Well
Pr. Disp.
INSPECTION RECORD
f CITY 4F EAGAN PERMIT TYPE: +,ll I I c? iut; ?
f 3830 Pilot Knob Road Permit Number: cyll 1 r:0
? Eagan, Minnesota 55122-1897 Date Issued: o+. 104 r' •+f, ? (612) 681-4675
SITE ADDRESS: APPLICANT:
? ?, ? t i:1 rit ? !
, ;; ; I r M, 1414 li R ri! i 1:Ii f: ,(i: ?
? i t? # 114 n F{t t i,li 1': 2NU t,. 1.' ) 41 .'V I :!.: 0
PERMIT SUBTYPE:
I i . r, t . .
I IllI ( 1 N6
i ?
I
`
TYPE OF WORK:
F, F 1' fl 1 k
Fi ( FtFP1.A['F IiF E k i
f 1hAI
Perm3t No. Permit Holdet Data 7efephone A
ELECTAIC
PLUMBING
HVAC
Inspectfon oeta Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFIN(3
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TES7
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FlNAL 12h'?? A"'f
CITY OF EAGAN ? Remarks
Addition 'T'fiomas Lake He3Phtaa Addition Lot Mkr-/ aik !j PBrcel #10 -75950
oWner street 1538 Glemson Drive stBte Eagan, MN 55122
c:i . . f? ? -
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. ,t
STREET RESTOR.
GRADING
SAN SEW TRUNK 1,773
* SEWERLATERAL 1951 37-61 7-52 $
WATEii MA I IV
* WATER LATERAL 1981
WATER AREA
STORM SEW TRK 1981 312-37 20.82 15 249.91
* STORMSEW LAT 9$1
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER,
SAC
PAR K
CITY OF EAGAN ? Remarks
Addition 'j'jj,QmAa T.akP He9g- t,rc.Additian Lot ?? B lk Parcel #10 ?-rarc? 399 n?
-.?
Owner dac; i!;)?. ? street 1538 B Clemson Drive state Eagan, M 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 Gt.r,G?
* SEWER LATERAL 37. 61 7. 52 15 A012172 - 3
WATERMAIN
* WATER LATERAL 1981
WATER AREA 9 7 7
Q,?[>
STORM SEW TRK 1981 312.37 20-82 15 249.91 A012172 5-5-83
* STORM SEW LAT 19$1
CURB & GUTTER
SIDEWALK
STREET UGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN Remarks ??a- --L--?`?'??'-?Q?? ??/?f
Additicn ''homas Lake Eleigh4Addition Lot , Rik Parcei #10
Owner 1540 Clemson Drive S?te Eagan, 1I 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, g ]„11.8 A01212 --83
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 37. 61 7.52 1.05 A0121T2 5-5- 3
WATERMAIN
* WATER LATERAL 1981
WATER AREA 1977 q44u
STORM SEW TRK 249.91 A012172 5-5-83
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
9UILDING PER.
SAC
PARK
1--
' CITY OF EAGAN
Addition Tiiama
2?' ,
Owner(Ld
?
street 1540 B C1en(son Drive
Eagan, MIN 55122
Improvement Date Amouni Annual Years Payment Recsipt Date
STREETSURF, 4 121.89 A03MT2 5-5-83
STREET RESTOR.
GRADING
SAN SEW TRUNK /973
x SEWER LATERAL 61 7
i 15•05 f?Ql'?,71't'? 5-?j- 3
.
WATERMAIN
WATER LATERAL
WATER AREA /977 6Gp0
STORM SEW TRK 1981 312-37 20-82 29.91 A012172 5-?- 3
? S70RM 5EW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
6UILDING PER.
SAC
PARK
' . .. . . . J . . .ye. . .. ' . . ,7 _ -. . ' .,? i
.. .. . . .. . ' . .
? ?? ` ?
SEDGWICK HEATING 8 AIR CONDITIONING CO.
HOUSE HEATING TEST RECORD
ADDRESS 4b C?MSr0 t,1 ?(Z?v t CITY E jO+G n tl?
OCCUPANT OWNER ?-1`°=' WAsh Psu R nr
HEAT LOSS DATE HTG. INST. ----
SOLD BY `-- INSTALLED BY
Electrical Work By RG a r.'- Gas Line By _ 5? u1ic-1t
TYPE OF HEAT GA_ FAZ HW _ STEAM SPACE HTR. UNIT HT R. OTHER
GAS DESIGN CONVERSION
MAKE ? 2v a r?T MAKE OF BURNER
Model ?9 4C ?-W Q ? ?Fd ?o Model --?-'-'
Serial _ 4 (> 8 6 A O 3 7 4$?_ Max. BTU Rating -
INPUT _ 50, c>oo MAKE OF FURNACE
Model
CONTROLS
THERMOSTATHeat Plug Vent Size
Valve ?x's4 sr.z` ayC -a- _ KIND OF LINER SIZE NONE
Limit - ST-e?,'yN c n Draft Hood Regulator ? ES
Limit Setting _ -7 S n° r Filters Size Number 1
Fan Setting ?nt" ° kE? Chimney Location Inside x Outside
Pilot Type - ?L.Ec'C4za tA k t Chimney Construction _ r-lrA-55 L3
Pilot Make ? P s? w?k qctti O aQt
Pilot Model
Pilot Timing ? ?.15`s' eq %JT-
L.W. Cut Off
Pressure uA C? Percent C02 ?
Input CFH so Percent O
z
Stack Temp. c2 Percent CO r, e' ? e
Smoke Bomb '- Wiring - ?K
Draft TestTag yF_-?
Door Pressure Lighting Inst. 08-
Date Tested C? - _-I- - ? 7
Company Testing ? Qc-%(-
Name of Tester ? c Fi 2 r-N C??
Form 235
:::5S(?(
J
" SE DGWICK HEATING & AIR CONDITIONING CO.
HOUSE HEATING TEST RECORD .?/,
ADDRESS C-LAi?EIM SW1 n2ti?lE CITY ti::
OCCUPANT?- ` OWfVER
HEAT LOSS - DATE HTG. INST.
SOLD BY ` INSTALLED BY
Electrical Work By TfS e- at c-, Gas Line By 7?c- ??m 1-1 %c_V!-
TYPE OF HEAT GA_ FA-_.,&-- NW_ STEAM SPACE HTR. UNIT HTR. OTHER ?
GA5 DESIGN CONVERSION
MAKE - a R1!t, TZ3+? : MAKE OF BURNER -"--?
Model Model ^-----
Serial 0 8Lf3n yJ' 80.1 Max. BTU Rating '-"'-
INPUT civ. Qn 0 MAKE OF FURNACE `-
Model
CONTROLS
THERNIOSTAT T E>]:? L? Heat Plug Vent Size - ?
Valve - S X_31fS NA 1o -KIND OF LINER SIZE NONE
Limit _ °J? -vA --- s Regulator =1 ? S
Draft Hood ?- ? 1 c +?1
Limit Setting 1 Sa° F _
Filters Size Number _ 1
Fan Setting Chimney Location Inside x Outside ?
Pilot Type _ ?__ ? ?"s ?nN ? Chimney Construction _c-?-p 55 L2 "
Pilot Make SPK'. tZK t y?1__?T? t? ?
Pilot Model
Smoke Bomb
Wiring , t'--?
Test Tag
Lighting Inst.
C-- 7
Pilot Timing f Draft
L.W. Cut Off Door Pressure
Pressure 3- S "W - Q-- Percent C02 /
Input CFH 5c' Percent O 2 &4
Stack Temp. 0&;0 ? Percent CO t-J 0 h1 ?=-
Date Tested
Company Testing cia-, F> 1?p w ?c?
Name of Tester CC? ?-j R: P+ i,?!
Form 235
,
?Sl?IS
SEDGWICK HEATING & AIR CONDITIONING CO.
HOUSE HEATING TEST RECORD ??? /,?/J ??j??t??? y,?. ?
ADDRESS ? S.3 g C.?•-??`?bN ? R 1\A?: CITY ?Ac? 1qr,?
OCCUPANT OWNER6JEW Ho%R i2.on1
HEAT LOSS ?-- DATE HTG. INST.
SOLD BY ! INSTALLED BYLK. wtctt
Electrical Work By L3E*) 91 Gas Line By
TYPE OF HEAT GA_ FAX. HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE - +?t.1+'a n1 T MAKE OF BURNER -
Model i.Jv ?O S c'? Model -
5erial A n 3 F? 13 Max. BTU Rating
INPUT 5A o0o MAKE OF FURNACE `
Model
CONTROLS
THERMOSTAT TP33 , Heat Plug -
Valve SX:3 4t5 I So al- c?--
Limit r o
Limit Setting - .2s?° ?
Fan Setting
Vent Size
KIND QF LINER
araft Hoad DL=-Sr c nl
Filters Size
Chimney Location
SIZE NONE
Regulator
Number S
Inside '<
Pilot Type G?c -ruzc,? ?c Chimney Construction CU4S?"? T=13
PilotMake "Pg(ZK. IGtr?Tr??
Pilot Model
Smoke Bomb ?-"
Pilot Timing _ r rljST-P% T" Draft "
L.W. Cut Off Door Pressure-
Pressure 3? C• Percent CO pate Tested
2
Input CFH 50 Percent 02 7 `7o Company Testing
Stack Temp, l 9 h°E7- Percent CO tJtiK 1 E- Name of Tester -
Wiring O K
Test Tag N f(a s
Lighting Inst. n )L
Form 235
. .., :.. . ... ?S??S- ?
SEDGWICK HEATING & AIR CONDITIONING CO.
HOUSE HEATING TEST RECORD 44,61)
ADDRESS Ci-Ew1So t,! _DIRIVE- CITY C fa 5a, A t.,l
OCCUPANT OWNER ?.1 EL,.1
HEAT LOSS " - DATE HTG. INST.
SOLD BY " - INSTALLEO BY t?!r%,4 ic.K
Electrical Work By - Sj=_: r4 !'Z Gas Line By - ? vJ L c4K-
TYPE OF HEAT GA_ FA?,e HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE _ -k 21, sa_.j ra c.4 T
Model 3114 Cq A W O?r-,
Serial L2a-S G <-
INPUT ?- ?---- -
CONTROLS
THERMOSTAT Heat Plug
Valve L4 -
_
Limit G_ vvN c o
Limit Setting ?.SG° F
Fan Setting ? Dr) ° G"
Pilot Type $Z-7 L?G-c-r u2 n nJ rc'
'
-2 PA 0.FC r.
Pilot Make l , To 13,
Pilot Model _ !-f 5 C t
Pilot Timing 1?.,1 r>r,F? r` T
L.W. Cut Off
Pressure 3- S" W- c- Percent COZ
Input CFH S O Percent 02
Stack Temp. ? 4?? ° ? Percent CO
??
MAKE OF BURNER
Model
Max. BTU Rating -
MAKE OF FURNACE
Model
Vent Size t,::>
KIND OF LINER SIZE NOIVE
Draft Hood nir- GNA Regulator N ES
Filters Size Number
Chimney Location Inside x Dutside
Chimney Construction C'LA 55 73
Smoke Bomb
Draft
Door Pressure
Wiring Q K?
Test Tag V ? 5
Lighting Inst. n??
Date Tested f- r- 8 7
CompanyTesting Sk74 W, cK
Name of Tester CoN ItZ f\ CQ '
Form 235
FOR SALE T. H. CITY OF EAGAN
3830 Pibt Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
NQ 12742
Receipt Ta be used for 1 OF 4 PLEX Est. value $ 61 ,000 pate OCTOHER 8 19 86
SiteAddress 1540B CLEMSON DR Erect C? Occupancy R3
Lot 3 Block 1 Sec/Sub. THOMAS LAKE HTSRemodel ? Zoning E'p
2ND
Parcel No Repair ? Type of Const Itsi
. Addition ? No. Stories
119 IlEW HORI ZQiV HOMES Move ? Length 46
3 Name
P.O. ?X Demolish ? Depth 24
o Address Int. Impr. ? Sq. F+
City PiPL S phone 4 2 0- 3 9 0 0 Install ?
= o Name S?E Approvals
? Q Address Assessment
? ciry Phone Water 8 Sew.
w
? W Name
? ? Address
< W City Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State ot
Minnesota Ststutes and City of Eagan Ordinances.
Signature of Permittee "
NF:w HORIZON HOMES
Police
Fire _
Eng. _
Planner
Council
BIdg.Off. 9 8 $6
Var. Date
'
Permit $ 316.00
Surcharge 30.50.
Plan Review 158 . 00,
SAC 575.00'.
Water Conn. 50T. 0 U I
Water Meter 63 . 50 Road Unit 290.00
'i
Tr. PI. 156.00
Copie ,089.0 p
Total
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota SEatutes and Ciry of Eagan Ordinances.
8uilding Official ?? ?? /
ParmN No. Psrmit Moldar Date Talsphons N
PIun)61ny /0/-)7/
H.V.A.C.
EIlCtr1C cl
SoRMSr
Irupsctbn Date Intp. Commenb
FooNnys I
FooNnysll
Foundatlon
Fnminy
Roollny
Rouyh Plby. ? - - G .41
Rouph Hty.
Imul.
Fireplacs
Finsl Htp.
Final Plby. -?-g7
Bldg. Finel
Cilrt. Ote.
DoCk Fty.
Deck Frmy.
We11
Pr. Dhp.
• PERMIT # % 11
.:.?561S '
, MECHANICAL PERMIT
RECEIPT #
? CITY DF EAGAN
3830 PILOT KNOB ROAO, EAGAN, MN 55121 DATE fV
CONTRACT PRICE: PHONE: 454-8104
Site Address BLDG. TYPE WORK DESCRIPTION
Lot " Block i Sec/Sub_ _Z__1
Re
New
s.
? Name lt Add-on
M
u
? Address N Comm. Repair
c City nQi n wFNTUU n?rlw h
O
M
INNEAPO
RI FF?^'
LIS t
er
,
- Name FEES
c Address RES. HVAC 0-100 M BTU -$24.00
p City Phone ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WOFiK
' uJ GAS OUTLET5 - 1.50 EA.
Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM BEYOND $1,000.00)
Gas Piping Outlets #
Other
FEE
J v SIGNATURE OF PERMITTEE
S/C:
TOTAL•
FOR: CITY OF EAGAN
.?,
'' • " PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: -
FIuTRSrT aQ19r.• DWANF•.OU-Alnn
Site Address
Lot Biock
m Name
? Address ?
c City
? Name - -c Address
p City Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE
MINIMUM - COMM/IND FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
$10.00
20.00
.50
(.?
BLDG. TYPE
Res.
Mult
Comm.
Other
FOR: CtTY OF EAGAN
WORK DESCRIPTION
New _
Add-on
Repair.
NO. FlXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen 5ink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
fiough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL•
(Ctrttfira#it af Mrrupanry
titp of Cagan
Eppal'bbtPttf 11f Wllt1bil1# JWPdiDri
This Certificate rssued pursuant to the requiremenu of Section 306 of the Uniform Building
Code certifying that al the time of issuance this structure was in compleance with lhe variaus
ordinances of the City regulaling breilding construction or use. For the following.•
ux aALSIific.uon t? F G P; 9ie6. F?mi? No. ', 4•.-
0ccuuoar Tra R 3 zoo;ng n;,u;d Tya Co- r' r3
owoerofBw7dinjnl,i ?Y"?tT7lW Fl'i?:. Addre,
BmldingAddren ;.'•[43 47'R1?ItYAT LI.oa&q, ,' --
Buflding OH'xial
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Esgan, MN 55121 pATE:
Zonirp: No. of Units:
Ownsr:
/lddresz
Site /1ddr
Plumber.
I "+w 1'0 -eylf wm tie CIIy of M"n
OrJImm"s,
By
Dore of Insp.:
CorwiecNon C}+cepe:
Account Deposit: ?
Pormit Foe:
Surdhorpr
AAisc. Chorpss:
Totol:
DaM Paid:
CITY OF LkGAN ? yyATER SERYICE PERMIT
3930 Pilot Knob Aoad ?
P.O. 3ox 21199 3U ? PERMIT NO.: 13 6
Eepan, MN 55121 DATE: 10-2 -86
Zoning: M No. of Units: /+-Alex
Owner: New IIorizon Iiomes
AdQress:
5ite Addess: ?emsan r ve omas s.
Plumber ompson um g _
Reader No.: o /6 4-X ,;c? -.7
1 apres to comply with the Gty
meter
I
of
Paid:
isc. harges.
TotaC F?.50p?'• -:eto
r
By Date Pald:
Date of Insp.: Insp.•
CITY OF EAGAN r
3e30 PnotKnob Road WATER SERVICE PERMIT
P.O. Box 21199 { PERMIT NO.: i`
Eayan, MN 55121 DATE; '?''-E `
Zoning: ' -'
'
No. of Units: .ex
Owner: :,
Cv ilorizon :ioyaes
Address:
- ?• r ve
Site Adda T emson : «o,?:;? ? .._ •, s ? .
- • - -
Plumber.
?
Meter No.: Connection Charge: p"
Size: Account Deposit: ' r` `.
Reader No.: Permit Fee: ' p`
I ayree to comply wtth the CFty of Eagan Surcharge:
Ordinances.
p? A
M• C "j
CITY OF EAGAN SEVIIER SERVlCE PERMIT
3830 Pilot Knob Rwd
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 pATE; t
Zo^i^D: No. of Units:
OwrNr. .
Addross:
Site /lddi
Plumber.
1 prN fo oonn* ski !!w 01lp N Eqpw
OediNnon.
ey
Dote of
Irap,:_
F.O. Box 21199
Esgan, MN 55121
Zoning: R3
Corrwetlon Chwrpe:
Acoount Deposit: , . Prrmit Fee: SuKJwrp:
Misc. Chorpm
Totot:
Doh Rold:
_
WATER SERVICE PERMIT
PERMIT NO.: ]J
DATE:- r ?
No. of Units:
Owner. :`.ew Ho izon pom s
Address:
Sltepddeas; 153ER 1_ msnn nri vo T? pl Tbnmac TU F7tq T7
Meter No.: - ?1 / SF ,Y(0 3 /
SizEf + fioc!'C
Reader No.: Q
I agree 4o compiy with the CIIy
BY -+in
Date of
l z ? ?? ?(a
CITY (%F EAGAN
3830 rliot Knob Road -
P.O. Box 21199
Eagan, MN r5121
Zoning: r '
eg 511? _ (1(1? A
na,-L
Dete Pald: ? ?
?--- - •
WATER SERVICE PERMIT
PERMIT NO.: "117
DATE: iLL-28-R (' ?
No. of Units: '' -pIeK
Owner. New gorison Homes
Address:
SiteAddess: 15388 ('??aan Priv e T' T'1 T'
Plumber. '1'1w*npson Pl urnhing
Meter No.: Connection Charge: 500 _(lQnt?
Size: Account Deposit: 15 _ tla?'t
Reader No.: Permit Fee: 1() _ t) (h,d
I agree to compry with the City of Eayan Surcharge:
Ordinances. Misc. Charges: 1 ??..QQpd 'r??
ey
Dete of Insp.:
Irap..
1 -30 3SEq
Road
Tatal:
Date Paid: A
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECCIVED
FROM
AMOUNT $ /
"7e,"G G
a o Rs
o
? ? CASH
1JN_ >7 qq ./?.
PUHD ODE AMOUNT
V ?J ? CJ C?C.
C? ?-) U
d
? l 7 G'
Thank You
_ Na 67840 Y
--?
wnita-Pave?. coav
Yellow-Posting Copy
Pink-Fiie Copy
^. BI,.DG. PERMIT ti0.1:?
?y
-
01-32?0 Bldg. Pei?mit
01-3422 Plan Check /'?c, ?> c!
01-3445 Surch./ndm,
01-3446 01-2155
17-3860
20-2275
20-3865
20-3868
20-371b
20-2252
SAC/Adm.
Surcharge
Road Unit
SAC
Water Conn.
Water Trmt.
Water Meter
Acct. Dep.
20-3713 Water Permit
20-3743 Sewer ?ermit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
TY OF EAGAN SOM SERVlCE PERMR
P0 Pilot Knob Road
0. Box 21199 PERMIT NO.:
gan, MN 55121 DATE:
nirg: No. of Unitc ,. j
Address:
h wwply wMU W Cihr oi EeM¦
of Irnp.:
Owner. -
Address: -
, Site Addess:
tn umb er. eter No.: ze: '? ! • ,?
eader No.:
"od
ConnK.tian Qaryp: Q 7 5=^? ;_ 1 nc1
AOcoIXIt Deposit: i..
Ponnif Fee:
PERMIT NO.:
DATE: 7n ?R_Rh
No. of Units:
Surehwrps: i
Misc. CMrpss:
'
I agree, to comply wlth the G1y of ???,?VhV'S'urch e"NE
OMlnances. ? es: 15? (lanrl TL
R? otal: 63. _
oy Date Paid:
1e of t . Insp.•
-/ -- /?- ??- --
Total:
Dob Poid:
WATER SERVICE PERMIT
CITY OF EAGAN WATER SERVICE PERMIT
383C P{Id KAob Road • •' ? t ??;
O. Box 21199
P PERMIT IVO.: ,
.
Eagan, MN 55121 DATE: 10-2R.-F6 ;
Zoning: -?3- No. of Units: -4?^l"s
he7f Rnr{2nn Hnia a
Owner:
Address: Tt? utQ 7T
7
h
Site Addess: I5GO TIA1"'?n ?{°° rsmas -
T 4 R
T
Plumber. -
Meter No.: Connection Charge: -UaJD;d-----
Size: Account Deposit: 15 C3C?c?_
Reader No.: Permit Fee:
5
d
I agrse lo comply with !he CNy of Eagan 4?
Surcharge:
A TT,
5E 00
' Ordinances. n
Misc. Charges: 1
Total: ?? 50r'_` -_
BY D8t8
Date of Insp.: Insp.
CITY OF EAGAN
3830 Pilot lCno6 Rosd
P. 0. Box 21199
Esgan, MM 85121
Zoninp:
Owner:
Address:
ft *onNf wieii !w CIlf? of fMp*
of Irap.:
CITY GF EAGAN
8830 Pilot-Knob Road
P.O. Box 21199
Eagan, MN 55121
Zoning:
SEMIER SElViCE PERMR
PERMIT NO.:
D^TE:
No. of Units:
ConntCtlon Chorpa:
Aoc«,rK oepoqt; ?
Pomft FM:
Surchorpe:
Misc. Cho?om
Totd;
Doh Pold:
WATER SERVICE PERMIT
, PERMIT NO.: c rIQ
.. DATE: ? ? ,? 8 8 6
No. of Units:
Owner: "
Address:
Site Add@SS: 1 54nR f'7 :, ..;;?;? nr?..o T Z 4 i •?.? _ _. __ _ __
Plumber. _
Meter No.:,.
Size: 5AL"
1 aQree to oomply with the
Dete of Insp.:
• c?a
ges: - i SF 00 a?
,.,.aI. ,
Date Peid: ? r
Insp.:
CITY OF EAGAN a . IKATER SERVICE PERMIT
3830 Pllot Knob Road
P.O. Box 21199 PERMIT NO.: 0
Eagan, MN 55121 DATE: ?"1-10 trc
Zoning: _ p3 No. of Units: --- 4 -pi ?
Owner. irn_,.4_?.014
Address:
Site Addess: 1540A f:7 wmta.+.+ n«j. ... • 7 R1 Thnm e T) i7f c ZZ
Plumber: 'i'!'tamlaenn !>lnmhing
Meter No.: Connection Charge: S(l_r_)_ r_?„ ,
Size: A
1 5
D
ccount
eposit:
Car1
Reader No.: Permit Fee: - 1(1 R(`.?a
I agree to comply wfth the qty of Eagan Surcharge:
Ordinances. Misc. Charges: t SF, sla alv
Total:
63
By .
Date Paid:
Date of Insp.: Inso._ _
This repuesl vaid
78 rtwnths fwm . J
f 36763
Re est Pate ?
,,.,`1
? Fire No. Rouph-in Inspertion
fleq d,
?Ready Now?ll Nouty InsPec,
?
??
1??
? ?
?es No ?or When fleaAY
fcensed Elec[ncal Contractor
? Owner
1 hereby raquest inspectian ot above
electrical work instelled at:
St eet Addr , Bo R te No. Gt
e
? ! ( V ? 1..?
cUOn a. Towns i0 Name or No. flange No. Counry
?u0anf; PRI I Phone No.
?
Power pher - A?ldress
C
?fJ wal Comrac[or (Company N I C???ir or s Li ns
i g ddres ICJQ?? tj?? c r or,Own¢r Mabj
. J L' L qR Instaf aLOn/1?`???/^/
. ! •
Au rited 5 0natureC Va
r Ow C k In allaLO Pry
?
N
l
? r ` (
/
MINNESOTA STqTE BOAPO OF ELFCTflICITV THIS INSPECTION FEQUEST WILI NOT
Grig9s-Midwey Bltle. - Aoom N-191 ? BE qCCEPTED 8Y THE STATE 80ARD
1821 University Ave.. St. Peul, MN 66104 UNLESS PNOVEH INSPECTION FEE 1S
Plone (612) 297-21'11 ENCLOSED,
REQUEST FOR ELECTRICAL INSPECTION ea-aocwt.na
See instructions for compleqne this form on hack ol
?^ Vellow copv.
? 36 7-tj ? "X" ge/ow Work Covered by 7hls Request ?J
dd Aeo. _ Type oi Bwlaing Apoliancea riiree Equipme. Wve?
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. Bwlding Qryer Electric Heatin
Commeraal Bldy. urnace Silo Unloade,
Industnal 81Ag. .qv ContlinonW Bulk Miik Tenk
Farm , ?nr, oec??v _me? iSimnivl
...
....,.
.71.... t er Sueufy
777..,._r_. Dther Oth?r
tl P'e ServicaEntrence5ize k Fae Feadets/Subleetlers N F, Cucwts
Oto200qm s
Above 200 qmps Oto30Am s
31 to 700 qmps Otn30Am s
31 to 7D0 Am s
Swimming Pool Above 100_Am s
V A6ove 100_P.mps
Transiormer5
Signs Irrigation dooms
Special InSpecbon Partia6"Other Fee
Mem?rks s6 TOTAL FEEAW-L0.
aouen,
?.,haElec,.,r,.1
Inspector, here6y
Fnal
c?
?/`- 'L
D9to
? bs7 cerbfy thet the above
1 ectwn has been
eB
enla
Thie repuesl voiE 18 montlre trom
lhls requ¢sl vaid /??'??? ?.?
18 months (rom .
EC 36764
Jl rv/
fleq:,es Dat? ?
??
- fire No. HouPh-in InsVecbon
equ ed?
?PeadY Nyy\-?II Notrty Insaec-
?or Wh
R
, es ?No en
eady
,>B?Poensed Elettncal ConVactor t hereby iequestinspecLOn ol above
? Owner electricel work instelled at
Street Address, B or Fo N.
?
O Cit
Y P
section" o. To ship Name or No. - Range No. Countv
Oc u ant (PRINT) Phune No.
, Sup "I er hddress
nCal ConVactor ICompany Nam ? Co r,tor'S
s
r i? ?
np Adtlr s ICOM? ?mr r'Owner Mekin
ki) n t?sti )
? ?°l
?+?L"
"31
./
/
Ir
J,
orae Signatur IContr
t d0
n r Ma
n Install 1
Pho b?r
MINNESOTA STATE BOAPO Oi ELEGTqICITY TNIS INSPEGTION NEQUEST WILL NOT
Grsggs-Midway Bldq - Noom N-191 BE ACCEPTED BY THE STATE BOARO
1821 1lmversilV Aye.. SL Peul, MN 55104 UNLESS PftOPEP INSPECTION FEE IS
Phorre 1612129].2111 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION ee-oouoi.oa
' See instrucLOns for com01ebn9 ihis larm on back oi Yellow caoV. l ?
U7Ra "X` BeJOw Work Covered by This Request
dtl Xao- TVPe oi 9uiltl,ng Aoobancea ripred Equiumem Wved
Home Range Temporary Service
?uplex Water Heater Ligh[?ny Fixtures
Apt Bwldmg Dryer Electn.. HeaLn
Commercial Bldy Fumace Silo Unloader
InAustnal Bldg. Art Condrtioner Bulk Milk Tank
Farm omr? oec? v ??nF? 1soc?,ry7
I a,! SUCCIIy Othef 01M1e.
LmmmAa IncnPCtfOb haa Halnw
k F e- SarviceEntranceSae # Fea Fanders/Subleeders # F e Cvcwts
0 to 200 qm s 0 to 30 Am s 0 to 30 Am s
Above 200 Amps 31 to 100 Amps 31 to 100 A s
Swimming Pool I Above 100_Amps Above 100_AmPS
Transtormers IrngaLOn 13oort?s Partial.Other
-Fee_
Signs pecial Inspection S' C /
TOTAL FEE
flemarks 1-r7 I
Poueh-in the ElecfripaI
InsDec?or. hereby
F?nal certdy that fhe above
inapaction has been
meae. ---
Thie reoueel ralE 18 montha Irom
Th,s request vmtl /C/7JI y(^
18 months Irom
C 36765?-Y, 6
F.- Ipesi Uate //
U ?
I
I Pire No. Rouph-in Insperbon
e eA>
?ReadY Now ill NoLfy Inspec-
H'h
R
d
Gd- Yes O No ¢n
ea
y
XJZTCensetl Elecincal ConVactor I hereby repuest inspaclron of above
? Uw^er electrical work mstallad aL
Sheet Ad ress, B Route No. Ci[y
?+ W ...
ectmn o. Towns io ame o . Range No. Counly
O pantlPqlNT Phone No.
l
P. Supp . Address
-Ftjcj'cal Coniractor (COmpany N
's 5-n
C??nt ctor
? ' ?
!
g dr (Co tr ct r or wner
V
i e fns
St
lletm
C
Au nz Signa
wre ( nVacto wn akm Ir allavon) Phn¢e Nu?ber
n
MINNESOTA STATE BOAflD OF ELECTRICITY L,07..- THIS INSPECTION pEnUEST WILI N07
4ri98s•Midwey Bldg. - Noom N-191 BE ACCEPTED 8V THE STATE BOARD
1 921 University Ave., St. Peuf, MN 55700 UNLESS PNOPER INSPECTION FEE IS
Phone 1812? 297,2111 ENCLOSEO,
Z / REQUEST FOR ELECTRICAL INSPECTION ee-ooooi.oa
/?/?J? •?? , See instruMwns lor complabng this form on beck o/ vallow copy.
?"X'" Below Work Covered by 7his Request
C 36765 ,?
Ad? dp. Typa ol Bwltlmg ApOlinncea Wired EqwGment Wired
Home Range Temporary Service
Duplex Water Heater Lighhny Fixtures
Apt Bwlding Dryer Electnc Heatin
Commeraal Bidg Furnace Silo Unloader
Industnal BIAg. Art Conditwn r Bulk Milk Tank
farm otnv. _neu v einrr ISUCUfy)
t,r Sueu y ther Other
PouBh-in Da/te ('
?z"8 /
. th \
a „i<aI
? P IJ Inspector, ?a?eby
Final ? cerbfV that the above
insOection has been
;
' J
I?N
Thus reauest void
18 monffis fmm , ? b ?-•' <
C•. -' C.? .?
C 3 S 7 6 6 c
P q est Date
? Ptre No. RouPh-m Insper,UOn
Re etl? ?
E]fleadY Nu ill Novty Insoec-
V ? Yes lar When Hgady
icpnsed EIecCncal Convactor I heleby aequast inspection of ebove
?Owner electrical work mstalled at
St eet Address, 9ox or oute Crry
?
ecuon o. Towns ip Name or No. ange No. Counly
c upantlP TI Phone No
?
? .
oy Supp r Atldress
I J
? wal Con[ractor (Company P1Hrwe ?_ Cont ctors ?cen e ?
MaiM1 AJres (ConVactor or Ow er akin0 [nsta, a) ?
onz d Ba u¢ ICOn ctor/ ner Installau, I Phon umDer
C L
mlryryESOTq STqTE BOAND OF ELECTHICITV l ?F+? TH15 INSPECTION REQUEST WILL NOT
Gnges•Midwey 61de. - Noom N-191 -•v BE ACCEPTED BY THE STATE BOAHD
1821 Universrtv Ave., $t. Paul, MN 55104 UNLESS PflOPEN INSPEGTIpN FEE IS
Phone (612) 297_2711 ENCLOSED.
Y
REQUEST FOH ELECTRICAL INSPECTION ee-oooot-oa
lV ?2? ` YC 0 See insbucpons lor com0lebng 1his form on back of Yellow copy. /
P_ .1 tj 7 ?j F '"X" Be/ow Work Covered by This Request -
Acf ReD TYPe ot Builtlrng Aooimncas Wved EquiVment Wved
Home Range Temporary Service
Duplex Water Heater Ligh[iny Fixtures
Apt. Bwlciing Dryei Bectne Heaun
Commercial Bldy. Fumace Silo Unloader
Industrial Bldg. qv Condition Bulk Milk Tenk
Farm Otne, pea v oihe?ispcuivl
I er Sueciry Oiher pihn,
LU/!lUl/f@ 1/ISOCGIIOfi fP.P ff?/OW
fje ServiceEnM1anceSize 4 Fee Fender N Grcwts
U to 200 qm s 0 to 30 0 tn 30 Am s
A6ove 200 qmps 31 to 1 31 to 100 A 5
Swimming Pool g
Above Above 1QQ_Amps
Transiormers Irrigati ParUaLDther Fee,
Signs Special
W ' `,
emarks TOTAL FEE??ja1l
HauBh-in
D te
f i i
1, the Elect?ricalf
Inspecmq nereby
Finai certdV thxt the above
ms
ection nes b
p
een
Rue reouesl vottl 16 months irom
?-----------------
I FQC?[?ce;lise ?
? ?z?-? 1 I
? Permit#: ?
I
z? ?
? Permit Fee: ?
I
I ?
I Date Received. ?
I ?
I
j Staff: I
L - - - - - - - - - - - - - - - - - I
2008 COMMERCIAL BUILDING PERMIT APPLICATION
Date: Site Address: lJ?$ &dYlrC/) ?Q . I':Ly0 C:UL/Y150N 7)/lTenant Name: 153g \ G;, iSqU " 1"
(Tenant is: _ New / _? Existing) Suite #:
PROPERTY OWNER Name: i 6 Phone:
Address / City / Zip: 1533L'Joai
s,s,J DR 153i[{ " ?Syn Plom?a nrw? ?540 -13
,
Applicant is: _ Owner Contractor
TYPE OF WORK Description of work: 43- f' rv\
Construction Cost: 01, 6
CONTRACTOR NamelAkimin /' "O/?s License#:
Address: asc) ? •
City:d? -<?-4 'PfliJ? i ?527 ? ?r State: )4'J Zip: ,SS021?
'
Contact Person:el??q) 73-W ' v Ri C.
Phone: 6,3I ^aSFi "1 Q6 I
ARCHITECT I Name: Registration #:
ENGINEER
Address:
City: State: Zip:
Phone: Contact Person:
Licensed plumber installing new sewer/water service: Phone #:
lJOTE: Plans and suppbrting documents thai you submit are considered to be pubiic; informafion. Portions of
ihe information may be classified as.non-public if you provide specifk reasons that:would permit the City" to
condude that the are trade secrets. '
I hereby acknowledge that this information is complete and accurele; that the vto& will be in Z
Eagan; that I understand this is not a permit, but only an application for a p rmit, and work
accordance with the approved plan in the case of work which requires a review nd approval of
x ? ////IA/ ! )!G/( ?
Appli anYs Printed Name
3nce with the ordinances and codes of the City of
to stagrt without a permR; that the work will be in
Page 1 of 3
• COMMERCIAL
2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4675
,)-I 3- `?l5
Foundation Onl New Construction Interior Im rovement
• StrucWral Plans (2) sets . ArchitecWrel Plans (2) sets • Architectural Plans (2) sets
• Civil Plans (2) . SWCtural Plans (2) • Code Anatysis (1)
• Certificate of Survey (1) • CivilPlans (2) • ProjectSpecs (7)
• CodeAnalysis (1)" . LandscapingPlans (2) • KeyPlan (1)
• Project Specs (1) • Code Analysis (1) " • Master Exit Plan (1)
• Spec. Insp. & Testlng Schedule " . Certificate of Survey (1) • Energy Calculations (1) not always"
• Soils Report (1) . Spec. Insp. 8 TesUng Scheduie (1) " • Eiec. Power & Lighting Form (1) not always"
• Meter size must be established • Meter size must be established • Meter size must be established - if applicable
• ProjectSpecs (1)
1 • EnergyCalculations (t)
1 • Electric Power 8 Lighting Form (1)
1 • Master Ecit Plan (1) 1
1 • Emergency Response Site Plan (1)
1 • Soils Report (1) 1
• MqES SAC determination letter . MGES SAC determination letter • MGES SAC determination letter
call 651-602-7000 wll 651-602-1000 call 651-602-1000
Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for details.
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.
DATE: le WORK TYPE: _ NEW -REMODEL CONSTRUCTION COST: 7? 72 2-
SITEADDRESS: l J3 ') yd 'a 5- )5
TENANT NAME: //w" Z-C?? SUITE #:
FORMER TENANT NAME, IF APPLICABLE:
DESCRIPTION OF WORK --;? i__ /_
Name: z `?r? Zv?7 Phone #: ( 7l3 ) ?' Z? ? ?1 G .3 C
PROPERTY Last First
OWNER p
SheetAddress: ?d /?a,jc• ? ?5!54
City: State: l?JI zip: S.s Y Z?I
Company: Phone #: (?IZ_ Cz ?3
CONTRACTOR !_
StreetAddress: " ? dJ ? 7City: State: ?? Zip: 5 S ?/
ARCHITECT/
ENGINEER Company:
Name:
Street Addiess:
Phone #:
?' ;
! 1 ? lJ
nn #• ? •
i
City: State: Zip: _
Licensed plumber installing new sewerlwater service: Phone #:
I hereby acknowledge that I have read this application, state that the information is correct, and agree to?y with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: </? %,.-
Updated 7102
s
THOMAS LAKE HEIGHTS 2ND 75951
PERMIT
DATE &
TYPE
r
t 10/86 4-PLEX
3/85
3/85 4-PLEX
4/85 4-PLEX
5/85 4-PLEX
5/SS 4-PLEX
10/85 4-PLEX
LOT BL ADDRESS
-- - - _"_ `?
010 Ol 1538/ CLEMSON DR
020 01 1538B/
030 01 1540B/
040 01 1540
---
-- _--`-
O50 Ol _?
1542/ CLEMSON DR
060 01 1542B/
070 01 1544B/
080 01 1544
090 01 1546B CLEMSON DA
100 01 1548B/
110 01 1548/
120 01 1546
130 01 1552/ CLEMSON DR
140 01 1552B/
150 01 1554B/
160 01 1554
170 01 1556/ CLEMSON DR
180 01 1556B/
190 01 1558B/
200 01 1558
210 Ol ] 562/ CLEMSON DR
220 01 1560/
230 Ol 1560B/
240 01 1562
250 Ol 1566/ CLEMSON DR
260 Ol 1564/
270 01 1564B/
280 01 1566B
31
APPROVED 3/85
PAGE 1 OF 5
/
/
X D00.0
(000.0)
-44---
qH
\ X/
1
Denotes Iron Monument-
Denotes Wood Stake
Denotes Existing Elevation /
Denotes Proposed Elevation-/
Denotes Direction of Surface Drainage
/
?6 y
? I
BC OCK /
Proposed Top of Foundation Elevation=
Proposed Garage Floor Eievatfon= 927 0
Proposed Lowest Floor Elevation= 9?7.5
I hereby certity that this is a true and correct representation ot a survey of the boundaries ot
Lots 1, 2, 3, and 4, Biocl; 1, THOMAS LAKE HEIGHTS 2ND ADDITION, DaY.ota
County Minnesota.
And of ihe location of all buiidings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows ihe location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this , 15 TN day oi sP; t.am':,ar „19_SG_.
?-
au A. Jdivnso
Land Surveyor, Minn. Reg. No. 10938
E OF SURVEY
iLE4o' CERTIFICA {?
? • oa r?a
McCOMBS-KNUTSON ASSOCIATES, INC. eo +?/'?[?/'y?'(?'y,CQ
to4tottno tRmeteec E ueo suaIrou 0 $q1 ru?MUt rue no,
Mw 1"M11ZV) ?I r"MYI`Q
, .??. wNNENOLIf W MUiCMIti90N.MINx[?OiA 74 30
i ?
M' ? ?
1986 BIIILDING PEIWT APPLICATIOH - CITY OF BAG9N
60TE: ALL CONTRACIOHS !lOST BS LICENSBD iIITH THE CITY OF EAG9N
SINGLfi FAMIILY DHELLffiGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SQRVEY9 1 SET OF ENERGY CALCULATIONS
MfJLTIPLE DWELLINGS - RSSIDENTIAI, REdTAL 09ITS FOR SALB DNITS VI
INCLUDE 2 SETS OF PLANS, CERTIFIC6TE OF SOR9EY - CHECH WITH BLDG. DSPT.,
1 SET OF ENERGY CALCULATIONS
COHIMRCIAY.
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATZONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
/ C r . T l l? ?
?vV
?
p
To Be Used Fo . Valuation: /
Date: q-l9 "9?v
Site Address 153 r 6C,C mSOAj . OFFICE DSE ONLY
Lot ? Bloek ? Ereet 7( Oecupaney 9.5
Parcel/Sub??Q/yy,?QXA10 Remodel
?Repair Zoning
Type of Const ?
VL/
Owner ,(?/L? ?/YLLO? _
Addition
?1?Move # of Stories
Length
n
/"U
Ow 137 Demolish Depth 24 _
•/
Address Int.Impr. , Sq Ft
Install
City/Zip Code
Phone APPROYAIS FEES ,
Contractor JQ Atp-_ Assessments Permit
Water/Sewer Surcharge 36
Address Police Plan Review
Fire SAC ? 7e
City/Zip Code Engr Water Conn 5p
Planner Water Meter a
Phone CouncilRoad Unit az-4
Bldg Off ??/3n/
Y= f{G, Treatment Pl ?
s
Arch./Engr. 7
APC Y Parks
Variance Copies
Address T(YfAL ?
City/Zip Code
Phone #
3
HOTE: ADDSESSES FOR CORNER LOTS - CONTRACTOR/HOHEOIINES MIIST
IS DS3IR6D. NO CHANGS3 iiILL HE 9LGOWED OPCE BQILDING PEED
y
.3?
WHICH ADDRfiSS
FOR SALE T. H. CITY OF EAGAN
Ll-n y B-.1 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8700
BUILDING PERMIT
Receipt Ii
N° 12740
6,?3 75/
Tobeueedtor 1 OF 4 PLEX Est.Value $60,000 Date OCTOBER 8 1986
SiteAddress 1538 CLEMSON DR Erect C} Occupancy R3
Lat 1 Block 1 Sec/Sub. THOMAS LK HTS Remodel ? Zoning PD
Parcel No. ZND Repair ? 7ype of Const. VN
Addition ? No. Stories
w Name NEW HORIZON HOMES Move ? Length 46
s
Address P.O. BOX 1367 Demolish ? Depth ?4
o
Ciry ?LS pnone 420-3900 Int. Impr.
t
u
I ?
? Sq. Ft
ns
a
i o Name SAME Approvals Fees
$ a Address
- Ciry Phone
r?
w W Name
?i
Address
z
< W City Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and?City o Eag n Ordina?. '
Signature of Permittee ?
A Building Permit is issued to. NEW HORI ZON HOMES
all work shall be done in accordance with all ap1ooohhhccca+ e State of Minp`es?o.?
8uilding Official \`?
Assessment
Water & Sew.
Police
Fire
Planner
Council
Bmg. off. 9/3 0/8 E
Var.
Permit $ 313.00
Surcharge 30.00
Plan Review 156,50
SAC 575.00
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.00
Tr. PI. 156 . 00
Parks
Copie 2.0 .00
T_InI
on the express condition that
and City of Eagan Ordinances.
? • ?? - /? ? Ll/
1986 BIIILDIBG PEHlIIT APPLICATIOH - CI1R OF EAG9N
NOTS: ALL CANTRACTORS MQST HE LICENSED iiITH THB CITY OF fiAGAA
3IAGLE FAFILI.Y DTaEI.LINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
M[1LTIP[.E DiTELLINGS - RESIDENTIAL
INCLUDE 2 SETS OF PLANS, CSS'
1 SET OF SNERGY CALCULATIONS
C0M4MRCIAG
RENT9L DNITS FOR SALE ONITS ?
OF. SOAVEY - CHECg iIITH BLDG. DSPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 7 SET OF
ENERGY CALCIILATIONS,
0?
$2, 000 LANDSCAPE BOND/ -PA
To Be Used For: Valuation: ? Date:
Site Address 1.6.3 S' ?6 66C /7750A-)? LIZ OFFICE DSB ONL]
Lot v Bloek ?
Parcel/Sub
/) OMCc-oJ t1S A.4-, e ,
Owner
Address 11310
?
City/Zip Code
Phone SW ",3r9?Q
Contractor Ja/}2?
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
Erect ? Oceupancy fS_
Remodel Zoning ?
:ZRepair _ Type of Const
Addition A of Stories
?•Move Length ?
Demolish _ Depth ?
Int.Impr. _ Sq Ft
Install _
APPBOYALS FSfiS
Assessments Permit -3/16
Water/Sewer Surcharge ''s?fl_
Yolice Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off ? Treatment P1
APC Parks
Variance Copies
YOTAI. z 11'v;
POTE: 9DD8ESSBS FOR CORNEB LOTS - CONTRACTOR/HOMEOiiNfiB MOST DESIGBATE AHICH ADDRESS
IS DESIRED. HO CH9NGES iiII.L BE ALLOTdED ONCE BQII.DING PERMIY IS ISSQED.
9
FOR SAT,E T.H. CITY OF EAGAN :
L 174, P- 1 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N° 12741
PHONE: 454-8100
BUILDING PERMIT Receiptq-T?
7obeuaedfor 1 OF 4 PLEX EstValue $61,000 pate OCTOBER 8 ?g 86
SiteAddress 1538B CLEMSON DR Erect IN Occupancy R3
Lot Z elock 1 Sec/Sub. THOMAS LK HTS Remodel ? Zoning PD
Parcel No. ZND Repair ? Type oi Const
Addrtion ? No. SloneS
? Name NEW HORIZON HOMES Move ? Length 46
= P.O. BOX 1367 Demolish ? Depth-24
o Address Int. Impr. ? Sq. Ft
Ciry MPLS phone 420-3900 Install ?
i o I Name SAMF
? Q Address
? Ciry Phone
1- a
F W
Name
s ? Atldress
a W Ciry Phone
I hereby acknowledge that I have read this application and state that ihe
information is correct and agree to comply with all applicable State oi
Minnesota Statutes and City ofjiSgaryOrdinagyRy!
Signature of
Assessment
Water & Sew.
Police
Fire
Planner
Council
eid9. on. 9/30/86
Var. Date
Permit $ 316.00
Surcharge 30.50
Plan Review 158. 00
SAC 575.00
Water Conn. 500.00
WaterMeter 63.50
Road Unit 290.00
7r. PI. 156.00
Parks
Copies
Total $2,089•00
A Building Permit is issued to• Tm?n nvni c,uiv nuri on the express condition that
all work shall be done in accordance with all ?appiXiF? State of Nlinneso_ S?utes and Ciry of Eagan Ordinances.
Building ONicial `-? ? ?
_.
.?
AOTS: Ai.L
/? ? ?? 04,
7986 BIIILDING PEBtIIT APPLICATIOA - CITY OF E9GAN
M[IST BE LICSt1SSD IiITH THE CITY OF EAGAH
SINGLE F9lQLY DflEI.LIIiGS
INCLUDE 2 SETS OF PLANSP 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
?
MOLTIPLS DWELLINGS - RESIDENTIAL RENTAL DeIITS FOB SALS ONITS
INCLUDE 2 SETS OF PLANS, CERTIFICATS OF SORYEY - CHBCB iiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMAfERCTAi:
INCLUDE 2 SETS OF ARCHITECTURAL & STRIICTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
??F Ll????
To Be Used For.,??j7p? , Valuation: Date:
Site Address 15?10 OFFICS IISE ONLY
Lot Bloek ? Erect ? Oecupaney le-T
y? ?
/,,
? Remodel Zoning ?
Parcel/Sub
?L( a_Aepair _ Type of Const ?
Addition ik of Stories
OwnerL7C.tJ A-) In N g? ?76.Move Length ?
/? _
Demolish Depth 241
Address p"? 0. 4bJl 134,17 Int.Impr. _ Sq Ft
Install
City/Zip Code 17?7 -&_ V3-)
Phone 4,A6'30aQ APPR09ALS FSES
Contraetor dQ/YLJL Assessments Permit
Water/Sewer Surcharge 30_
9ddress Police Plan Review 15Cv. SD
Fire SAC :5 7'T_
City/Zip Code Engr Water Conn 50 D
Planner Water Meter 4g&.5D
Phone Council Road Unit 290
Bldg Of£9- - Treatment Pl [Q
Areh./Engr. APC Parks
Add Variance Copies
TOTAL ?
ress
City/Zip Code
Phone 4
NOTE: ADDHESSES FOR CORNE6 LOTS - CONTRACTOR/HOIiEOiiNER lSIIST DESIGNATE iiHICH ADDRESS
IS DESIflED. NO CH9NGES NII.L HE ALLOpSD ONCE BUILDING PBRMI? IS ISSUED.
FOR SALE T.H.
L 1-4, B 1
BUILDING PERMIT
Na 12743
Receipt # 21?
Tobeusedfor 1 OF 4 PLEX Est.Vaiue $60,000 Date OCTOBER 8 1986
SiteAddress 1540 CLEMSON DR Erect Occupancy R3
Lot 4 elock 1 Sec/Sub. THOMAS LK HTS Remodel ? Zoning PD
Parcel No. ZND Repair ? Type of Const Vn
Additian ? No. Stories
w Name NEW HORIZON HOMES INC Move ? Length 46
3 Address P.O. BOX 1367 Demolish ? Depth?d
0 Ciry MPLS phone 420-3900 Int.lmpr.
I
ll ?
? Sq. Ft.
nsia
Z o Name SAME Approvals Fees
? ¢ Address
? Ciry Phone
a
F w Name
? ? Address
z
a W
Ciry Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of E gan rdinance
Signatme of Permittee?
A euilding Permit is issued to: NEW HOR ZON HOME£
all work shall be done in accordance with all
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
State
Assessment
water & Sew.
Police
Fire
Planner
Council
eldg. on. 9/30186
Var. Date
Permit $ 313.00
Surcharge 30.00
Plan Review 156.50
SAC 575.00
Water Conn. 500.00
Water Meter 63 . 50
fload Unit 290.00
Tr. PI. 156.00
Parks
Copies
Total $2.084.00
on the express condition that
and City of Eagan Ordinances.
4 j'•
Building Official rl?(?r/?? • ??-y_
??.
1986 HQILDING PERFIII APPLICATION - CITY OF EAG9N
NOTE: ALL COATRACTORS MOS? BS LICENSSD WITH THE CITY OF EAGAN
SINGLE FAlIILY DiIELI.IBGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MDLTIPLE Dii6LLINGS - RESIDENTIAL RENT9L iNITS FOP SALS QNITS VI/
INCLUDE 2 SETS OF PLANS, CEBTIFICATS OF SORYSY - CBEC[ fiITH BLDG. DEPT.,
7 SET OF SNERGY CALCULATIDNS
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SE2 OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE SOND
? d 4- Z?
To Be Used Fo . 27• Valuation:?
Date: % `14 - $?
Site Address 6&1?150/l) . OFFICE QSE OPLY
Lot .3 Block ? Erect Occupaney A'S
Pareel/Sul?jOj)')Q?1 vu[?,cx. ??cr/?f1f Remodel
a._-Repair _ Zoning
Type of Const PP
-7?
Owner?f C(?
?Tryzl ??l.J ?fJ?YLC?t, Addltion
/-)f.Move # of Stories
Length
-41.Vv
p
Address Impr. _
Int? SqFt
City/Zip Code ?., ?
/? G2, ?9)/1•,5344 Znstall
Phone Uao - 3?6v APPHOVAIS FE6S
Contractor ?C[ /yL-e-1 Assessments Permit
?
Water/Sewer Surcharge
Address Police Plan Review
Fire SAC $
City/Zip Code Engr Water Conn
Planner Water Meter ?.3'. d
Phone Council Road Unit 290
Bldg Off - - ? Treatment Pl
Areh./Engr. APC Parks
Varianee Copies
Address TOTAL ?
City/Zip Code
.
Phone 0
AOTE: ADDEESS6S FOR CORNER LOTS - CONTRACTOR/HOMEOiiNEB MOST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CH9NGFS IiILL BE ALLOiiED ONCE BIIILDING PSBMIT IS ISSUED.
FOR SALE T.H.
L .1-4,.B 1
, Y
CITY OF EAGAN A'
3830 Pilot Knob Road, P.O. Bpx 21-199, Eagan, MN 55121N2 12742
BUILDING PERMIT PHONE: 454-8100
ro be used for 1 OF 4 PLEX
$61,000
Receipt N 6 ?'? C--
oate OCTOBER 8 g(
siteAddress 1540B CLEMSON DR ,19_
Lot 3
Block 1 Sec?Sub. THOMAS Erect
LAKE HTS Remod
l ?
? Occupancy R3
Parcel No. 2ND e
Repair
? Zaning PD
Type of Const------ 44
a NEW HORIZON HOMES
W Name Addition
M ?
? No.stories
o Address P•0• BOX 1367 ove
Demolish
? Length
Depth 74
city MPLS phone 420-3900 Intlmpr. ? Sq.Ft.
Install ?
ao Name SAME ' -_ •
?8 Address
.
ciN Phone
Ga
W w
Name
?i
m ? Address
CiN Phone
I hereby acknowledge that I have read this application and state ihat the
mformation is correct and agree to comply with all applicable Stete of
Minnesota Statutes and City of ga Ordina .
Signature of Permittee
A Building Permit is issued to: NEW HORIZON HOMES
all work shall be done in accordance with all a
State of Minnes'
Building ONicial ( ca - , t _
Assessment_
Water & Sew.
Police _
FirB -
Planner
Council
Bldg. Off. 9/ 8/ 8 6
Var. Date
' Permit 5 316.00
Surcharge 30.50
Plan Review 158.00
SAC 575.00
Water Conn. 5 0 0. 0 0
WaterMeter 63.50
Road Unit 290. 00
Tr. PI. 156. 00
Parks
Copies
---
s '
rnr.i 9.00
on the express condition that
City of Eagan Ortlinances.
-?-r-' i
I 4
? V?? ??' 1 ZV'C?1 , • ? ? `/? ?? ? ? RnA? v 3?a(? ?.l
;r'?? i? 1 f:t?l_ ?ov?s ?1 ??r`.?E ?, ?;?•L .? ? f?l? 26 , 7 54
NEATLOSSCALCULATIONS HEATlMG&AIR COWDITIONOIUG CO. MINNEAPOLIS,MINN.
Weather6trips A.S.H.V.E. ConstruCtion No. Insulation
mWows Doors Gwde Out. Wall Inl. Wall Ceiling Roo( Floor Kind How Applied
Reference
Yes-No Yes-NO 19__
FLL0VIW(? o_ Rodn Length Wid[h ? Z Heipht ? FI. ('(`?SYM ?.pROan Length ??/O Y{ideM '!i Heieht
YJindows and Doors-Crackage and Area Win lows an d Doors- Crecka ge and Are a
No. W,nrh
of nnu Ha.ynt
of ene No. of
1,hIS Lineal It.
ol crack 4rea
6q. iI.
No' WiArh
ol ane Moiqnt
ol ene Nn. oi
hte Lineal ft.
ol craek Area
sV. It.
1 e-i 2 .2 a l b z zi ??
? ° 4 R °J 2
a ? ? ?o
Coaf Btu Coef Btu
inriaetion 133 in,naana, 21 3 -198
Giass 2q Giass ?1 5
Exp. wall ExP. well IQ
Net exp. wall Net eHp. wall 4• 25$
?FITWBft o0?' 1 117 2 u Int. wall
ceiiine 26 cauin0 2of? 2,S 1
FI oor Floor
Total Btu.
7 5"' _
Total Btu. 3 a
Required sq. ft• E.D.R. or bq. ins. W.A. Leader area Raquired sq. ft. E.O.R. or sQ. ins. W.A. Leader area
fL Ropn Length 13 WiMh HeiBM FL (S' 2+0tkan Leng[h ? 5 Wldth I 40 Heiyht
YJindows and Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and Ar ea
No. H'idth
l NB?qM
of ane No. al
I? ?14 Lmeal N.
0l crack Area
'+0. ft• No
' WiAth
ol ane HxIqht
?f ann No, uf
li
h14 Lineal It.
of [reck Area
sG. ti•
o
dne
u g NT.u i(o ? l
Coef Btu Coef Blu
Inliltration 2240 Infiltration .2 1 3Z r`a?
Glass di S? AOUf? Glass
Ezp. wal l :;'C `K 5?0 Exp. wal l ? 2 X ??o
-
Net exp. wall
,
Nat exo. we?l
? n
,
2
321
Int
wall Int. wnll .
.
CBiling ?1 z•5 2 Cailinp ?SQ ?•j 13-15
- - Floor 2`Cl !1 VO
S Tolal Btu
Totel Btu.
,
Required sq. ft. E.D.R. or sq. ins. W.A. Leader areo Required sq, ft. E.D.R. or sq. ins. W.A. leader area
FI. '?t Ropn Length ' 12 Wu1th ? HeiBht 1 FI. Room Length ? Width ? Height`
Windows and Doors-Crackage and Area Wiodows and Doors-Crackage and Area
h
y/itl?hHa?Qht No. uf lmeal. A.ea
Nn Wiqrn H¢?pb? No. nl Lmeel 11. 4rea
N?' UI N118 u? oAnY. II h?9 Of CIdCk gG??•
4V? It•
. 01 dnB Of OPlIB II ht0 OI LtBCk
Coet Btu Coe f Btu
Inliltratron Infiltrabon
Glass Glass
Exp. wall Exp, w»II
Net exp. wall Nef exp. wall
Int
wall Int. wnll
.
Ceil-ng IZ.'xC -I CefImO
- ---(lax LA
Fioor
Total Bfu. Tota? Btw __
Requirod sq. f1. E.O.R. or sq, ins. W.A. ;,4.:de•r aroa 2 ? 0 ?uqwred sq. it. E.D.R. or sq. ins. W.A. Leader erea
HEHT LOSS CALCULqTIONS
o°•
HEATINGB AIR
"?"
CONDITIONING CO.
MINNEAPOLIS, MINN.
Wea[herstrip5 A.S.H.V.E. Con6truction No. Insulation
Windows Doors Guide
Reference QLA yyall int. Wall Ceiling poot Floor Kind How Applied
Yes-No Yes-No 19_ ,
gFl. 'Q Room Length ?Q Wid[h Heieht FI. Roan LanB[h Width HeiBht
Ydindows and Doors-Crackage and Area Windows an d Doors- Cracka ge and Are a
No. WiArh
al enn HeiqM
ol ene No. of
Ir hls L?neal 11.
ol crack Area
sa• t t•
NO' W,aln
ol arre HoiOht
of ane Nn. ol
li h?s Uneel It.
vr crack Area
sV• ?,•
z 2 a0 i(o
Coet Btu Coe/ 8tu
Inliltration 74pcl In/iltration
Glass 16 Glass
Exp. wall ),, Exp. wall
Net exp. well 2 Net exp. wall
Int. wall Int. wall
Ceiling Ceiling
Floor 10 Floor
lotal 8tu. Totel Btu,
Required sV• ft. E.O.F. or Sq. ins. W.A. Leader erea Nequired 6q. ft. E.D.R. or 5q. ins. W.A. Leeder area
F1. (\yv?? Roan LenBth %'? Width Heieht FI. fioom Length Width Haiyht
Ydindows and Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and Ar ea
.
No '''d??
ol ane Ma
iqht
ot an<
No, of
hhIS
lmeal ry,
oi crack
Area
.fi•
O'
Wid,h
ol ene
Mx?
qM
of dna
h No. M u S ?
lo/meal crack !1.
Area
SG. R.
Y 9 a -
3 -1- -10
Coef ef Btu Coef Btu
Iniiltretion 1 11-7 2223 Infiltration
Glass Glass
Exp. wall Exp, wall
Net exp. I I 2g2 9. ? ?? Net exp. wall
lutrwell f 2 ?fU .22 Int. wall .
Ceiling CeilinQ
Floor ?-X I 42 ? L Floor
Total Btw Total Btu.
Pequired sq. ft. E.O.R. or sq. ins. W.A. Leader areo Required 6q. tt. E.D.R. or sq. ins. W.A. Leader area
FI. r {?? LengtR 1+$ Width HeiBht FI. Room Length Width Height
Windows a nd Doors-Crackage and Area W indows a nd Ooors -Crack age and Ar ea
No. W'4??
l Heiqht
f No, ul
b M Lmaol It.
f cr
k A•ea
?,
<G No.
ol ana
uMl
nne
lNi a ??g M
lmeal q.
ol crack
Area
sY• ft•
o
ana ane
o s o
ac .
? ?
e
Coef Btu Coef Btu
Intiltretion Intiltrnuon
Glass Glass
Exp. wall Exp, wnll
Net exp. wall 7X`(> S6 q.) ?.?Cot_ Net eKp. well
Int. wall Int. wnll
Ceiling ?-
- Ceiling '
--_-?
_'.
Floor 7. ? D'J I J?•5 ?
lYaa Floor
7uta1 Btu. Total Btu.
?.
Req
urced sq. h. ED.R, or sq, ins. W.A. Leader area
uired g tt. E.D.F. ar sQ. ?ns. W.A. Leader erea
p? Q.
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: eurLoiNG
Permit Nu mber: 0 2 7 7 6 0
Date Issued: 0 6/ 0 4/ 9 6
SITE ADDRESS:
1538 CLEMSON OR
LOT: 1 BLOCK: 1
7HOMAS LflKE HEIGHTB 2ND
P.I.N.: 10-75951-010-01
DESCRIPTION:
REMARKS:
D E C K)
-s-F-?-? 2S
REPAIR
434 ALT. RESIDENTIAL
r? €
I _J.'?. ?£. " , .
FEE SUMMARY:
CONTRACTOR: - ppplicant - OWNER:
NELSON, KEITH 14206550 CASEY CONSTANCE
18511 86TN PL N . 1538 CLEMSON OR
MAPLE GROVE MN 55311 EAGAN MN
(612) 420-6550
I hereby ackn.owl.ed9e ttrat=T, have?, resd ?hie: application? and° sYate' thaC the
information is correct and agree to comply with all applicable State of Mn.
?Stetutes and.City of-Eat}an,Ordinances.;
.
APPLICANT/PERMITEE SIGNATURE
(REPLACE
$failding-,,Permit Type
;,BadiFding bl°c?rk 7ype
, ?Census Code
?--,
r r
rY
t
r ? 4
a.-
s(?9.?S??C? ? I?-
CITY OF EAGAN ? ,, ,,,,?•y. r
jqqW996 BUILDING PERMIT APPLBICATION1(RESIDENTIAL) '
681-4675
New Gonstrudion Reauiremenls Ra od uReoair Reauirements
? 3 regislered ake surveys ? 2 copies of plan
? 2 copias o( plans (include beam 6 window sizes; poured tnd. design; etc.) ? 2 site surveys (exterior addRions 8 decks)
? 7 energy plculafion{ ? 1 energy ealculalions for heated additions
? 3 coDias of tree presarvetlon plan N lol plattad aRer 711/93
requlred: _ Yes _ No
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: (;"7pQ1n
STREET ADDRESS:
LOT BIOCK I SUBD.lP.I.D.
PROPERTY Name: /4-0 )1 6M41J ?111AMXIL PhOne #:
OWNER ,.S* J ,a.,
Street Address: I S 39 ? 1 EmSdrU D(L
City: b76'A10 State: N/-/ Zip:
CONTRACTOR Company: Phone #:
Street Address: License #:
city: 1-'7a state: A71V zp:
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration
5treet Address•
City: State: Zip:
r-- -
Sewer & water licensed piumber: Penalty applies when address change and lot
change are requested once permit is issued.
i hereby acknowiedge that I have read this application and state that the information is correct and agree to comply with all
appiicable State oi Minnesota Statutes and City of Eagan Ordinances.
Signature of Appiicant:
r/ L,
OFFICE USE ONLY i Si9gU ?
?W,?Y 3 b
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes _ No
~ 1991 BUILDINIIIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTZPLE DWELLINCS
040*1"? Date:
2 SETS OF PLANS 2 SETS OF PI.ANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CP_'iC'ULATIOPIS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLZES WHEN: TYPING OF PERMIT IS REQUESTED, SUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL SE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: Ar:,cK Valuation
Site Address 63M lC'.vKSO4 64. F
Lot ? Block _L
Parcel/Sub _ I?iphfi/. ?J?A?,^N,? ?l?,
Owner (?ONn.1 (E L?ffS?Y
Address /.5.3VCIV-1-14?50,J 64.
City/Zip Code C-)q
Phone 45Z-96(Z
Contractor 9:1(-fL 3IZpT en-)
Address 74-7 Q 6i1cn.t,4itJe- 'Tfe .
City/Zip Code A. 0. ?vlAl. ss-12:i
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
OFFICE USE
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length ?
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
COMAlERCIAL
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL
?40
?
/,ao
agrees that all work shall be done in accordance with
(Signature o Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
, --- ? -
. ..
-
''. CITY OF EAGAN
„ 3830 Pilot Knob-Road, P.O. Box 2 7-199, Eagan, MN 55127 N? 18978
BUIL"DING PERMIT PHONE: 454-8100
'
Receipt # _ L
I 3 I-'?3
To ba used for DF.CK Est Value $1, 000 Dale APR 29
, ?y91
Site Address 1538 CLEMSON DR
Lot _ 1_ glock 1 Sec/Sub. THOMAS LAKE HTS OFFICE uSE oNLY
Parcel No. zND
Ottupancy _ FEES
? Name CONNIE ?SEY zomng _
W
?
Address 1538 CLEMSON DR (Adual) Const - Bldg. Permit 25.oo
o
City EAGAN Phon
452-9612 (Allowable)
surcnarge - 50
e x of stones
, a Name SAME Length 12' Plan Review
?` Address D?th 10' SAC, City
F
Clty PhOne S.F. 7olal
S.F. Footpnnts _
_
SAC, MCWCC
ww Name On Site Sewage _ Water Conn
w
?v
AddfeSS On $IIB Well - Water Meter
?z
a?'
C'?Ty Phone MWCC System
Ciry Warer
_
Acct oeposn
I hereby acknowlege thal I have read this applicahon and stale Ihat th
i PRV
g
e - S/W Permit
e
nlormanon is correct and agree to comply with all applicable Stale of
Minnewta StaWtes antl Ca f ?
e
pump
-
SnN Surcharge
Eagan Ordinanc9?
Si
natur
f P
?
•
?
Treatment PI
g
e o
ermite
( FL-a
- APPROVALS
A Bmlding Permil is issuetl to: CONNIE $ASEY
Pianner Road Umt
on tha express condition ihat all work shall be tlone in accordance with all
applicable State of Mmnesota Stat
t Council Park Ded
u
es and Ciry of Eagan Ordinances
Bidg. Ofl
Copies 1.00
Building plfiqal
\ Variance - 707AL 26. 50
- '?' ryN
' • ?' p ?
?
., ,
:
?I
k.
/
/
O? Denotes Iron Monument- /??.
Denotes Wood Stake ? ? ?
X000.0 Denotes Existing Elevationv/ (000.0) Denotes Proposed Elevatio?? ?
-*-- Denoles Direction ot Surface Drainage
,p ?
H _"'3" LAKE.
? GoT / OCK i
Proposed Top of Foundation Elevatlon=
Proposed Garage Fbor Elevation= 9z7 0
Proposed Lowest Fioor Elevffibn- 9Z75
I hereby certiry that this is a true and correct representafbn ot a survey ot the boundaries oF.
Lots 1, 2, 3, and 4, Blocl: 1, THOMAS IAKE HEIGHTS 2ND ADDITIDN, DaY,ota
County Minnesota.
And of the location of all huildings, if any, thereon, and all visible encroachments, if any, trom or
on said land. It also shows the bcation of the stakes as set tor a proposed building. As surveyed
by me or under my direct supervision this 15 T H day of GP; *en?,P+- „19R6. .
au A. Jo so
l.and Surveyor, Mmn. Reg. No. 10938
El CERTIFICATE OF SURVEY
for .
McCOMBS-KNUTSON ASSOCIATES, 1NC. ??'??/?,?/'?? ?y?
rceatovn? uaiutoe.treu 0 ar! rw1ea ??t f fM11L? ?iV1Y1GS
?MMMENOLM rr MIiCM11apN.MM1[W7A
t
HORIZON HILLS HOME OWNERS ASSOCIATION
ARCHITECTURAL CONTROL APPROVAL
According to the attached copx of your Architectural Control
Application dated ,,?,?,(' 1991 for the addition/
alteration of cr-n-1-;..v .
approval is qr nted pending the receipt of a City of Eagan
Building Permit.
Once you have obtained a City of Each Building Permit, please
mail a copy of it, along with any applicable drawings as required
for the building permit, to:
Horizon Hills Home Owners Association
Attn: Architectural Control Committee
Post Office Box 21423
Eagan, Minnesota 55121
As stated on your original Application, no work may begin until
the Architectural Control Committee has been supplied a copy of
your City of Eagan Building Permit.
The approved com letion date of this addition/alteration shall be
?„4 3i 1-`'(l . If your project is not completed
by this te; please contact the Architectural Committee for an
extension request. Failure to obtain an extension by the
approved completion date could result in HHHOA completing the
addition/alteration project and assessing the costs to you.
Date: . a
Approved by:
White Copy - Homeowner/Canary Copy - Horizon Hills File
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
CW51f5L/9
te/??/90
BUILDING
027850
06/11/96
SITE ADDRESS:
P.I.N.: 10-75951-040-01
1540 CLEMSON DR
LOT: 4 BLOCK: 1
THOMAS LAKE HEIGHTS 2ND
DESCRIPTION:
,. (DECK REPLACEMENT)
B611dinq-,PermiC Type SF (MISC.)
j,€Bu.ildi.ng 149,rk Type REPAIR
f, Census Code 434 ALT. RESIDENTIAL
i
? i
e_
i -
1' ?I
:
t:
?.?t.,'
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
$45.00
$45.50
CONTRACTOR:
OWNER: - Applicant -
WASHBURN HELEN
1540 CLEMSON DR
EAGAN MN 55122
(612)688-0502
?
I hereby acknowledge that,I have read this applicationand staCe that theinformaCion 3s correct`and agree Co c?omply wittr ail applicatsle State o`f Inn."
Statutes and City,of Epgan Ordin,aFlCes.. .
?
URE
APPLIGANTlPERMITEE SIGNATURE ISSUED BY: S G
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1400 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New ConsWCtion Raoulrements aemMJeLReoair Reauirements
? 3 registered aRe surveys ? 2 copies of plan
? 2 copies o( plane (include beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exteiior addRions & decks)
? 7 energy calcuiatlons ? 1 energy calculations tor healed additions
? 3 copies of trce preservetion plan B bt platted after 711193
requlred: Yes
/ 17
DATE: G2/ /? Ik
CONSTRUCTION COST: / ?
exx? S??S
DESCRIPTION OF WORK: ??4e)
STREET ADDRESS:
LOT ? BLOCK SUBD./P.I.D. #: tki m 2tij
shbtLrn Phone #:
LCL
PROPERTY -
Name: li
OWNER '"" J7
Street Address
City: ' State: /?( W Zip: S!D/ LZ
Phone #: 111Z6 -6J__3_D
fi4jS6n') l?0'/?:STG{G{iv_?
CONTRACTOR
._
Company:
Street Address: License #:
City: Ik"IL ?/ 071-e- State: Zip: .?5?7ZZ
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration #Street Address,
City:
Sewer 8 water licensed plumber:
change are requested once permit is issued.
State:
Zip:
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificaies of Survey Received
_ Yes _ No
Tree Preservation Plan Received _ Yes - No
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling a 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
0 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex ? 14 Fireplace o 21 Miscellaneous
? 05 SF Misc. ? 10 = plex c;W,"-t5 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
,,2432 Addition Of-Z4-Repeir- 0 37 Demolition
IeCo,"gcC £xisMerg 9Ap p,q
GENERAL INFORMATION
Const. (Actual)
(Ailowable)
UBC Occupancy
Zoning
# of Siories
Length
Depth
APPROVALS
Planning
_ Basement sq. ft. MC/WS System
_ Main level sq. ft. City Water
_ sq. ft. Fire Sprinklered
_ sq. ft. PRV
_ sq. ft. Booster Pump
_ sq. ft. Census Code.
_ Footprint sq. ft. SAC Code
Census Bldg
Census Unit
Building 2 -1 Engineering Variance
-;7Ty-
?
O
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Capies
Total:
Valuation: $
% SAC
SAC Units
PERMIT
-k'CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: BuILoiNG
Permit Number: 027761
Date Issued: @ 6/ 0 4 J 9 6
SITE ADDRESS:
1540 CLEM50N DR
LOT: 4 BLOCK: 1
THOMAS IAKE HEIGHTS 2ND
P.I.N.: 10-75951-040-01
DESCRIPTION:
(REPLACE
B`uildirit3?,Permit 7ype
fBuilding Uo.rk Type
Census Code ?`-
? -
?
?
°^ ?..
i.. s5 - _ ?...
D E C K)
REPAIR
434 AIT. RESIDENTIAL
4q tfr'iry?, x
;tF 8%r „°?,?gr° 4 fwf(? ?.?{?(•.yi-``;C :6?? ?I
°j
REMARKS:
STORM DAMAGE - NO FEE
FEE SUMMARY:
CONTRACTOR: - Applicant - OWNER:
NELSON, KEITH 14206550 WASNBURN HELEN
18511 86TH PL N 1540 CLEMSON OR
MAPLE GROVE MN 55311 EAGAN MN
(612) 420-6550
?
I hereby acknowledge that I have read this epplicatian and state that Che
informetion is carrecC amd a,g,ree,,to pomply w3zh all aqplicable State ofi Mn.
Statutes andCity oP Eaga'n Ordinances,
APPLICAN7/PERMITEE SIGNATURE
--fi.a6,11M.
ISSUEDBY. IiiIGNAMHE
CITY OF EAGAN '
3830 PILOT KNOB RD - 55122
??' 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New ConsWCtion Reoidrements RemodeLgeoair Reauirements
? 3 registared stte surveys ? 2 copies of plan
? 2 copies ot plana (indude beam & window sizes; paured tnd. design: etc.) ? 2 site surveys (ezterlor add8ions 8 decks)
? 1 energy ealwlatlons ? t energy calculations (or healed additions
? 3 copies ot tree preservaHon plan H lol platled aRer 7f1/93
required: _ Yes _ No
DATE: S-- j e ' 9z
DESCRIPTION OF WORK:
raRm
STREETADDRESS: ? sq0 ?' I?7YlSd/v D?
LOT It BLOCK J_ SUBDJP.I.D. #:
PROPERTY
owNeR
CONTRACTOR
Name: ? Joa) Phone #:
?yl RRlT
Street Address: lS`%b J&71'156 ND 9 _
City: State: ? Zip:
Company: ?Z'-11m /?ZS'6N Phone #: &IZC -('53D
Street Address: gZa7"L /C License #:
c ity: e?; dec? ?/€ State:Y//t Zip:
ARCHITECT! Company:
ENGINEER
Name:
Phone
Registration t
Street Address•
City:
Sewer & water Iicensed plumber:
change are requested once permit is issued.
State:
Zip:
Penalty appiies when address change and lot
1 hereby acknowledge that I have read this appiication and state that the informa ion is correct and agree to comply with all
appiicable SWte of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Plan Received _ Yes
CONSTRUCTION COST:
No
No
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
0 02 SF Dweliing o 07 4-plex
0 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
0 31 New ? 33 Alterations
? . 32 Addition ?R 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Ailowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Muiti Repair/Rem. ?
0 13 Garage/Accessory ?
? 14 Fireplace ?
O?7 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Variance
Y? y
/
O
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
•-' TY' ? ?
ti . N. 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 Bidg
Census Unit
% SAC
SAC Units
CITY USE ONLY
L ? BL RECEIPT#: Z /
SUBD. RECEIPTDATE:
PERMIT# ?II 'J
2000 PLUMBING PERMIT (RESIDENTIAI,)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when pertnits are required for each unit
? backflow preventer for underground sprinkler system
CiYTIIDCc
EACN //
TOTAL
Alterations to existing dwelling - minimum fee
Descnbe: REPLACING WATER HEATER $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet ' minimum - 7 3.00 x = $
Hot tublspa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavato 3.00 x = $
Septic System new/refurbished 'requires MPC lie. 75.00 x = $
Septic System abandonment 30.00 x = $
RpZ new installationlrepaiUrebuild 30.00 X = $
Rough openin 1.50 x = $
Shower 3.00 x = $
Underground sprinkler if dwelling is under wnstruction
Underground sprinkler if existing dwelling 3.00
30.00 x
x =
= $
$
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Water turnaround 30.00 x $
State Surcharge .50 --> ---? --> $ 50
TOt01
3n . 50
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
---- - -- -----
- . -
-- • -- ------------- ---- • ------------------ -------------------------------- cort ------------- --------- ------ -------------
- appiicable - City of - Eagan - ordinances -
-
I hereby acknowledge that I have read this appliwtion, state fhat Me information is ed, and agree to compty - with - all -
It is the applicanPs responsibility to notify the property ownar that the City of Eagan assumes no liability for any damages caused by the City during its
nortnal operational and maintenance activitias to the facilities construded under this pertnit wrthin City propertylright-of-wayleasement.
SITEADDRESS: 1538 CLEMSON DR,, EA('AN- MN 55 -18fi5
OWNERNAME:: ('ONNTF A C:A4FY TELEPHONE#: 651- 457-96119
(AREA CODE)
INSTALLERNAME: MARK SCHLINK TELEPHONE#: 507- 334-6177
(AREA CODE)
STREETADDRESS: 9389 140TH
CITY: MONTGOMERY STA ZlP: SLDF,A
" ? SIGNATURE
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*lOTS: PAYMF'nTP OF FEE AT TIME pF
APPLxcMoN noFS Nom oonsriTUM
APPROVAI, OF PERMIIT.
INSPDLTION OF SEWM AN]/OR WA1II2
nCTATSA'IIQD7$ P1II.T, NO1' $E $C[M-
[n.Fn t7rrrn, PERMIT xr,s aEM
APPR(3VID.
P ease Print)
1) PROPERTY ADDRESS: IGj3pj Cj,Q,M`j(MJ '-
LEGAL DESCRIPTION:
Lot Block Sub?ivision or Tax Parcel ID )
I£ EXISTING STRL't7L'RE, DATE OF ORIGINAL BC'ILDING pERMIT ISSL'ANCE: '
?
PBESENT ZANZNG/PROPOSID OSE: (hbn Year)
? COI"fMERCIAL/RETAIL/OFFICE ? R-1 SINGLE FAMILY
Q IPIDL'STRIAL 0 It-2 DCPZ.EX (Ztao Units)
rl INSTIT[,'TIONAL/GOVIIPM1ENp ? R-3 'iOWDIIIOL?SE (Three + Units) ( C?nits)
, p R-4 APARTNENP/CONIDOMINIONl ( Units)
2) ? -
, AD
CITY, STATE
PHONE:
. 3) I For Cify Ose
N?• b ? Plimibers License:
ADDRFSS: Active
i CITY. STATE. ZIP:
1" ' /) ?
2 ? EScpired
Not recorded
PHONE: pA$TER LICIINSE# Staff-Intlal
4) •?« • • i?•
NAME: ?A
K/ iI :V ?/l O lA
S. ?
?
ADDRFSS:
QTY. STATE, 2IP:
PHONE:
-5) ? v ? ? r • a?• : ? • ? - ??
[?CONNE(.TION 10 CITY SE42 CONNFX.TION Tq CITY WATER OTf?R '
7? ?' / ?
6) ? ?• -• i- ? pj,gp„gE HOLD APPROVID PERMIT EY)R PICK-OP BY ONE OF ABOVE
PLEASE MAIL APPROVID PERMIT TO 4, ABOVE
7) r ?• • . { ? .1 ?/UV . (Circl?one) r.z... .
I11.?Q ? rn
FOR CITY USE ONLY
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $
$ $ /D- 5 D
$ $
$ $
$ $
$ s
$ $ A?' (J ?
$
"
$
$ S7S <<ra $
$ $
Y $
$ $
$ $_
$ $
.?;73?C - p 4 7SVo
RECEIPT RECEIPT
-
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLUDE SL'RCHARGE)
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLCDE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOC'NT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSESSMENT
TRONK SEWER ASSESSMENT
LATERAL BENEFIT/TRPNK SEWER
LATERAL BENEFIT/TRC'NIC WATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
DOES CTILITY CONNECTION REQLIRE EXCAVATION IN PC'BLIC RIGHT OF WAY?
F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGZNEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING LONDITIONS:
APPROVED BY:
TITLE:
DATE: ?? /Z.?/ ??
. CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
'?f#*##**f*****#***f##****Y a .?#y_I
*IOTVE: PAYMF'Nr OF £F.E AT TIME G.' ?
ArPrscaTTaN noFS Nom oorsriRYIE
APPROVAL OF PEEiNIIT.
INSPFXTION OF SSSWER ANID/Ot X1g3t I
neAT.TATTpr7$ pJIIS, A117P $E $(IHED-
ULID UNrII. PIItNIIT flA5 BFEN
APPRdVID. ?
... --
P ease Print)
1) PROPERTY ADDRESS: ?cj3Q? rj
?
LEGAL DESCRIPTION: Z I ?T?1(LYy?f?S I.?t.jC4. 2
. Lot Block Subdivision or Tax Parcel ID )
IF MSTING SPRCLZL'RE, DATE OF ORIGINAL BC?ILDIN3 PERMZT ISSCANCE: '
?
. PRFSED7P ZONING/PROPOSID L'SE: (Month Year)
[D CO.tiY1EE2CIAL/FiE1AIL/0FFICE
Q IbID[.'STRIAL
n INSTITi'TIONAL/GOVERN?M7'p
? R-1 SINGLE FAMILY
Q R-2 DL'PLEX (TWo C?nits)
? R-3 ZOWNfiOL?SE (Three + Units) ( L?nits)
Q R-4 APAR'IP'ENT/COPIDOAIINIUM ( Units )
2)
ruahE:
ADDRESS:
CITY, STATE, 2IP:
PHONE:
• 3) • y,:,• For City l?se .
- ??: ? Pltunbers License:
ADDRESS: , Active
E?cpired
; CITY, STATE. ZIP: r Not recorded
PAONE: ? •n ?j MASTER LICENSE#
St?a rInitial
4) ??r • • ? i?•
A
n1 D 6A
,
ADDRFSS: •
CITY. STATE, ZIP:
PHONE: •
-5) ? r• i r• ?• : a a• • ??
- (? CONNECPION Zq CITSt SSWII2 ?CONNDCTION TO CITY WATER ?(7TUM ' .
6) '? v "•?• Q PLEASE HOLD APPRpVID PEE2MIT FOR PICfC-C?P BY ONE OF AB(3VE `--` -
? PLEASE MAII, APPROVID PERMIT 40 1. 2. 3? 41 ABOVE
(Circl? one) .
7)
r r. u.. ?Z
?' /VV (? ?
?
' :? Y: • Y' 1'I: M ? •'? 1? ? I' •? • ?' ? GI' ? h YJI' • ?'? IY .
• . ?. ?*. . D• ? ?J
• 1. •?' Ii. I I ;:r ril.'.?y?? I II '?1 ? •• ;?• '?
II Y" :???
FOR CITY USE ONLY
.. .
PERMIT # ISSCED
Pd w/Bldg. Permit FEES:
$ SEWER PERMIT (INCLL'DE SL'RCHARGE)
$ $ WATER PERMIT (INCLUDE SL'RCHARGE) ..
$ ?-3 5 Z' $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ S SEWER TAP
$ $ IS C?-? ACCOUNT DEPOSIT - SEWER
$ S / S?U 1? ACCOL'NT DEPOSIT - WATER
$ -O r. S WAC
$_ SAC
$ S TRC'NK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRL'NK WATER
$ ?•? U ? $ WATER TREATMENT PLANT SDRCHARGE
$ $ OTHER:
$ 12- 7 V, S-D $ .?? (J l1 TOTAL
? -7 3 7 .!;- (• ' ,f (/()
RECEIPT RECEIPT
DOES DTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
Q ROADWAY" MDST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING LbNDITIONS:
APPROVED BY;
TITLE:
DATE : ?D 2 ? ??
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
Dk71'6: PAYMEKr OF nM AT TIME pF ?
APPLICATION DOES NOr CMiSMWM
APPROVAL OF PERPIIT. i
INSPF7L'PION OF SE.TeM A[•II)/Ot FFk7EIt ?
ITZTAT?AmTONS WILL NCYP BE SCHED-
UI,ID t]NrII. PIItMLT HAS BFMI
APPROSJID. ?
P ease Print) !
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF EXISTING 53RCCIL'RE, DATE OF ORIGINAL BC'ZLDNG PER.'?7IT ISSL'ANCE:
(Dbntn Year)
PRESENP 7ANING/PROPOSID C!SE:
Cl CO.MMEFtCZAL/RETAIL/OFFICE
Q ItIDCSTRIAL
n ZNSTIIT.'TIONAL/GOVII2bMENT
? R-1 SINGLE FAMILY
Q R-2 DCPLEX (7to L?nits)
? R-3 105MOIISE (Three + Units) ( Onits)
? R-4 APARTMIT/CONIDO.MINIUM ( Units)
2) ADDRESS:
CITY, STATE, ZIP:
PFiONE:
, 3) For [aty Use .
NAME: 6 ? Pltmibers License:
ADDRESS: , i Active
A
bcpired
; ?ITY. STATE, Zip:
U-i r ? Q Not recoraea
PHONE: 6• ?j MASTER LICENSE# I? StaTr Initial
4) ... • ??.
NAME:?
?,{ I? ? ?i1 ? `I
9Yr2
ADDRFSS: '
CITSt. STATE. ZIP:
PHONE: •
•5) ? v ? ? ?: •?• : o • a? - >?
' 9?CONNECTION TO CITY SEWIIt (?Q/COISNffJC.TION ZU CITY WATER
'
? 0'I' ? HER ' .
j
`
6) '? ?• •Iwk r ? PLF.ASE HOID APPROVID PERNIIT FOR PICK-UP BY ONE OF ABOVE .--•- `"
(?f PLEASE MAIL APPRCNID PERMIT TO 1. 2, 3 4, ABOVE
Z
(Circl?? one ) .
» r .U. - ,v?? ?, 10 ,
• 7c • ?• Nr. w ? .. ? ? ? r a? • ?r a :.• ? r• ??• ?•i ?u ? • y. _? • a? ?• • ? ?
5 r. •? • 1:.. 1 I ;:•:b •.l1ar 1 /1 :n• ? ?? a• ? 11 ?• 'r •?.
FOR CITY USE ONLY
PERMZT # ISSL'ED
• ????
/
Pd w/Bldg. Permit FEES:
$ -S-Z) SEWER PERMIT ( INCLL'DE SORCHARGE )
$ $ WATER PERMIT (INCLUDE SC'RCHARGE) ..
$ G> 3' S?i $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ /rj , CrT? ACCOUNT DEPOSIT - SEWER
$ $ a--?) ACCOUNT DEPOSIT - WATER
$ $ WAC
$ Li 7S ?5-Z) $ SAC
$ $ TRL'NK WATER ASSESSMENT
$ $ TRCNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRL'NK WATER
ca-e) $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ S-z) S S? O O TOTAL '
? 73 ? S'
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQOIRE EXCAVATION IN POBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A"PERMZT FOR WORK WITHIN POBLIC
Q ROADWAY" MDST BE ISSL?ED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : Z d-
?'?i
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*ATF: PAYMU OF FEE AT TIt+JE pF r'
ArrrscrazoN noFS rOr ooiSMWM
APPROVAL OF PII2NIIT.
i
nvsPDCizox oF sEWEx r,rro/CR WA!=
INSrar.r.amrONS 4TIIL NOT BE SCZED-
UIED UNFII. Pf]2NIIT HAS BEESI
APPROVED. l
______________?
P ease Print)
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF EXlSTING STRCCIL'RE, DATE OF ORIGINAL BL'ILDING pF•RMIT ISSCANCE:
(Month Year)
PR£SENP 7ANING/PROPOSID LSE:
? COn?EEiCIAL/REPAIL/OFFICE
Q IIIDL'STRIAL
? INSTIS[.'TIONAL/GOVERWfEN'p
? R-1 SZNGLE FAMILY
? R-2 DCPLEX (Two L?nits)
? R-3 20WNHOLISE (Three + Units) ( Llnits)
? R-4 APARTMENf/CODIDOMINIUM ( Units)
2)
NAP9E:
ADnxESS:
CITY, STATE, 2IP:
PHONE:
• 3) • u,: y
'
1 For City Lse .
??: j Plimbers License:
ADDRESS: , ?
_
f) Active
?
CITY,
STATE. ZIP: }^ .
'
" S ' ? EScpired
Not recorded
PHONE: MASTER I,ICENSE# I? gt?tial
q) •.« 2 • ??•
NAME: h D
/t ?
P,DDRESS: '
CITY, STATE, ZIP:
• PHONE: .
?CONNECPION TO CITY SEWER CONNDCTION TO CITY WATII2 [3
6) ?? ?• ?- • r ? PI.EASE FIOLD APPROVID PEf2MT FOR PICK-UP BY ONE OF ABOVE ......
--
Q? PLEASE MAIL APPROVID PERMIT TO 1, 2, 4, ABOVE
l ,/ • (Circlone) ?n/ 7) r.S.L?m I?1 .%A-V f n
. FOR CITY USE ONLY
PERMIT # ISSL'ED
Pd w/Bldg. Permit FEES:
$ SEWER PERMIT (INCLL?DE SL'RCHARGE)
$ WATER PERMIT (INCLUDE SL'RCHARGE) .
$ WATER METER/COPPERHORN/OCTSIDE READER
$ S WA"PER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ CrZ $ WAC
$ $ Sl1C
$ $ TR[?NK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRL'NK WATER
$- $ WATER TREATMENT PLANT SCRCHARGE
$ $ OTHER:
S /?_G' ?? S-2+ $ S4 O/J TOTAL
.6y.3?s' 0
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MOST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY;
TITLE:
DATE:
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
S I S .SC?
Date .5 I /V 1 /? Z/
Site Street Address ?5 S/O .? ?/ ?c?
/'??-a 17Y?- t?J?v
Unit #
Property Owner kp .ru.n j '721 (.% &tMx Telephone # ( 4,,T'/)
Contractor ?i -?1 lIO V''-4P4tJ b- L? Telephone # (/, 5/) ?? b5 3 4/0
Address 3 le, M Ino-AeQ '-7e OQ. City YO-A QM ) State L17"l Yl. Zip /&3
The Applicant is: _ Owner V Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water Softener i' Water Heater $ 15.00
? replacement _ additional
Lawn Irrigation System RP2_ new _ repair buii? o $ 30.00
State Surcharge
g'Y
1 '90',
$ .50
Total $
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
rnkR?/ .?4e_VLe,n6 _?y? ??
Applicant's Printed Name Applicant's ignature
1336
1�
Use BLUE or BLACK Ink
I -
ForOfflceUse
of Eap Permit ~ U~l
I Permit Fee: S 1 • 1
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received: I t) j
Phone: (651) 675-5675 1 I
Fax: (651) 675-5694 1 Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: - k l - 13 L8 t5 '843 ) S d 5 b (hJ~?'~
Site Address: Unit:
Name:'~r T~l✓ri ~i -_Phone: -Z• 72f- _S S-ad
Residentf
:Owner Address / City / Zip: _
Applicant is: Owner Contractor
Typeof Work. Description of work: QF r1
' - - -
Construction Cost: L- 11 (:0% 5 Multi-Family Building: (Yes _ / No
Company: W'q C7 ./75_Lr Contact:
Address: ~Q ; nne-h Aa- --_v__ City: M in nea4 1 s
Contractor ~
State: AJ Zip: _ 5'5 0 Phone:
-41
License ..sr_ 19 10 6 2- Lead Certificate ~ = 2 !Y2,7'7
- l
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 ff 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) 4540002 for protection against underground utility damage. Cali 48 hours
before you intend to dig to rive locates of underground utilities. www.Q29INDrstateoneoa11.251
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x~l(z0.bei Cr-2vten x_
Applicant's Printed Name ApplicanjKs Signature C/
Page 1 of 3