1545 Clemson Dr?
. SEDGWICK HEATING 8 AIR CONDITIONING CO.
t??,L??
HOUSE HEATING TEST RECORD
ADDRESS L•??'M _ _
SCNr? btR ? V E CITY ?-1-1 ??41?1
OCCUPANT - UWNER ? = Li
HEAT LOSS -" DATE HTG. INST. -
SOLD BY " INSTALLED BY
Electrical Work By Gas Line By - -,-'I c4 Lj tc- K?
TYPE OF HEAT GA_ FA-L HW _ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE LU ?2?1 W ti1T MAKE OF BURNER
Model 39 14 CC A (.?l o 5-6 Model --
Serial L9 QP, 97 2? Max. BTU Rating
INPUT ?oda MAKE OF FURNACE
Model `
--???C?ONTROLS
THERMOSTAT?`L Heat P1ug ""--
Valve S?f 3 y 5 N 5 oX --.1-
Limit - 57-,IZ7oti C_o
Limit Setting ;ZSc)° F
Fan Setting 1 0 0° F
Pilot Type E-L- L.EL 1'?,Zo h! l C
Pilot Make
Pilot Model
Pilot Timing 1 r`1 5 i 14N T
L.W. Cut Off
Pressure 3- Percent CO
Input CFH L4? Percent O2 Z ( 3/
Stack Temp. a3 a' iC Percent C0 ?PJ L
Vent Size
KIND OF LINER -
Draft Hood /" t7 u c
Filters Size
Chimney Location Inside_
Chimney Construction C--?
Smoke Bomb "
Draft "
Door Pressure
Date Tested Lj - a- 3
Company Testing -?; gw-c> c
Name of Tester C-C, " ;
SIZE NONE
. Regulator ? t- lz?
_ Number ?
? Outside
? 55 g
. Wiring
_Test Tag
_ Lighting Inst.
-??
; w ?L K_
R+q?
Form 235
? ` •r? ? SEDGWICK HEATING & AIR CONDITIONING CO.
HOUSE HEATING TE5T REGORD ??? V11y_41___,nL
I .. i?
? ADDRESS C?I...C..10 Sn1?1 CITY ?t? C.-11'tiI
OCCUPANT OWNER-?/ r_ w 1-1-c?ti2?z?n1 1--Iowv!v--S
HEA7 LOSS `- DATE HTG. INST.
SOLD BY INSTALLED BY ,,I, c t<
Electrical Work By Gas Line By _ 5
TYPE OF HEAT GA_ FA'/, HW_ STEAM SPACE HTR. UNIT HTR. OTHER
. GAS DESIGN CONVERSION
MAK E ?"S ?,Z ? j ? iv -r' M .----- --------?
w
Model rt c.-.I D
Serial 2 A b 4 A ?AQt??
IAfPUT
CONTROLS
THERMOSTAT?_ Heat Plug ?--
Valve 5?( 3 t/ S ?? Sr? Y--
Limit ? k?n C o
Limit Setting F _
Fan Setting - f nn° l?
Pilot Type ?LCc' Ts' c kU ?,?
Pilot ??lake SPA ' K??U i?"o+rZ
Pifot Model - rl 5 L t
Pilot Timing - 1'?l ST r4 n,?T
L.W. Cui Off
Pressure ? - S 0 C • _ Percent CO y `Y o
Input CFH ? Percent Oz ? 5
Stack Temp. a as° F Percent CO !'Ja?? ?
AKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Mode! - -
„
Vent Size 6KIND OF LINER ""- S12E NONE
Draft Hood Regulator ?l 4Z? S
Filters Size- _ Number I
Chimney Location Inside ?
Cfiimney Construction C-t-18 SS C-
Smoke Bomb ? lNiring a+<_
Draft Test Tag ?l F 5
Door Pressure ` Lighting Inst. C>K-L
Date Tested -$ 7
Company Testing - ?? 1?'-? :"i < <--ItL
Name of Tester AA L')
Form 235
SEDGWICK HEATING 8 AIR CONDITIONING CO
.
HOUSE HEATING TEST RECORD ??/?y??? ;?'? ? G?
j
? ADDRESS C-?M---nn J CITY • C-'s;?'i'j II
OCCUPANT `- OWNER ??()Q knw.j?? ?nAAF= s j
HEAT LOSS " "-' DATE HTG. INST.
SOLD BY ' INSTALLED BY 'S?DU?t1t? i<
Electrical Work By Gas Line By Ci ja- +•+
?
TYPE OF HEAT GA_ FA? HW _ STEAM SPACE HTR. UNIT HTR.
OTHER ?
GAS DE$IGN CONVERSIdN j
MAKE - )? 5t'zV Wr'j T MAKE OF BURNER ------ J
Model _ 3 44CaA-1 6 a-4 a 5o Modei
Serial oZ q S (o A Co 8 Pa !0 5 Max. BTU Rating ?I
1NPlJT S D, oao MAKE OF FURNACE I
CONTROLS
THERMOSTATT?3?14 Heat Plug
Valve - 5X 345 ?l Sd X--
Limit- 5`r?%),\ C-o
Limit Setting C;1-Sp' ?
Fan Setting
0
Pilot Type 43C L-?-= L'S"(?aNI C--
Pilot Make SPR Ytfc_ I c iV i TC) 1?-,
Pilot Model Fl S L '
Model
Vent Size (a
KIND OF LINER SIZE NONE
Draft Hood 1N 1?!l IA LE L7 Regulator JE-= S
Filters Size Number ?
Chimney Location Inside Outside
Chimney Construction C-L-yASS L>'
Smoke Bornb t---`"`+
Wiring d w-
Test Tag v?S
Lighting Inst, nk-
Pilot Timing Draft
L.W. Cut Off Door Pressu
Pressure 3,'S??vJ<<- PercentCO a 1.
Input CFH 4 6 Percent 02 2 1 L4 °1o
Stack Temp. atO` F Percent C0 /J otl-J S
Date Tested `-? - a-0 - L;1? f
Company Testing S?-N< <-JI C?<
Name of Tester C-?1'-j s?c1
Form 235
.,:
' -f SEDGWICK HEATING & AIR CONDITIONING CO. ?
HOUSE HEATING TEST RECORD ????,?-?;??? ?. ? ?
ADDRESS IS y? B CL-EMSoN L. R l\/E- CITY -- N
OCCUPANT -- OWNER 1v1EN&1 !jb%91ZoN t-iovHES
HEAT LOSS DATE HTG. INST. ?
SOLD BY INSTALLED BY S9-Qs2ii «i (-A<?
Electrical Work By ?L-?t C-K-
Gas Line By ---X---s > C
TYPE OF HEAT GA _ FA X HW_ STEAM 7
SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER --'
Model 39 4 c 4 a.,a v 2, 14 o S? Model
Serial -2Q-43( . l9 & 7q Max. BTU Rating -'
INPUT ? L`0 MAKE OF FURNACE
J_CONTROLS ? tt
THERMOSTATT?3? Heat Plug Vent Size
Valve_ S,?Z 31-4 S 1tiJ`_?oK- ?-- KIND OF LINER SIZE NONE
Limit `?'rL7-- "1 c C? Draft Hood iN b ttC-4--Q Regulator !?4a- 5
Limit Setting a'SO ??F Filters Size Number ?
Fan Setting 100?r Chimney Location Inside %'<' Outside
Pilot Type Al-? L-c--=C_Tc?opj r<-- Chimney Construction
Pilot Make
Pilot Model _
Pilot Timing.
L.W. Cut Off
Pressu re Percent C0
2 ? a Input CFH ??P o Percent 02 15 `7o
?
StackTemp. PercentCO ?o El-
Smoke Bomb
Draft
Doo? Pressuri
Date Tested _
Wiring zs +rl-
Test Tag -?:j ?- ?
Lighting Inst. C' ?
- -"j
-o -S7
Company Testing -5 C--- ?s <?i Lj ' t-K,
NameofTester CO^i 'ZFN 1??
Form 235
w
CITY OF EAGAN ° ? ? 0r)
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt #
To be used tor R E PLA C 1' Est. Value Date
SiteAddress
Block - Sec/Sub. i' ?'Tti 2?it) On Site Sewage
Lot 1'
MWCC System
Parcel No. On Site Well
City Water
°C Nan
.o
? Q Add
? City
Address
City _
A Building Permit is issu
all work shall be done in
Building Official
Phone "'Jv-"O'v
P I..`.?'.P1,A4LS
Phone
I have read this
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr.
Planner
Council
Bldg. Oft.
APC
Variance
OFFICE USE ONLY
_ Occupancy
_ Zoning
_ Type of Const
_ (Actual)
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
_ Permit
_ Surcharge
_ Plan Review
_ SAC, City
_ SAC, MWCC
_ Water Conn.
_ Water Meter
_ Road Unit
_ Treatment P1
_ Parks
C
l
oP?es
TOTAL
on the express condition that
Statutes and City of Eagan Ordinances.
Permit No. Permit Hoider Date Telephone it
Plumbing
H.V.AC.
Electric
Softener
inspectlon Date Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
il
I
, .
BUILDING PERMIT
P?' 113??
Aeceipt a (- 4 / -? ?--
To be usad tor 1 OF 4 PLEX Est Value $61,000 Date MAY 5 ,19 ?b
Site Addr
?s 15478iLFL?'SSQN DZ Erect ?X Occupancy R3
YD
t Z
L
l THOMA5 LAXF:
/ Femodel ? zoning
o
B
ock Sec
Sub
.
?
1J
Parcel No HZ'S Repair Type of Const.
A
. Addition ? No. Stories
'? E?3 t10:2I ZON H(?ME$ Move ? Length 44
Name '
W
367 Demolish ? )7
Depth
o Address P. U. BOX
1 Int Impr. ? Sq. Ft
City ? _
j'S Phone Install ?
Name SA14$ Approvi
Q? Q Address Assessment _
~ City Phone Water & Sew.
Police
? W Name D. GR 1 SWOLD Fire
x ? Address En
? W
riw Phnnn 435-7524 g.
01 ,,.,.,,,,
I hereby acknowledge that I have read this application and state thatthe
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: NEw ri0i2IZUN i-i(.?r•lEf'.?
all work shall be done in accordance with all applicable,State of Minnesot
t SA.LL tStv I`i 5 CITY OF EAGAN
3830 PUot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Fees
Permit ? 316.00
Surcharge 30.50
Plan Review 158.00
SqC 575.00
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.00
Tr. PI. 156.00
Parks
Copie
TotaL $2,09. O l?
on the express condition that
and City ot Eagan Ordinances.
Building
. .
NO wrmn Hoid.r o.a TNophone ?i
Plumbfny
I N
?+.vr?.c. ?
EI*ctrlc ,
C,
-
Soflener
Inspactlon DaN Insp. Commenb
FooUnysl ?
Footlnqs II
Foundatbn
Framiny
RooNny
Rough Vlby. 17-144 'J24
Rouph Hty. ? r1 ` ?
insul. ?
Fireplace
Final Hty. -
Flnal Plbq. ~
Bldq. Final ?
Grt. Occ.
Oeck Fty.
Dack Frmy.
Wall
Pr. Dbp.
J v PERMIT #
, • ? . ? MECHANiCAL PERMIT RECEIPT #
CITY OF EAGAN
qSq.gA oAN, MN 55121 DATE:
T PRICE ?1 Gi ?J S 3830 PILOT KNOB
?C _
, Site
Block
Cv
_t? B?DG. TYPE WORK DESCRIPTION
? ??O ? ?
' '?Res. New
Mult Add-on
Comm. Repair
Otfier
? m Name ? - --i'
Address
? ? ?ity ?GfT
Name
c Address
0 Cilty
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outtets p
Other
M BTU
M BTU
M BTU
M BTU
CFM
/
FEE
S/C: `
.
TOTAL: ? ?-
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMMIIND FEE - 146 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - GOMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
,
SIGNATURE OF PERMITTEE ?- ?
FOR: CITY OF EAGAN
. r . , PERMIT # 9 Q,
, , . PLUMBING PERMIT RECEIPT # ?O a
• CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Address ?? I e --- ' BLDG. TYPE WORK DESCRIPTION
Lot - ? Block Sec/Sub T'
Res. New x
m Name Mutt Add-on
m Address Comm. Repair
c City ? I J k?-t Phone? Other
- NO. FlXTURES TOTAL
Name Water Closet - $3
00 ? ° .
.
"
c Addr
ec Bath Tubs - $3.00 -
?-'
0 City ?
/ 2 Phon Lavatory - $3.00
w
r - $3
? Sh
00
o
e
.
? Kitchen Sink - $3.00 J'
FEES
COMM/IND FEE - 1% OF CONTRACT FEE UrinallBidet - $3.00
?Laundry Tray -$3
00
MINIMUM - RESIDENTIAL FEE - $1Q-00 .
j Floor Drains - $1.50,
MINIMUM - COMMlIND FEE - 20•00 ? Water Heater -$1.50
STATE SURCHARGE PER PERMIT - •? Whiripool -$3,00
(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 ?
SIGNATURE OF PERMITT?j FEE
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL: ???<-?
?INSPECTION REC------ ------- ----
4RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: '• "' 61
Eagan, Minnesota 55122-1897 Date Issued: ? 51 4 10,0 !''
(612) 681-4675
SITE ADDRESS: APPLICANT:
;{F TfMl :'Nlti Atd_t;F. F.A
PERMIT SUBTYPE: TYPE OF WORK:
i r'IRA1 0
F?
UI ,r.r?l1 I L?Ih1 ?.Fi[-NI1??L?3)
paor M; . I I I i i'MAI
Permlt No. ParmR Holder Date Telephone i
ELECTRIC
PLUMBING
HVAC '
Inspectlon DaU Inip. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAI
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
rarnvuOn - r'ux 5F?t,r: uiW 1TLiCITY OF EAGAN 1
.;_
'_ . 3830 Pilct Knob Road, P.O. Box 21-199, Eagan, MN 55121 rQ
PHONE 454-8100
I?LDING PERMIT Receipt #
be used Iw 1 OF 4 PLEX Est value $ 61 ,000 Date rAY J
Site Address 154 7 CLEMSON DR
Lot Z h Block 2 Sec/Sub. THOMAS LAKE;
Parcel No. H i S Z[lD
?
i
3
0
a
10
=U
oi
UQ
r
U?
W
W
?Z
U ?
¢ W
<
i?8 lo" 3
19 $6
Erect E]X Occupancy R3
Remodel ? Zoning P»
Repair ? Type of Const36EIt
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth
Int Impr. ? 5q. Ft.
Install ?
Address Assessment _
Ciiy Phone Water & Sew.
Police
D. vf;ISvJOLU
Name Fire
Phone
I hereby acknowledgethat I have read this application and state thatthe
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: yxVJ HO7I ZO??F HOt?lE
all work shall be done in accordance with all applicable State.v( Minnesc
Planner
Council
BIdg.Off. Jp
Var.
Permit Y J+V - vv
Surcharge 30.50
158
00
Plan Review .
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit 290.00
Tr. PI. 15 ti . U U
Copies
Total $2, 0s9.00
on the express condition that
of Eagan Ordinances.
-e
ri _, I ftrmft No. I PermM Ho1dK I Dsb I TMspf?one # I
Commenb
Plby.
Htg.
Ht9.
Plby.
FinN
Dhp.
PERMIT # ?
MECHANICACPERMIT RECEIPT #
CITY OF EAGAN
3830 PILO T KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100 ?
5ite Address ?
-,
, BLDG. TYPE WORK OESCRIPTION
' Lot
•?=L..?=' Block Sec/Subj '
ti.'L,
R
? N
?
m Name (y es.
ew
M
lt Add
-on
u
? Address i
C
R
r
epa
omm.
c City 1?? L S Phone - O
ther
Name FEES
?
? c Address RES. HVAC 0-100 M BTU -$24.00
p Ciry 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 GAS OUTLETS - 1.50 EA.
Forced Air `
? M BTU COMM/IND FEE - 196 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
t
CFM (ADD $50 S/C IF PERMIT PRICE GOES
Ven BEYOND $1
,000.00)
Gas Piping Oudets #
if Other
'
FEE
?' .
f ?u'i?'l ??i? ,6t" ??
? E'i_'ti??
? • JG SIGNATURE OF PERMITTEE
S/C:
TOTAL•
? FOR: CITY OF EAGAN
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
? Sibe Address 1 1 " ! ( I , L- ` '
Lot Q (0_ BIoCk _c-__1 ;
m Name -
.Address - ' "-r
c City Phi
Name --?- ?
3 Address . .
p City Phi
FEES
COMM/IND FEE - 1%OF CONTRACT FEE
MINIMiJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FOR CITY OF EAGAN
,?•
?
BLDG. TYPE WORK DESC
Res. r New
M ult Add-on
Comm. Repair
Other RIPTION
NO. FIXTURES
Water Closet - $3.00 S TOTAL
Bath Tubs - $3.00
Lavatory - $3.00 _
5hower - $3.00
Kitchen Sink - $3.00
.Urinal/Bidet - $3.00 ?
? Laundry Tray - $3.00
Floor Drains - $1.50
j 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 v
? 150
GRAND TOTAL:
?
Fo be used ior 1 OF 4 PLEK
? SiteAddress 15458 ?'EMS'
L?t 28 Block 2 Sec/Sub._
Parcel No.
W Name NEW HOR I ZUN
? ; Address P • O• ?X ?'3
o .,.?. .. . .,
City " Phone
Z o Name S?E
? ? Address
~ City Phone
0,
F W
Name D. GRI
? a Address
a uZ, r.in, eti.,.,o
I hereby acl
information
Signature of
and City of Eagan (
A Building Permit is issued to: :vE?l
all work shall be done in accordance with all
, •? 3830 Pilot K
?
BUILDING PERMIT
cinr oF EAGaN 11894
ad, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt # ,
s $61,000
Assessment
Water 8 Sew.
Police
Fire
Eng.
? Planner
Council
)n and state that the Bld Off_
applicable State of _ 9'
HOMLS
i
Erect OX Occupancy .3
Remodel ? Zoning PD
Repair ? Type of Const. Via,
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth 1:7
Int. Impr. ? Sq. Fl
Install ?
Var.
Permit S
Surcharge
Plan Review
SAC 316.00
30.50
158.00
575.00
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.00
Tr. PI. 156.00
Parks
Copie ?
Total . a0!
on the express condition that
City of Eagan Ordinances.
? PyrmM No. Parmll HoWw Dtle TNephone M
PlumbNq
mm??x.
Eleckic --
Sottener
InspsCtbn Dab Insp. Commonb
Foodnysl ? ? ??
FooHnys II
Foundstbn
Framiny • d ` ? ? /"0
RooBny
Rouyh Plbp.
Rouyh Mtp. fd
Ar
g?? ' '
Imui.
f -
Fireplaee
FMN Nty.
Final PIUp. ?/ -
Bidy. Finai
Ceri. acc. ?.B
Dock Fty.
Dsek Frmy.
Wslt
Pr. DNp.
< .
.
067S
Q- J -i ?.23
MECHANICAL PERMIT
CITY OF EAGAN
PILOT KNOB ROAD, EAGAN, MN 55121
PERMIT #
RECEIPT #
DATE _
BLDG. TYPE WORK DESCRIPTION
, ?? i ,
iriT '1
? N
?
? fiffoK
l
? , u ,, . ew
s.
` Name • . l
M
Add
m -
-
, -on
u
t
?c Address ,. .
_
,,
,
- R
i
C
.
'
`
, omm.
r
epa
c City PMQc?e
, 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 1 GAS OUTLETS - 1.50 EA.
Forced Air ? v M BTU ?4-'0 COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU U 20.00
Air Cond.
M BTU E URCHARGE PER PERMIT -.50
(aDD $.50 S/C IF PERMIT PRICE GOES
Vent CFM BEYOND $1,000.00)
Gas Piping OuUets #
Other
FEE
?-' SIGNATURE OF PERMITTEE
S/C:
TOTAL•
FOR: CITY OF EAGAN
r
PERMIT #
. ' PLUMBIN[i PERMR RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
m Name
? Addr?
c City`!
? Name
3 Addre:
p Ciry _
FEES
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMiJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $50 S/C IF PERMiT PRICE GOES
BEYOND $1,000.00)
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. ? New ?
Muft Add-on
Comm. Repair
Other
NO. Flx'TURES TOTAL
Water Closet - $3.00 S "
"
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
Whiripool - $3.00
Gas Piping Outlets - $7.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50 ' '0
FEE --v
STATE S/C: '- `
GRAND TOTAL• -
PLUMBING PERMIT
CITY OF EA(iAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
Site Address
Lot ?27.W
m rvan
? Add
c City
Name
; Addre:
O CitY __4
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
PERMIT #
RECEIPT #
DATE: _
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 SBath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Ki?chen 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
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE: 00
STATE S/C:
GRAND TOTAL:
I FOR: CITY OF EAGAN
, . _ . . . _ --------?.-t-)WNHOD6E - PU t:?,"1; CITY OF EAGAN -:, n
'?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 118
` . ' PHONE.454-8100
BUILDING PERMIT Receipt #
?A. To ne used iw 1 OF 4 IPL$tX Est Value $ 61, 0 0 0 Date MAY 5 , is 86
Site Address 1545 CLEM54N UR
,
Lot z 5 Block 5ec/Sub. THOi•,
Parcel No. HTS
? Name NE3N HOR I ZON HOMES
W
3
Address
?• d- BOX 1367
° Ciry -NPI•3 Pnone 420-3900
o Name
=
oQ Address
~ City Phone
W
Name (''ftISWULD
F
_
- Address
?
y
<W Ciry Phone 435-7524
<nowledge that I have read this application and state that the
is correct and agree to comply with all applicable 5tate o1
Statutes and City of Eagan Ordinances.
5ignature of
A Building Permit is issued to: jJF.W tiC>RI Z01•: f:vi'E3:S
all work shall be done in accordance with all applicable State of Minneso
Building Ofticial
Erect ? X Occupancy R3
Remodel ? Zoning pn
Repair ? Type of Gonst .U*•
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth 2'7
Int. Impr. ? 5q. Ft,
Install ?
A ---? •-- c??.
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
Var.
Permit $ 316. 00
Surcharge 30.50
Plan Review 158. U U
SAC 575.00
Water Conn. 500 . 00
Water Meter 63. 5U
Road Unit 290.00
Tr. PI. 156.00
Parks
Copies
Total ? 9 . UO
on the express condition that
and City of Eagan Ordinances.
Pamil No. Plarmft MWdW Daie TNephom k
Piumbiny ?. c._
H.V.A.C:
Ekwfflc" ?.--
sonener
Inspeetion De" Imp. Commenb
Foodnysl s ?
FootMgs II
Foundatbn
Fnminy
Roofinp
Rouyh Plby. - 3
Rouph Htg.
Inaul.
Fheplace
Final Hty.
Final Plbp. S'
Bldg. Finel
c«i. oa.
Ooek Ftg.
Dsck Frm9.
Wo
Pr. Disp.
.MRR.
PLUMBING PERMIT
• • ' CITY OF EAGAN
3830 PILOT KNOB ROAD, EACiAN, MN 55121
Site Address ' - ?' ' ? ! _k
LotC2, '? BIoCk ca
A? Name
?o Addre
..
c City
-
? Name
c Addre
O CitY -
FEES
COMM/IND FEE - 146 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
-,
SIGNATURE
FOR CITY OF EAGAN
PERMIT #
RECEIPT #
DATE • l ?,? ? I?I? l!
BLDG. TYPE WORK DESCRIPTION
Res. x New
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 S
Bath Tubs - $3.00
Lavatory - $3.00
? Shower - $3.00
Kitcheri Sink - $3.00
Urinal/Bidet - $3.00
-?-Laundry Tray - $3.00
?
Floor Drains - $1.50
? ?
Water Heater - $1.50
Whirlpool - $3.00
?
i_Gas Piping Outlets - $1.50
Soitener - $5.00
Well - $10.00
Private Disp. - $10.00
y Rough Openings - $1.50
FEE
STATE S/C: '
GRAND TOTAL: ?
-
. • •
, . ?
CONTRACT PRICE: ?Gi 7 S ?
Site Address ?
lot r--\'- Block
r[n crn^?u??Y urA7tNC 4
m Name
.S Address
c City
? Name ?
c Address
p City P
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping OuUats #
Other
MECHANICAL PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN,
v L' M BTU
M BTU
M BTU
MBTU
GFM
?
FEE
S/C:
TOTAL•
PERMIT #
RECEIPT #
MN 55121 DATE:
BLDG.TYPE
Res. tl?
Mult
Comm.
Other
WORK DESCRIPTION
New
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 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 - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
:
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
? ? •? INSPECTI4N RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: •'
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 ?
SITE ADDRESS: APPLICANT:
: i t M'-UN I41- N. {t f?f?. 1 ?1N
!IF ltiFlT ;: lVtl 46:t^^7 3 92'
PERMIT SUBTYPE:
TYPE OF WORK:
INSPECTION D. . .•
I
?..
Pertnlt No. Permit Holda Date Telaphone Y
ELECTRIC
PLUMBING
HVAC
laspectlon Date Inap. Commenta
FOOTINGS
FOUNO
FRAMING ?
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PL86
FINAL HTG
ORSAT TEST
BLDQ FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL ??, ?`.
IN
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: ;
, ,„ .. '. . i' .
PERMIT SUBTYPE:
„
i I .1 1 iNpi
;1ti leLUt'!( a -..
ON RECORD
PERMIT TYPE: {' 1 "6
Permit Number:
Date Issued:
,a&I. c0Nr_i4f:1'f c?
1 r. t .' ! . 'st ri'?t
TYPE OF WORK:
A I it'kAF 1 1.1r+
iif-( R E ti". nN?
Permk No. Parmit Holdar Date Telephone k
EIECTRIC
PLUMBING
HVAC
InspecUon Date Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP80ARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FtNAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG io
DECK FlNAL
o ?
CITY OF•EAGAN Remarks
addition Thomas L ke EleiYht ?di ion Lot 10 -25 Blk ??- Parcel #10 '1`°"--61&."
Owner street 1545 Clemson Drive state Eagan, FW 55122
Improvemeni Oate Amovnt Annual Years Payment Receipt Date
STREETSURF,
55
94
5 uZ. 9 A012172 5-5- 3
STREET RESTOR. .
GRAdING
SAN SEW TRUNK 11771
rtSEWER LATERAL ?761
7, 2
?
WATERMAlN
* WATER LATERAL 1981 P '
WATER AR EA / 4 7
STORM S
EYV TRK
24c?, g?,
A 1 2
--8
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATEfi CONtN,
BUILDING PER,
SAC
PAR K
CITY OF•EAGAN ^? Remarks
l4ddition `?OID_a.c T.9.k_. HP.ig $:???d i ipn Lot 10 -113"' Blk f 2- Parcel ?
owner Street 1545 B Clemsotl DriVe state Eagan, MII$ 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 8
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973
* SEWEFi LATERAL 37.61 7-52- - S
WATERMAIPI
* WATER LATERAL IgRl
WATER AREA S. 1 2 5-5-83
STORM SEW TRK 249.91 A0121 Q 5- -a3
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER. I
SAC
PARK
CITY OF EAGAN plia Remarks e'ZGO
Addition Thomas Lake Height4dAddition Lot 0 A4, Rik 4a -" Parcel #10 4
Owner street 1547 C1eT4SOI1 D7CiYe stete Eagan, Md 55122
Impravement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1981 279.71 55.94 5 111.8 A0121 2 --8
STREET RES70R,
GRADING
SAN SEW TRUNK 17
*SEUVER LATERAL j'J, 61 7. SZ 1.0 A0121 Z
WATERMAIN
*WATER LATERAL
WATER AREA /9? CS.i,pL?
STORM SEW TRK 249. gl A0321 2 --83
*STORM SEW LAT
CURB & GUTTER
SfDEWALK
STREET LIGHT
WATER CONN,
SUILDING PER.
SAC
PARK
CITY OFi EAGAN Remarks 7.4mI
/lddition Thomas Lake Hei-ht Addition Lot A1LA7 eik Bt 2-- Parcel #10
owne? 'Ir street 1547 B Clemson Drive state Eagan, MN 55122
Improvement Oate Amount Annual Years Payment Receipt DBte
STREETSURF. 1981 279.71 55.94 S 1.$
STREET RESTOR.
i
GRaDNG
, AN SEW TRUNK
S
?
?
i * SEWER LATERAL ,?.. 19$1 ? r61 , '?.?. S 1•0 0121 2 - 8
WATERMAIN
* WATER LATERAL 19$1
WATER AREA 1981 136.51 27.30 5 5.61 21 2 5-5-83
STORM SEW TRK 3 1981 312. 37 . 20.82 15 2b9.91 A012172 5-5-83
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
5AC
PARK
CITY OF EAGAN WATER SERVICE PEiNMR
3830 Pilot lCnob Road
P. O. Box 21199 PERMIT NO.:
Eagen, MN 55121 DATE: Zonlnp: No. af Urats: ?pI4:•x
pN,r,,,; A'ew Rori2or: FoiuLs
/lddress:
Site Address: _ _ =_`??r'3as Lk RLs ?
Pluiriber: _
Mthr No..
Size:
Reodx No.:
1 Nm b eowOll wNh !w Cihr of bwo
OndMeWAaM.
By _
Oote
oF I nsp..
Connecffon Qhar": 7VU. U;: L
Aooount Depoalt:
Permit Fee:
SurcFKWQq;
Mite. Charyn: '' ?••' ?
?
Total: Pta-ri
Date Paid: '
Insp.:
._ . =- ° b_ . ... _... _.., - ?_ .. . ..a'
CITY OF EAGAN WATER SERVICE PERMlT
3830 Pilot K nob Rasd
P,,O. Box 21.199 3 o- /161 PERMIT NO.:
Eagan, MN 55121 DATE: ?
Zanirg: Na of Units: `} - T' ?x
OwMr. :.ew Harizon F.omes
/lddrcss: -
Sih /Iddrcm
Plumber: _
Meftr No.:,.
te aenply wi1k tiw Ct?t?' u
? A ?? sc. rpn:
Dote of
% /3 -'P6
Total: 53. 5r1pd mete I
Dat* Po1d:
Insp.:
TY OF EAGAN s?M SOVO PERM
30 Pilot Knob Road
0. Box 21199 PERMIT NO.:
gan, MN 55121 DATE:
rtin0: NO. of Units: '{ - :, ; ' '
Fnsr:
--Addross: `/ _
mbar. -
.?
IrM h MIl/lb wllr /M C11T oi ypn GorxNCHon ChOqe:
.
logo"M• /,ooouM DspOSit: .' i1: '
??
Pomdt F":
Surthorpe: .
Misc. Chorgs:
of Irap.:
Totol:
Doh Pald:
OF EAGAN
Pilot Knob Rosd
MN
WATER SERVICE PERMIT
PERMiT NO.:
D/1TE: No. of Unkr.
.jet I:nri7nn FTnssar,
Address:
No..
ittg
6 1.2$ 92 T
Connsttion Charge: '
Accourrt Depooit: ,?.
Permit Fee;
Surrhorge: '0 P'-1
Misc. Chcroes: ? r ? , iir?D? 11'
- -
Totol:
Dote Paid:
Reoder No.:
1 pr« to oovaply wi16 llwi Clyr of bgm•
Ordi11011cm
By
Oate of I nsp.:
I
? CITY,OF EAGAN VIIATER SERVICE. PERMIT
3834?'Pilot K?nob Roed ?
; P. q: tlox 21199 PERMIT N[?.:
EAgan, MN 55 1.T?1 ? DATE:
Zoninq: ? ? .
F,`:? Na. of Units:
Ownsr: i'orizon Horn?s ??
Addrasx
rc?;
?/? C emson Drive T?_ • R - omas =ts '.
Plumber, Thompso:1 F u
Meter No.• p, pal - I
Slze: O.q11 r .,
? yPM t0 OOAI* M? ? Aw=,~ _? ? .... . ,,.
? REpU1RE'?"??
?
TotaL• __ b.s . SUpd meter
B Dot* Poid:
Dote of Insp. Intp.:
CITY OF EAGAN
3$30 Pilot Knob Road SEWER SERVIC E PERMIT
P. O. 8ax 21199 PERMIT NO.:
Eagan, MN 55121 DyTE:
Zontnp: 71
No. cf Units:
Ownar:
Ilddreu: ----
Sita Address:
c-r
Plumber. - ?"_n?. •.?? ?? ?
I y1?N te 00111?? W?l?1 ?(?
of lk
w
C ?0 . i?f',n?
7 S
p onnection C7wrge: .(?i
Ordlmmam 11COOUrM Deposih. rl;, • .-
Permk Fea:
Surdharpe:
B
Y Misc. Chorpea;
Dote oF Insp.: Totol:
Insp.: Dote PoM:
OF EAGAN
Pi1ot Kno6 Road wATEe sEmria Pow ?
3ox 21199 PERMIT NO.: '
, MN 55121 DATE: -F' - No. of Units: 4 •?ex
- ???7ri??a ':a*les
llddr+ess:
AAeNr No.: i
Slze: Ca+nection Charge; s. ?
Reod?? No.: ??coount DePosif: ?- • , ' ' • ,
Permlt Fee: ?
aenpb wm !w C1hr of bM¦ SurcFwrye:
Orlhw°M' MIse. G,orges;
8Y Totci:
DoM Paid:
DaM of Irap.: Irop.:
CITY OF EAGAN
3830 Pilot Knob Road WATER SERVICE PERIWT
P. Q. Box 21199 ?,l l '7`
?.? PERMIT NO.: ?
Eagsn, ivlN 5Rf21 J DATE:
. , • ?+ eX ?
Zonirg: Own.r: No. of Units: p ?
`eW or ? an oroes
Addross:
sih ^dd?m
Plurrber.
Meftr No.: d ?
Size: ? ?•' ??dut?
Reoder No.:4s 371/,
I NmN h 00wlphr wm as
1. • -'P
Mlsc. fJho,- - • n
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199 SEWE1t SERVICE pERMn
PERMIT Np.: ?
Ea9an, MN 55111 DATE:
Zorving'
Ownwr: No. of Units:
Address:
SiM Addrass: 7 r -
Plumbsr. ? .? i
- , . , -
? MM h e?wp1f wia !Iw Cily Of ""a
OeNw??eM ConnWian
?O?'
. /looow+t Depait: ^ 0
P*+mif Fee: c;
By Surcfioe?pe: - . ..;,
Dote of Irup.: Misc. Clqrpis;
Insp.: Totol:
DoFa Pold:
O. Box 21199 PERMIT NO.:
"O1 ?? 1 dg I DATE:
L' - - No. of Units:
Address: i }•;; .; I.:remson I'rive 117
No.: Cwmection ChorQe: !1-
/lccourn Deposlt: -- S .
ir No.: Permit Fee: - C.
• h esiuply wm tie Qep of E"pn Surdwrge:
Vnew Misc. Chorges:
Total: - ?'
Dots Poid:
of Insp.: ;
Ina
p,
CITY OF EAGAN
38"0 Pitot Knob Road' . WATER SERVICE PERMIT
•
• P. 6. Box 27199 t
PERMiT NQ.:
Eagan, MiV 55f21 ?,., D AT E:
Zonirg: ? No.ofUnits: ex
pemer;
Addross:
Si1! hdd?lSS: - ? r .7y CZESi1S0:": r.i:;^,
:.ls J.d :?'
PlI.NItber:
? Metar No.: 02 .S onnection Charpe: -, •. f}(lprj
? Size: " ? e ore 1 ?'
Xec ??t: 5 , ill}p_'
? Reoder No. tLE
. - NON• RM
{?tEw: I0.00n6
I m te _ o p?i
w8y ?? s: L_F;.i .pd 'rF?
OrJt.?sa?.d?75 3 ro?
3
Total: 63 . 5t1;,1 i::eLer
BY Dote Paid:
Dnte of Irap. Irnp.:
0-- / 3- f6
GITY OF EAGAN SMR SOyICE PERMR
3830 Pilot Knab Road
P. Q. l3ox 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
IO^i^0: No. of Untts:
Owner. *r.•.r.?
Addrcss:
Site Addross:
Plumber.
?: ,. . .
I yne to eemolp wMr fW CilY of iegan
OrJlmamL
By
Dare of Insp.:
iI
connectra, aorge:
Account Depos;t:
Pen»It Fee:
Surcharpe:
Miac. Chorgss:
Total:
Date Pald:
RESIDENTIAL
' BUILDING PERMIT APPLICATION ?
CITY OF EAGAN
yb 31 // 3830 PILOT KNOB RD - 55122 ? ? •O ?
851-881•4875 r
New ConstrucUon Reauirementx
. 3 registered site surveys showirg sq. R ot bt, sq. R of house; anchR mofed areas
(20% maximum bt coverage albwed)
. 2 mpies ot ptan showing beam & windax sizes; poured found design, etc.)
. 7 set of Eneigy Cakulatlons
. 3 coples M Tree Preservation Plan tt lol pWtted after 711193
. Rim Joist Detail Optlons selection sheet (bldgs wBh 3 or less unb)
DATE
JOB SITE
IF MULTI-FAMILY BUILDING, HOW MANY UNITS? 41
PROPERTY C
TYPE OF WC
APPLICANT
ADDRESS _
PAGER # CELL PHONE #
vawaioN t I 7YID
FIREPLACE(S) _ 0 _ 1 _ 2
_ PHONEgl/?2?3KZ-05.3?
AIAIPCODE SSG
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Coniractor. _
Mechanical System Includes:
Sewer/Wcfer Confractor.
_ Air Conditioning
_ Heat Recovery System
All above irrformation must be subm'itted prior to processing of application.
Phone #
FAX #
Fee:
Phone B
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicanf?,nl.?? 7/
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1Nt
_ Water Softener _
_ Water Heater _
_ No. of Baths
RemodeUReoalrReaulremeMS
. 2 copies of plan
. 1setMEnergyCakuWtbnsfarheatedadd'Aions '
. 1 site survey for exterior addiGOns & dedks
. Indkale R home aerved by septic system tor additions ?
?
Phone #:
Iawn Sprinkler Fee: $90.00
No. of R.I. Baths
OFFICE USE ONLY
r
? 01 FoundaUon
? 02 SF Dwelling
? 03 07 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? OB 06-plex ? 16 Fireplace
? 09 07-piex ? 17 Garage
O 10 08-plex W18 Deck
? 11 70-plex ? 19 LowerLevel
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
0 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Aft - Multi
? 33 Ext. Aft - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demoiish (Interior) O 44 Siding
O 32 Addition 0 36 Move Bldg. O 42 Demolish (FOUndation) 0 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof 13 46 Windows/Doors
? 34 Replacement 'Demoiltion (Endre Bldg only) - Give PCA handout to applicant
C?l
?
Valuation c3fjrj D Occupancy Ile-3 MC/ES System
Census Code ya y Zoning jA-,b Ciry Water
SAC Units 0 ? Stories Booster Pump
Nbr. of Units ? Sq. Ft. PRV
Nbr. of Bldgs ? Length Fire Sprinklered
Type of Const Width
?
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (newheplacement)
Approved By Ila , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
Footings (new bldg)
Footings(deck) FinaUNo C.O.
Footings (addition) Plumbing
Foundation
Drain Tile
Roof Ice & Water Final
Framing
Fireplace _ RI. _ Air Test _ Fiaal
Insularion
FinaUC.O.
?
HVAC
RESIDENTIAL
' BUILDING PERMIT APPLICATION
?? 6 313 GTY OF EAGAN
3830 PILOT KNOB RD - 55122 n
651•681-4675 7v SO
NewConsWction Reauirement6
. 3 registeied sRe surveys showiig sq. ft M Iot, sq. fl M house; anill roofed areas
(20% maximum bt coverage aibwed)
• 2 capks o( pian showing 6eem & window sizes; poured fomM design, etc.)
• 7 set ot Energy Calwlations
. 3 capies ol Tree Preservation Plan if lot plaped after 711193
• Rim Joist Defail Optlons selec0on sheet (bklgs wiHi 3 w less unib)
RemodelfReoairReoulrements ????ro?
• 2 mpi? of pWn
. 1 sef of Energy Calailatans for Aeated addAions
• 7 site survey fa exterior additions & decks
• Indicate H Iwme served by septic system for edtlNOns
DATE 21,2`f /O / VALUAlION 'Y.31 70 -
JOB SITE ADDRESS / S Y76 IF MULTI-FAMILY BUI ING, HOW MANY UNITS?
PROPERTY OWNE R9t/lJ 7- T f,c.2wZ:?
TYPE OF
APPLICANT
ADDRESS
PAGER #
CELL PHONE #
FIREPLACE(S) _ 0 _ 1 _ 2
_ PHONE# (bla? 3PoZ° 3 5:5a
RA-f ZIPCODE SSVrZ
FAX #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category
(check one)
Plumbing Conhactor. _
Plumbing System Includes:
Mechanical Contrador. _
Mechanical System Includes:
Sewer/Water Contracfor.
_ MINNESOTA RULES 7670 CATEGORY 1
- Residential Ventilation Category 7 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Phone #:
_ Waier Softener _ Iawn Sprinkler
_ Water Heater _ No. of R.I. Baths
No. of Baths
_ Air Condiaoning
_ Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
All above information must be submitted prior to processing of applicatian.
I hereby acknowledge that I have read this application, state that the information is cqrrect, and agree tQ comply
with all applicable State of Minnesota Statutes and City of Eagan1Ordinances.
Sfgnaiure of ApplicariY?? ?J?
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated tl01
OFFICE USE ONLY
r
? 01 FoundaGon
O 02 SF Dwelling
? 03 01 of _ plex
O 04 02-plex
O 05 03-plex
? 06 04-ptex
? 07 OS-plex ? 13 76-plex
0 08 06-plex ? 16 Fireplace
? 09 07-piex ? 17 Garage
O 10 08-plex W18 Deck
O 11 10-plex ? 19 LowerLevel
? 72 72-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
O 24 Storm Damage
? 25 Misc211aneous
O 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 Ext Ak - SF
? 36 Multi
Pf 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addkion ? 36 Move Bldg. O 42 Demolish (Foundation) O 45 Fire Repair
O 33 Alteration O 37 Demolish (Bldg)' O 43 Reroof O 46 Windows/Doors
O 34 Repiacement •Demoiition (Entire Bldg only) - Give PCA handout to applicant
V
l
ti A k `3
a
ua
on c
QQo Occupancy MC/ES System
CensusCode ?L3 Zoning P-h CityWater
SAC Units 0/ Stwies Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs ? Length Fire Sprinklered
Type of Const S^" Width
?
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Smcco Stone
_ Windows (new/replacement)
Approved By 646 , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Pertnit & 5urcharge
Treatment Plant
Plumhing Permit
Mechanical Permit
License Search
Copies
Other
Total
REQUIRED IN5PECTIONS
Footings (new bldg)
Footings(deck) FinaUNo C.O.
Footings (addiHon) Plumbing
Fa?mdation
Diain Tile
Roof Ice & Water Final
Framing
F'ueplace _ R.I. _ Air Test _ Final
Insulation
FinaUC.O.
?
HVAC
This request void
18 months 5rom
, -14 8
Request f]ate Fire No. FouPh-in InsGecUOn
SR¢p treA, ?fleady Now?W?ll '
I InSPec-
Yes ?NO [or When R¢?tlv
?Licensed Elec[ncal Conlraetor I hereby repuest mspection of abova
? o'^'^Pr electncal work mstalled ac
SVe f Address"', Boz or Raute No.
_ 41-- n( CItK ?/ y Y
ecnon o. 7owns ip Name or No. Ranye No. Covnty
oA
OccupaAnt (PHINT)
/YMV Phone Nc.
Puwer SuOP?? r
?6?bt??A rrAA- ? Adtlress
J
Ele
Contractar ny Name) I Convpr.tor's License No.
=
MaOwner Mabne Insta,lau n)
?.G
Authonzed Signalure ICOntractor Own r aking InstallatmN Phone Number
. .. .9? ? " , ? dl?.?2r?41
MINNESOTq STATE BOAPO Of ELECTNICITY • THIS INSPECTION REQVEST WILL NOT
Gnggs-Midwey 9lde. - poom N491 BE ACCEPTED BV THE STqTE BOAPD
1821 University Ava., Sp Peul, MN 65104 UNLESS PNOPER INSPECTION FEE IS
Phone 18121 297-2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPEC710N ee-ooooi-oa
? Sea instruct"ons for camoleling Ihis lorm on back of
vellow copy.
dpt "x' ee/ow Work Cnvn,ad hv Th.e aa,.,,e..,
AAcI ReD. Tvoe of Bwld,n
9 -
4GVlmnce, Wvel '
- ?c? )
ent Wired
Home
ftanye lemporarye
Service
Duple
x
Water Heater
ixtures
.Qpt Bwlding
Comme?cial Bid Dryer M
eahn
y. Fumace
der
Industrial 81dg. qir Condiboner 7ank
Farm mNSp ?ryl
»r uelv Oor
Om DUt e Jns nvciinn Fo< Rai,.?., p
pecial InspecLOn , ,-y
TO7AL FEE?/
flough-sn
? Date ?
.?y ?.?haElac,.'ca-l=
S"' iosoa??o,: narany
Final wrtdy that the above
?'?? _6? napection has bean
n r JF' mede
fliia reUUesl vold 18 mantM Irom -
Fea ServicaENranceScza n Fee Fenders/Subieeders p
Fee
Circwis
? to 200 Am s 0 to 30 Am s 0 to 30 Am>
Ahove 200 Amps?
31 to 100 Amps s
31 to 100 A
Sw?mmin Pool
g
Above 100_Amps 5
Above 100
Am s
iranstormers
Siqns Irngation Booms
c _
Partia6"Other Fee
Thq, repuest void
18 nwmhs from
C 12147
9equest Date Fr I
e
t_c_ nz 1
(o0131?Q,
:uer.tion y/
0Ready Now UCI Will Noufy Insoec-
?Np '?-??tor Wh¢n ReadY
ALicensed Electncal Contractor I hereby request inspechon ol above
? Owpef elBCtfical work insUIIwA ai
/?
Street Address, 78?ox or Roure No. y/? ?/?
/ / (v-?-/ /?N f /?`/l?
? '??
'--? g?/?y
T-/i ? V
ecuon o. Township Name or No. panye No. County
Occupant(PRINT) Phone No.
l;W
Powyer?Supplier
.U? 6 Atl?dr?,yy?s?p,{?
Electncal Conirac[or ompany ame)
/e Contracrytor's License No.
?V ?O?
MaJ?n Address (COnVactor or
O
w er Making iretaflavonl
/'
,
? e /..{?? ?.
Auffionzed Sig^ature (ContractoJOwner Mak?ng InstallaLOn)
?
Pfione_`u`mCei
i/
MINNESOTA STqTE 80AHD OF ELECTNICITV
Griggs-Midway Aldg, - poom N-191
1821 Umversity Ave., St Paul, MN 55104
Phone (612) 297.2111
THIS INSPECTION NEQUEST Wlll NOT
BE ACCEPTED BY THE STATE BOARO
UNLE55 PRpPER INSPECTION FEE IS
ENCLOSEO,
t -? _-?REQUEST FOR ELECTRICAL WSPEC710N ea-ooooi.oa
1 Sae inshucbpns for complaLng 'his form on back of yellow copy
P ? 2147 'X'' Below Work Covered by 7his Request 10?
ada neo. Tvoe ol emieine AODlmncea wiretl eq.ip„aenl wi.ea
Range Temporaiy Service
Water Heater Lightlny Fixtuies
Dryei Elactnc Heatin
1dy
& Furrtace Silo Unloader,
g, qir Condrtioner Bulk Milk Tenk
Farm
ONer oe?.? v D her Isns tyl
n.
.,,,.,
?. 1....
..... ...__ r.. .. , Other Oihi:r
- _
?
?ceEnfrenceSae b Fee Feede rs/5ubieeders Cucufts
200 qm s 0 to 30 qm s o 30 Am s
r tAb
ove 200 qmps 37 to 1 DO Amps to 700 A
mming Pool Above 100_Amps g 100
Am s
Alb
ove
siormers Irrigation orr,s r
_
tial- Other Fee
5 SVeCial InSpeCbon
TAL'FEE \
Pough-in
?ate [r
the Ele?tncqi
Insoacloq hereby
Final ? certity Hret the above
inspec[ion hes baen
?J` ?aa.
This reQUes1 va1018 monihs irom
:h.s requast void ?
18 nwnths trom ?
Raquest UT?? Fre No. qouPh-in InsVecUon
•? * C_ ?` R?qyired? ?qeaAy NowXWill NotHY Inspec
? Yes C)N [o Wh p ?
I
Licensed ElecVwal Contractor I herab
Owner V request inspecvon of above
?
ai-r.i-i ......s .........?_
SVeet Atldress, 8ox or Hmte No,
CGE?y.fd ?rP?l.? ???? ?
ecuon o.
I ownship Name or No. RanyF No.
Cowily
4iin
OccvUantIPRINTI Phon
e No.
yy4???
Power $uppl?er Add es
?
Elec[ncal Con(ra tor iCompan Neme) Conhartor's Lmense No,
MQ
?
qd r?
? c OS??
?
q
s onV
tor or Ow?er Making lnst ?labonl
AuMOr¢ed Signature IContractorl ner Makiny InstallaLOnl Phone Number
-a
ca??w biqIE eOARD OF ELECTFICITY
Gne9s-Midway 9ldg. - qoom N491
1821 University Ave., SL Paul, MN 55104
Pho. (612) 297-2111
ini5 INSPECTION qEdUEST WILL NOT
BE ACCEPTEO BV THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
S-(3-,x(F, REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-oa
1 Sae mstructio?s tor tomplBting 1hi5 brm on back ot yellow copy. ?'
4 6 'X" 8elow Wark Covered by This Request
Ad?? PQ 4 Type ol Bun ltline App"ances Wvetl EqwVment Wvee 1
I I Duplax Water Heater --T? Liyhnny F xtures ?
Apt. Building Dryei Electrvr Hnar... a
? i.ommercial Bldy. Fumace j O? I I Silu Unloade.
? InAustnal 81dg, Air Conditioner Bulk Milk Tank
trenceS¢e k Fee f
aetlers?S
ubteetle?s tt Fee Circwts
n qm s
00 qm??y,
a Dro30Am 5
31 to 100 qmps Otn30Am s
31 to 100 qm s
g Pool Abave 100_Amps Above 100_Am s
mers
c
-_ Irrigatron &?orr?s PdrLal.?Other Fee
Herrv3rks J~???1jly?c`?u?? 5 ?? TOTAL,FEE ?
Haugh-m i . . i
? ace
? I
I, the lectncal/
?
??sua.
t-na.abv
Ftnal ?
I
Date cerUfy thaf tha xbove
? mspechon has been
a
m
a.
a
This request voitl 1
18 nwnffis tmm
Q 1_2145
Fe9uc? _
fC IVO. HOUgII-Ifl
Aequired
Now ? Will Nouty Insper.-
lor When qeadv
,(Licensetl Elecincal Contrdctor I hereby reCUest inspacOOn ol ebovg
? OWnPr BIBCtliCal wnrle inn1a11uA et
Str¢et Address, euz or Houte No.
/J G So G ilr`' U[Y ?
?
ecuon o. Towns?ip Name or No. qange No. County
loq L
Occupant PpINT?
???j???? Phone N?.
Powe/r upplier
S2.1!SE7 Addre.ss
?? 1 V
EI¢ctncal ConVacmr ( ompany ame) Comrar,tor's License No.
Z
?
-
E
i,: - ? OZ
MaJmq Address (ConV
a
c
t
r
o
or O ner M
aking InstailatmN
.
--
?.
-
?
'
?
??.C.i
rAuihorzed Sienature ICOnrracmr/Own Making Installatwnl Phone Number
? . • . r?_ ,?f'!;"?
.?J•_
nrvcauIw SIATE BOARD OF ELECTRICITY FMiS IrvSPECTION qEQUEST WILL NOT
Grigge-M1Eway Blde. - Aoom Nd91 BE ACCEPTED BY THE STA7E BOANU
1827 UniversrtV Ave., St. P.W. MN 55106 UNLESS PflOPEfl INSPECTION F(E IS
Phone (612) 297.2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTlON 0-9% ee-oo0o1 _oa
? See mytrucpona lar comoleting thls form on back o1 yellow cooV.
1 4,j '-X- - Below Work Covered 6v 7n,i, rro,,.,o, i
Hdtl Re
P.
itlin9 -
Appliances W
d ? ?
rte EqulUmenl W??ed
Range
porary Service
g Water Heater
D tiny Fixtures
n
Bidy. ryer
Fumace tnc HeaUn
dg.
q?r Conditioner Unlaader
N
ONer Milk Tank
ISOOrriy?
Other O
nmput e lns pecbon Fee Reln
w
k Fea ServiceEntrenceS.ie tt Fee Feaders/Subteeders ccwi
00 qm 5
? to Z
Abo0
0 to 30 qm s
s
0 tn 30 F?m s
qmps 31 to 700 qmps 31 to 100
A
t
Swimmirtg Pool
Transtormers Above 100_qmps '
Above 100_Am
Signs
Irngation Booms p
artial- Other Fee
Hertyrks
Final
(pis repueat riatl
GC)\
i, rna Frentr,osi
Inspector, hereby
certity that the dbove
inspect,on hgy bean
COMMERCIAL
? 2002 BUILDING PERMIT APPLICATION
_ CITY OF EAGAN
651-681-4675
D_S?
Foundation Onl New Construction Interior Im rovement
• Structu2l Plans (2) sets . ArchRectural Plans (2) sets • ArChitecW2l Plans (2) sets
• Civil Plans (2) • Structurel Plans (2) • Code Malysis (t) "
• CertifiCateof5urvey (1) . CivilPlans (2) • ProjectSpecs (1)
• CodeAnalysis (t) • LandscapingPlans (2) • KeyPlan (1)
• ProjectSpecs (1) • CodeAnalysis (7) + MasterExitPlan (7)
• Spec. Insp. & Testing Schedule " • Certificate of Survey (t) • Energy Calculations (i) not always"
• Soils Report (1) • Spec. Insp. & Testing Schetlule (1) " • Elec. Power & Lighting Form (1) notalways°
• Meter size must be esta6lished . Meter size must be established • Meter size must be established - if applicable
• PrqectSpecs (1)
b • EnergyCalculations (1)
1 • Electric Power & Lighting Form (1)
1 . Master Exit Plan (1) y
1 • Emergency Response Site Plan (7)
1 . SoilsReport (1) 1
• MClES SAC determination le8er • MClES SAC determina6on letter • MC/ES SAC determination letter
call 651-602-1000 call 651-602•1000 call 651-602-1000
Food & beverage or lodging facilities - submit plan to MN Deparhnent 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: WORK TYPE: NEW ? REMODEL CONSTRUCTION COST: ?5 pY I
- ?
SITEADDRESS: /Sy7 ? `op' Py-
TENANT NAME: SUITE #:
FORMER TENANT NAME, IF APPLICABLE:
DESCRIPTION OF WORK Z_L
Nazne: Ze'-? _ Phone #: (;V3) 6
PROPERTY Last First
OWNER /?
StreetAddress: ?'" ? U a
City: State: Zip:
Company: ?? Phone #:
CONTRACTOR
SneetAddress: 457-
City: 5tate: zo n ZiP: ss y ??
ARCHITECTI
ENGINEER Company: Phone#: T i o'lf
? v
Name: Regisiiation #:
-,? ---- -- _?
Street Address: - - - - "
City: State: Zip:
Licensed plumber installing new sewerlwater service: Phone #: L
I hereby acknowledge that I have read this applica6on, 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:
!y/ Updated 7l02
THOMAS LAKE HEIGHTS 2ND 75951
PERMIT
DATE &
'I'YPE LOT BL ADDRESS
APPROVED 3/85
PAGE 4 OF 5
12/83 4-PLEX 210 02 1542/ BAYLOR CT
220 02 1543/ CLEMSON DR
230 02 1543B
240 02 1546 - BAYI,OR CT
5/86 4-PLEX 250 02 1545/ CLEMSON DR
? 260 02 1547/ 1
270 02 1547B/ ?
- - ----.--_- _-,280 02 1545B _ -- - "
4/86 4-PLEX 290 02 1555/ CLEMSON DR
300 02 1557/
310 02 1557B/
320 02 1555B
4/86 4-PLEX 330 02 1565/ CLEMSON DR
340 02 1569/
350 02 1569B/
360 02 1565B
4/86 4-PLEX 370 02 1571/ CLEMSON DR
380 02 1573/
390 02 1575/
400 02 1575B
5/86 4-PLEX 410 02 ] 577B/ CLEMSON DR
420 02 1577/
430 02 1579/
440 02 1579B
5/86 4-PLEX 450 02 1581B/ CLEMSON DA
460 02 1581/
470 02 1583/
480 02 1583B
34
$UILD/NG * 2/
? (93u5)
N I7°25'29"E ?
3I.D0 31.00
(9so.s?
0
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3
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(930.0) z o
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(9Z9.o )
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X 928. 7 TC. r
CC EMSON o X926.7 Te.
OR/ YE
,.. ?-s
R EVIE
3y --.-----"
i3ATE _
O Denotes Iron Monument
° Denotes Wood Stake
X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevatione
(000.0) Denotes Proposed Elevation proposed Garage Floor Eievatione 93t. 5
-4- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 932.0
I hereby certify Mat this is a true and correct representation of a survey of the boundaries of.
Lots 25, 26, 27 and 28, Block 2, THOPIAS LAKE HEIGHTS 2ND ADDITION,
Dakota County, Minnesota
And of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this Znd day of Anril 19 86
F!W
LCOMBS-KNUTSON ASSOCIATES, INC.
GOIIWITIMClIIGII[(Ai 0 WO fURY1f011t f SIil tLLllllltf
??. i Y1NNE11IOLtf Y?/ NUTCMIMSpN. W IpECOT1?
/1_ /y?
? ?CC? ?c -4-Z-1-CP'?
paul A. Johnson
Land Surveyor, Minn. Reg. No. 10938
9 ""` CERTfFICATE OF SURVEY
/"= 40
? ?wE fior
fIIENR ?w . ?/1 {?y" , iV1.ES
7430
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C , .. ? •r{;
1985 BUILDIHG PEW1iT APP ' - F?
i3CATIOH„_ dilY?? £6GAH
:. HO'iE 9(d.,1'Ui1fK1CY'OES
; Ms s
*iST BE Llt1S?Dy.3Ft77i WCM tfFz EAG?A
r F
e,?
?- ... ? '_. - ?''? ' ?'' ? 5• a 4 ?- ? s' ?'? ik'S` . anb
` `•' - „" ?,?'..,• ' iNCLi1DE 2.5£TS. UF,PLAN5-'?
r 13 CER?IFIC6YES'OF-.SURVEY
, ?; ',: ,.,-- ?2 ' ?'•'?_' ? =-?? ? ?ENERGY'?CALCU?aTi0N5`.' ..
? ? - .,, ",.iw'?? :.?'??'-?'. • :":' ,:,;::.,,, '??- xr: ?' ? 'i a.:???? /„?? - ,r '/ . ' ', ' . .
To?9e Used.,P!or: yya3uati6n: `??!!4Date: ?-
§E OHLY `
. ? . :? ? ..- ` • ` ? ?
_ . : . . _ _ ?: . . . ._ .. . , ,
, _ - .. ?_, . •_ m??a..aJ _. ? .- -
Lote.??'rBlbdlc_ Erect': : OccupancY
Remodei . . 2oning . :
. - Parcel ? ,
YPe _of Const ..
O. . of
En - Stories
'. ' tr?rne"r Targe:, . ,. .
Hove,, - Lengtti
Demo3i5h= Depth
Address ..?.GrcS9_
City%2ip Code ---------------------- -
Phone AP?ROVALS , - ° . .
? Cootractor
. .. Assessments ;_ .Permit ? .?
'?-_Nater7Se»er- -:.Surcharge !'
, • - Address police' `plan.Pev3ex "?/
? .' . . _ " . ' . Fi're, ' - ? SAC?
City/Zip ?,Code ' . Engr,
?Water Conn r •
?Q-Q ?sp ?qr
.= Planner h'ater_ Neter
Phone , C6uricii . . • = Road Unit = ? 00 i?t:
Bld'g Of . Parks ?
9roh;fEngr. , `?(1? •1?G=? u?, ??(iL.. - , aPC% Treat.ment P2 . ....... .-2?
,.a. Variaqee. ,• ??? ? , + ,??"..
• Aadress ? ° 'x ` ., .. ? • ~T(3?AL
CityLZip Code
. , - {.:' .. ' , e y. .. «?1• r ? ?,.y.rv?/ . .-,
' Phone'D`
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_ . . ? ? a ? _l?,'. •, t.a y.?_. ,. ! " : ?°?-? ' " ? .
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TOWNIiOUSE - FOR SALE UBTITS CITy OF EAGAN
.'. 1 1 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N-° 118 82
BUILDING PERMIT PHONE: 454-8100 3
Receipt p _
70 6e usetl for ,
1 OF 4 PLEX Est. Value $ 61 ,000 m1Y 5
D
t
86
a
e , 1g_
SiteAddress 1545 CLEMSON DR Erect ?X Occupancy R3
Lot 25 eiock 2 Sec/Sub. THOMAS LAKE Remodel ? Zaning PD
Parcel No. HTS 2ND Aepair ? Type of Const Vn
w Name Addition ? No. Stories
NEW HORIZON HOMES Move ? Length 44
3 Address P.O. BOX 1367 Demolish ? Depth_4??
0 citY M-P?Phone 420-3900 Int.lmpr ? Sq Ft.
?
Insfall
= o Name SA`7E Approvals Faes
$? Address Assessment Permit $ 316.00
? City Pnone Water&Sew. Surcharge 30.50
W W Name D. GRISWOLD Police Plan Review 158. 00
?z Fire SAC 575.00
Q?
a W Address
Ciry Eng,
435-7524
Ph WaterConn. 500.00
one
Planner Water Meter 63. 50
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe CounCil
information is correct and agree to comply with all applicable State of Bldg. Off. DP
Mmnesota Statutes and Ciry of Eagan Ordinances. APC
Signature of
Var.
RoadUnit 290.00
rr. PI. 156 . 00
Copies
T,,,, i 2, 0 9. 0 0
A Building Permrt is issued to: " NLW tlViil'GON HOMES on the express condition that
all work shall be done in accordance with all a ' le ate of Min esota at es and Ciry of Eagan Ordinances.
Building Official p
,` ,?
f' . ?..rs11'y''
L p? "G?
!
? r o
1g85.t BUFi;DSHG ?ERMi2 A?PLICATZflN? C.I?Y t7F EA?,Ab?
74a'
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FC9TES OF.:S138VEY-,k ? ??? . .
£t?ERGY.CALC1,iLA739tIS•:
f To9e-UsedFor:' te.-
: -' ' ?.?t-. , °? , ,:,?, •
? Site Address + _pFFICE .OS£'O . -? ?
Lot e z?, °?"?Block3 ?? Sec"t7Su ` ? Erect ? Oeetiganeq ?
? . . ? . y : _ K+- .Eti - "C"..e,??`s'a' ti..`: :.. • F ? .'??E[OOfj?? rcr Z0[I):17g ' n.' .?. . _ .
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p8`OT`
? ?TI ?Bl"0-O?? ?O1'l'E$
;rner
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BUILDING PERMI
CITY OF EAGAN N ? 11884
3830 Pilot Kno6 Road, P.O. Box 21-799, Eagan, MN 55721 '
PHONE: 454-8100 " 1
T Receipt#?r„?l? 7
`l
7abeusedfor 1 OF 4 PLEX Est Value $61.000 Date MAY 5 19 86
Site Address 1545B CLEMSON DR
Erect
u'
Occupancy R3
Lot 28 Block 2 Sec/Sub THOMAS LAKE Remodel
? Zoning PL
Parcel No. HTS ZND Repair ? Type of Const. Un
Addition ? No. Stories
W Name NEW HORIZON HOLXES Move ? Length 44
z
Address P.O. BOX 1367 Demolish ? Depth 9
o
city NPLS phone 420-3900 Int, lmpr.
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nsta
o SAME Approvals Fees
Name
a
? Address
x
?
Ciry
Phone
a D. GRISWOLD
w W Name
?
?n Address
i W City Phone 435-7524
I hereby acknowledge ihat 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 Ordinance
%^
Signature oF Permittee °"
A Building Permit is issued to. ? EW HORI ON HOMES
all work shall be done in accordance with all applicabrle Stat7f Minnesa
Assessment _
Water & Sew.
Police
Fire
Planner
Council
Bldg. Off. DP
Var. Date
Permit $ 316.00
Surcharge 30.50
Pian Review 158.00
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit 290. 00
Tr. PI. 156.00
I Copies---$ '?. 00
r_._.
on the express condition that
Gty of Eagan Ordinences.
Building
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TOWNHOUSE - FOR SALE UNITS CITY OF EAGAN
° 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N-° 11883
BUILDING PERMIT PHONE: 454-8100 /? J 2?
Receipt# 6 ? J
7obeusedtor 1 oF 4 PLEX Est.value S61,000 Date MAY 5
86
?y
SiteAddress 1547 CLEMSON DR Erect C? Occupancy R3
Lot 26 Block Z Sec/Sub THOMAS LAKE Remodel ? Zoning- PD
Parcel No. HTS ?RD Repair ? Type of Const. V4}
Addition ? Na.Stories
W Name NEW HORIZON HQMES Move ? length 44
Address P• O• BOX 1367 Demolish ? Depth 2-;
a Ciry MPI'S Phone 4 0-3 Int Impr. ? Sq. Ft
Install ?
= o Name SAME Approvals Fee$
u Q Address
U Q
W W
?
xz
UZ
q W
Phone 435-7524
Planner
I hereby acknowledge that I have read this application antl state that the
informahon is correct and agree to comply with all applicable State o(
Minnesota Statutes and City of E gan Ortlinance .
n
Sgnature of Perminee ,4
A ewlding Permit is issued to: NEW H RI ZON HOMES
all work shall be done in accordance with all aoolicahmi-SA9t t nn.?no-f.
Building
Phone
Assessment
Water & Sew.
Police
Fire
D. GRISWOLD
Council
BIdg.Off. DP
APC
Var. Date
Permit $ 316.00
Surcharge 30,50
Plan Review E56' 0 0
SaC 575.00
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.00
Tr. PI. 156.00
Copies
7otal S2, 089.00
- on the express condihon that
of Eagan Ordinances.
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TOWNHOUSE - FOR SALE DNITS CITy OF EAGAN N2 11885 .
3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
Bl10LDING PERMIT PHONE: 454-8100 Receipt# (c 7
To be used tor 1 OF 4 PLEX Est. value $ 61 ,400 Date MAY 5 19 86
Site Addrss 1547B CLEMSON DR Erect L7- ?( Occupancy R3
Lot 27 Block Sec/Sub. THO Femadel ? Zoninq 11 D
ParcelNo. HTS 2 ND Repair ? TypeofConst Vn
Addition ? No. Stories
? NEW HORIZON HOMES
Name Move ? Length 44
z P O. BOX 136 Demolish ? Depth 97
o Address ? F
MPLS
? Int Impr t.
Sq
Ciry
phone Install ?
i o Name
0 ¢ Address
? Ciry -
Assessment
water & Sew.
Police
Fire
Eng.
Planner
Councd
BIdg.Off. DP
APC
Var. Date
Permit $ 316.00
Surcharge 30.50
Plan Review 158.00
SAC 575.00
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.00
7r. PI. 156.00
Phone
Uw w I Name D. GRISWOLD
¢ z Address
a W City phone 435-7524
I hereby acknowledge that I have read this application aod state that the
intormation is correct and agree to comply with all appiicable State of
Mmnesota Statutes and City of Ea an rdinanc s.
Signature of PermitteeL
A Bwldin9 Permit is issued to: NEW HORIZO OME$
all work shall be done in accordance with all ap lica6l tate of Min ,e`so
Building Of(icial
Copie 2.089.00
r,.... i
on the express condrtion that
anA Ciry of Eagan Ordinances.
PERMIT
C@TY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612)681-4675
PERMIT TYPE:
Permit Number:
Date Issued
BUILDING
029667
04j09/97
SITE ADDRESS:
1547 CLEMSON DR
LOT: 26 BLOCK: 2
THOMAS LAKE HETGHTS 2N0
P.I.N.: 10-75951-260-02
DESCRIPTION:
(REBUILD)
Build.ing Permit Type
Building Work Type
Census Eo't#,e
-?
?
!' - -
?
.'L
r-
,_
?
DECK
REPAIR
434 ALT. RE5IDENTTAL
?
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
$5@.00
$.50
$50.50
CONTRACTOR:
NELSON, KEITH
? 18511 86TH
MAF'LE GROVE
(612) 420-6550
- Applicant -
14206550
PL N
MN 55311
I
OWNER:
ASHLAND
1547
EAGAN
ELI2ABETH
CLEMSDN DR
MN
1 hereby anknowl,edgs tMist I:Houe re,,ada:th,is, aPp?icatSo.n and, stat;e that.the
informationis corr2et and agree to comply witk alI applica6le State df Mr
Statutes and City of Esgan Ordinances.'
AP IC NT/PERMITEE SIGNATURE ISSUED B: SIGNATURE
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) ?ffd•;1 O
L ?? ? CITY OF EAGAN ? t 1
? 3830 PILOT KNOB RD - 55122 1±-.Z
6614675
MGw Construetion Reauiraments
RBfiodeUReoair ReouiremeMs
? 3 registered ske surveys ? 2 copies of plan
? 2 copies of pfans (indude beam 8 window slzes; poured fid. design; etc.) ? 2 ske surveys (exterior additlona & decks)
• 1 energy calalaNons ? 1 energy calwlationa for heated addkfons
? 3 copiea of tree preservetfon plan'rf lot plettetl after 7H/93
required: _ Yes _ No '
DATE: 7 7 CONSTRUCTION COST: - Y.
•
DESCRIPTION OF WORK: -?e-A U 1 L'17 7X, l D ?t-c- IQ-
STREET ADDRESS:
LOT -JLL- BLOCK
/ LI-27 ? l ??/Sdr?
9 SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
Name: r-ll? ?la,nfL Phone #:
Wi PX
Street Address:
City:
State: Zip:
Company: 15 e- I -rH /t12ZSa X/ Phone #: S12 0 L53Z)
Street Address: ) /L License #:
City: NAO/L- <fv4v;,?? StateZip: SS 311
ARCHITECT/ Company:
ENGINEER
Name:
Phone #: _
Registration #:
Street Address:
City:
Sewer & water licensed plumber (new construction oniy):
and lot change are requested once permit is issued.
Penalry applies when address change
1 here6y acknowledge that I have read this application and state that the information is rArreCt and agree to com ly with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: •?v -
OFFICE USE ONLY RECEIVED
Certificates of Survey Received _ Yes _ No MAR 26 1997
Tree Preservation Plan Received _ Yes _ No _ Not Required
State: Zip:
PERMIT
? CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 029319
(612) 681-4675 Date Issued: 12 J 3 0/ 9 6
SITE ADDRESS:
1545 CLEMSON DR
LOT: 25 BLOGK: 2
THOMAS LAKE HEIGHT5 2ND
P.I.N.: 10-75951-250-02
DESCRIPTION:
@`uilding--Prermit Type DECK
ldin`g. W6,,r,-kType NEW
?Census Code `"?.
_. 434 AL7• RESIDENTIAL
t.
J ?
,
?
`'Z`..tssl?' ??EUi"h
"v
? .-?['.z??'
r
§
; `r%!<r°' ? ., ??^•?c
. .?
,
lbz . ;e
,
REMARECS:
FEE SUMMARY:
Base Fee
Surcharge
5ubtotal
$45.00 COPY $.50
$.50 Total Fee $46.00
$45.50
CONTRACTOR:
S hereby acknowl,edge -1?hat 1;°heve E`ea,d t"h-ii
informatio'n is correct and agree to comply
? SCaCutes and City of Eagan Ordinances.;
?
? APPLICANTlPE?MITEE SIGNATURE
OWNER: - Applicant -
BRUCKNER BRIAN
1545 CLEMSON DR
EAGAN MN 55122
(612)452- 7392
ap.plica,'kion 07xd st,ate that the
wi:th al], applicsble Stato of Mn.
?rVin l?.u,,r1 I Tttl?
?I ED Y:SI NATU
? CITY OF EAGAN 7 '[L U!1Q
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
blyy Censlruei{en Reaairemenis $ernpdpVReoair Reeuiremenh
f /
%i 3 reqiaterod site wrveys ? 2 wpfes of plan
? 2 eopka of plam (fnduda-bssm d window s@es; pourad W. dssipn; eteJ ? 2 aNe aurveya (axterior a00iHOna b tlecks)
? t anergy plculelions ? 1 eneryy nleulaGons ler herietl additiona
? 3 copies M tree pasarvsNOn plen H lot pqtled aNer 7I1/93
mqulred: _ Yas _ No
DATE: ) Z- 3-9 (o CONSTRUCTION COST:
DESCRIPTION OF WORK: " ??s >>'?? h V-),N o f 4?e6 k
STREETADDRESS: - j S`/ S Clc?so??
LOT 1A BLOCK ISUBD./P.1.D. #:
PROPERTY
OWNER
CONTRACTOR
Name: 3(2 L-f.c%ii&vz &)?r) Phone #: `/S? -? 3 S 7
uiMi*
Street Address•- i ? `?'•s «M?°'"? D?
City: State: IV7ti Zip: Z?--
Company: <c /f ' Phone #:
Street Address: License #•
? City: State: " Zip•
ARCHITEC7! Company: Phone M
ENGINEER
Name: Registration #•
Street Address*
City: State: Zip•
5ewer & water licensed piumber: Penalty applies when address change and lot
change aro roquested once permit fs issued. •
i hereby aeknowiedge that I have read lhis eppiica6on anA state that the infortnetion is cortect and agree to compty vvith all
applipble State of Minnesota Statutea and Ctty of Eagan Ordinances.
1 Signature of Applicant: ??? ?•? c
OFFICE USE ONLY
?r,.? _..
Certificates oE Survey Received _ Yes _ No ,
DEC
Tree Preservation Plan Received Yes _ No
City of Eagan
Eagan, Miimesota
September, 1996
?*wsrlomao"
To Whom It May Concern
The holder of this letter is hereby authorized to build a deck with a total area measuring 10x20 on
the property owned by Horizon Hills Home Owners Association. The holder of this letter
understands that because the deck is built on Association property, it becomes the property of the
Association, with the unit associated with the deck continuing to exercise their private use
exclusions.
The Association will ensure the deck is constructed and the cement footing is poured to meet the
City of Eagan building requirements and will order the final inspection of such when work is
completed.
Please feel free to contact me with any questions or concems.
Sincerely,
Horizon Hills Home Owners Association
???, K?',6
Barbara Koob, Property Supervisor
Member-At-Large
cc: File
?? .
P.O. BOX 21423, EAGAN, MN 55121
(612) 688-0695
HORIZON HILLS HOME OWNERS ASSOCIATION
H L9 1 ?
COMMERCIAL
BUILDIN(i PERMIT APPLICATION
CITY OF EAGAN
651-681-4675
1t-A _
Foundation Onl New Construction Interior Im rovement
• Slructural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets
• Civil Plans (2) . SUUCtural Plans (2) • Code Analysis (1)
• CertificateofSurvey (i) . CiwlPlans (2) • Project5pecs (1)
• CodeAnalysis (1)" • LandscapingPlans (2) • KeyPlan (1)
. ProjedSpecs (7) • CodeAnalysis (1) • Master Exit Plan (1)
• Spec. Insp. & Testing Schedule • Certificate of Survey (1) • Energy Calculations (1) not always"
• Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Ligh4rrg Form (i) not always"
. Meter size must be established • Meter size must be esNablishad • Meter size must be esfablished - if applicable
• ProjectSpecs (1)
1 • EnergyCalculatlons (1) " y
1 • Electric Power & Lighting Farm (1) " b
1 • Master Ezit Plan (1) 1
1 • Fire Protec[ion Plan (1)" 1
1 • Soils Report (1) 1
• MCIES SAC detertninahon letter . MClES SAC determinaUon letter • MGES SAC determination letter
C211851-602-1000 ca11 6 51-602-7 000 call 651-602-7000
Contact Building Inspections for sample
Food & beverage or lodging facilities: Plan must be su6mitted to Minnesota Department of Health - call 651-215-0700 for details.
DATE 7- 30 ' d/ WORK TYPE NEW X REMODEL CONSTRUCTION COST P 2 5,
SITEADDRESS ISyS -? S yS/,? -fsY7 -/5 Y-7Q C( fa+5o., D2 •
TENANTNAME HD / ;zo,n P, A rI- a•i4. SUITE#
FORMER TENANT NAME
DESCRIPTION OF WORK S/?Ih
Name: 40- 14,nq°/n-hJ • Phone#: 7( a 3 ) 593 - 97 70
PROPERTY Last Fust
OWNER
Street Address IF$D `6P ?'?^ r?..P . N-
S
u ,?f l¢
CitY _ rge 1PrPh l/,[ Ay
I State Zip SS' L/ z 7
Company ??? ?x{eriJr !"lu-i/Pyy?" Phone# z Y3
CONTRACTOR ?US I.? .
Street Address: d l/ ? 5 f,
City State lol"v zip SS` y/g
ARCHITECT/
ENGINEER Company Phone # ( )
Name
Street Address
City
Registration # _
State Zi
Licensed plumber installina new sewer/water service: Phone #:
Il? II Irl IC
? .
; , I
Qv - --
I here6y acknowledge that I have read this application, state that the information is correct, agree t?with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ?' ?
OFFICE USE ONLY
SUBTYPE
? 01 Foundation
? 14 Apartments
? 15 Lodging
? 25 Miscellaneous
WORK TYPE
? 31 New ?
? 32 Addition ?
? 33 Aiterations ?
? 34 Replacement ?
? 26 Public Facility ? 30 Accessory Bldg.
? 27 Commercial/lndustrial ? 32 ExtAlt - Apts.
? 28 Greenhouse ? 34 Ext Alt - Comm.
? 29 Antennae ? 35 Ext Alt - PF
? 37 Nail Salon
35 Tenant Impr ? 42 Demolish (Found) ? 46 Windows/Doors
36 Move Bldg ? 43 Reroof ? 47 Repair
37 Demolish (Bldg) ? 44 Siding ? 48 Authorization
38 Demolish (Int) ? 45 Fire Repair
GENERAL INFORMATION
Census Code
SAC Code
No. of Units
No. of Bldgs.
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
First Floor sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
? Gas Service Test ? Heating
APPROVALS
Planning
Building
? Insulation
sq. ft.
sq. ft.
sq. ft.
sq. ft.
MC/ES System
City Water
Fire Sprinklered
? Plumbing
Engineering
? 5tucco/5tone
Variance
Permit Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water 5upply & Storage
S/W Permit
5/W Surcharge
Treatment Plant
Park Dedication
Trails Dedication
Water Quality
Other
Copies
Total
1-4 .?
?-)) .?
1-{ ) (-f .?
VALUATION $
% SAC
SAC Units
Meter Size
. , ? ? ? o c
1987 BOILDING PERMIT 9PPLICATIOH - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
IDICLQDE 2 SETS OF PLANS, 3 CERTIFICATES OF SQRVEY, 1 SfiT OF ENERGY C9LCQLATIO&S
NOTE: ADDRESSES FOE COENER LOTS - CONTRACTOR/HOMEOWNER MDST DESIGNATB NHICH ADDRESS
IS DESIRED. NO CHANGES NILL BE ALLOWED ONCfi BUILDING PERMIT IS ISSOED.
MQLTIPLE DWELLINGS - RFSIDENTIAL RENTAL UPITS FDR SALE i1NITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRVEY - CHECK TiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COhIliERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
1 SET OF SPECIFICATIONS AND 1
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
uo ? Iea faacy,
To Be Used For: -rYs ?
& STRUCTURAL PLANS,
SET OF
13c? .
Valuation??_ Date:
Site Address P-j-9j (? ??rnSpr? IJf1dP OFFICE DSE ONLY
a
Lot Block On Site Sewage Oceupancy
.1J
d'V
? MWCC System Zoning
--(?
Pareel/Sub On Site Well Type of Const
City Water `
(Actual)
n
Owner ?l?Q yf(?/ S)mme fi
- ? (Allowable)
? 11 of Stories
Address Length
????
City/Zip Code Depth
S.F. Total
Footprint S.F.
Phone 9PPROVALS FEFS
A)-r
0 P;
) s 6L
Contractor
j-l
(eb
?l(K Assessments Permit
3
38?d U
l Water/Sewer Sureharge
Address
,
e?hu??v
- Police Plan Review
f Fire SAC, City
City/Zip Code ,?rhS?j1T ?? Engr SAC, MWCC
Planner Water Conn
Phone Couneil Water Meter
Bldg Off Road Unit
Arch./Engr. APC Treatment Pl
Variance Parks
Address , Copies
?
TOT9L ?
City/Zip Code
Phone li
CITY OF EAGAN PJ° 13 9 0 6
- 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PH ON E: 454-8100
BUILDING PERMIT Receipt# ?? S? ?
7obeusedfor FIREPLACE Est.Value $1,300 Date JULY 14 19 87 Site Address 1547B CLEMSON DR OFFICE USE ONLY
Lot 27 Block z Sec(Su6. THOMAS LK HTS 2ND
' on5itesewage _ Occupancy
MWCC System Zoning
I
PaICeINo. OnSitewell =
TypeofConst
City Water _ (ACtual) '
rc Name NANCY SIMt4ET (Allowa6le)
W
z
Address SAME # ot Stories
Length
? Ciry Phone 456-5630 Deptn
S.F. Total
,o Name HEAT 'N GLO FIREPLACES FootprintS.F
?? Address 3850 W HWY 13 ppPROVALS FEES
? City B'VILLE Phone 890-8367 60
25
$
Assessments .
_ Permrt
tw WatedSewer _ Suroharge 1.00
Fw Name Police _ PlanReview
i?
0 Address Fire _ SaQCity '
u
aW
City Phone En r. SAC,MWCC
Planner _ WaterConn.
Council _ Weter Meter
I hereby acknowledge that I have read this application and state Bldg. Off. _ qoad Unit
thattheinformationfscottectandagreetocomplywithallapplicable APC _ TreatmentPl
State of Minnesota Statut9F and.City of g n Ordin nces. Variance _ parks I
?
Signature of Permittee ?? /? Copies
TOTAL ?
A Building Permit is issued to: HEAT ' N (figg FIREPLACES on the express condition that
all work shall be done in accordance with I licable State Mi ?n ota Statutes and City of Eagan Ordlnancea ,
Building Official i
U' -- 1
-
?, 7,00 (iR4? !3 ? 53 j
2000 FIREPLACE PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD - 55122
651 681-4675
?) °? SZ
Lv?
cv? g, 1
Date: /"Tlrl (1L, 3,o? o o
V
Description of Work: ` Construct new fireplace
Y Install Eas inserl onlv
Other
Job address: 15 [,5
Lot Block:
Applicant (circle one only):
_Gas _Masonry ^ Alterations to existing
i Install pas line onfv
-7 cy1 SJ
2- SubdivisionlP.I.D. #:
Owner Contractor
Permit Fee: $60.50
Name: A Cl'o- Phone #:/ ?_I7 al
PROPERT'Y Last First
OWNER StreetAddress: (5, l IpM.SCJ1/1 ?&1 Vt
City ? (',? ri a Y\ State: 191fiz - Zip: 5_5r1=
Company:?? 7ry5aZ-
{?Sl? ?Phone #:
(area code)
FIREPLACE ??
INSTALLER Street Address: ?T
(
Ciry /',( r ?121,I Qr
GAS LINE
INSTALLER Street
z,p:
Phone #:
(area code)
City
State:
Zip:
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 d City of Ordinances.
c ?O a
P
Signature
4--c,1- ?,-T Z -Io
i'.i ? ... 1
?`'??'%? lg?, ?`c?
CITY USE ONLY
L ll? BL ? RECEIPT #: gul.L
SUBD, a Or , DATE:?
1995 MECHANICAL PERMIT (RE5IDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on fumace
? Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc.
Date: ?-' 'v - ?
FFFC
? Minimum Fee: Add-on/Remode! (existing residence only) 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL o?Dr !!O
SITE ADDRESS: ???y, ???-?? AOl
OWNER NAME PHONE #:
INSTALLER NAME:
STREET ADDRESS:
CITY: 4?;Gs?iv STATE: 'Of/ ZIP:
PHONE #: (
City of Eagan
3830 PILOT KNOB RD
EAGAN, MN 55122
(651) 681-4675
Site Address:
1547 Clemson Dr
Lot: 26 Block: 2
Addition: THOMAS LAKE HEIGHTS 2ND
Description
Sub Type: Fireplace
Work Type: Alteration
Description: Gas Insert
Census Code: Addition/Bsmt Fm/Decks/Porch
Permit Type: Building
Permit Number: EA034787
Date Issued: 03/24/1999
UBC Occupancy:
Construction Type
Zoning:
Squarg Feet:-N,
. Chimney/flue must be inspectzd beforc wncealir.g.
Fee Summary:
State Surchazge - Fixed
Permit Fee - Fixed
0.50
60.00
$60.50
Contractor: - Applicant - OWner:
Condor Fireplace & S[ove St. Lic.: Bemadette Bowar
E282 Arthur Street NE 1547 Clemson Dr
Spring Lake Pazk, MN 55432
612-756-1341 ? Eagan, Mn 55123 651-688-7501
1 hereby aclrnowledge 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.
ApplicandPermitee: Signature
PERMIT
I ied By: Signature
t (.O.?-z?
1999 FIREPLACE PERMIT APPUCATION 3-`A
CITY OF EAGAN
3830 P[LOT KNOB RD - 55122
(651) 681-4675
Date: z-1 `j -q 1
Description of Work: _ Construct new fireplace _ Alleratinres to existing
? Install gas insert onlv _ Install gas line oitlv
Other
Job address:
L
Lot: Block: ?-
- -{?
Subdivision/P.I.D. #:-t V,? 1ti'l_kr.2
Applicant (circle one only): Owne C ac
Pern:itFee: $60.50
Name: _?? 7 L&_?An LUr) 1'" Phone #: r_,?(oQ?' -'r5? ?
PROPERTY Last First ?
04Wi ER /
Street Address: ? 64"1 !Pn( S nw 1?l V4
City ,a ';J & State: A Af Zip: _5 5 l3 2
Company:[ e'J f-' ' I n j?7D1LC' Phone #: ,bf FIREPLACE (?
INSTALLER Street Address: AzOz N'
City M rl r State: 10-6c_ Zip: S ?
Company: Phone #:
GAS LINE
INSTALLER Sneet Address:
Ciry State: Zip:
[ hereby acknowledge that I 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.
RECEIVED
sisnamie
MAR 2 2 1999
BY:-__-,-_-_
?'?rr?
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
COND05 WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
X ADD-ON A/C
ADD-ON FURNACE
FIREPL?.CE TuNSERT
DATE _O'l -(Q C) -`1 4
FEES
HVAC: 0-100 M BTU
ADDTTIONAL 50 M BTU
GAS OLTTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExISTIxG CoNSTRUCTioN)
STATESURCHARGE
TOTAL
3IT'E ADDRESS:_ 6I C,1 (f,'(1
OWNER NAME:
IN3TALLER:
a,DDxESS:1&AIN _Lc°,\C
CTI`I': STA7
TELEPHONE #:?
?
$ 24.00
6.00
$ 20.00
.50
.50
TELEPHONE #: `?1-cC aU - c Jt(Z? J
-? U-?,r ( ° 0\\in f-\I, 4,' '--"f1 "
ZIP CODE: L1???L-Lu
1994 MECHANICAL PERMIT (RESIDENI7AL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PERliiIIT
ClTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE: B u I LDI N G
Permit Number: 028957
10 / 0 2/ 9 6
Date Issued:
SITE ADDRESS:
1545 CLEMSON DR
LOT: 25 BLOCK: 2
THOMA5 LAKE HEIGHTS 2ND
P.I.N.: 10-75951-250-02
DESCRIPTION: oecK FTGS ONLY '
??kB?IdT? Permit Type MISGELLANEOUS
? ikd?ng"t#qrk Type ALTERA7ION
,c Qu?s.?'.pd',='%, 434 ALT. RESIDENTIAL
s, .
?
?}-
??
P0° ?eiR, k+ ? ?y Se^?-?
??? 'i??? 4w°s? ?a.?" . ??
REMARKS:
FEE SUMMARY: vALuaTZOrd
Base Fee $21.00
Surcharge ? $.50
Total Fee $21.50
$200
CONTRACTOR: - Hppllcanz - 4ANER:
J&C CONCRETE CO 18280877 ANN
8924 M7 CURVE RO 1545 CLEMSON pR
BLOOMINGTpN MN 55438 EAGAN MN
(612) 828-0877
aWl$?g$ tha'tilRl haus;r?acl.-?h.?s ?p`P1????=`zo?aatRd tat? ttrat.,th0 '
I hereby, aakti s?
' znforinat3nrl-,?.s ec?rt^e?;c't?n?E' agre?' tq,c°rs+p?',??'"+?`'tR? ??I` app1;?zable,BGav"R tif h1n '"
Statutes' ervdsGit? #f Eeg?r? ?frci?iknanca? ^ , ` `
.:
u
.. -. _ _ . ......_... , e.. _ , _m „ . ? ,
APPLICANTlPERMITEE SIGNATURE ISSIJE Y: IGNATURE
CITY OF EAGAN
d?? 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-d675
RemodeVReoair Reauirements
i 3 registered site surveys
? 2 cropies ot plans (Include beam 8 window sizes; poured tnd design; etc.)
4 7 errergy calculations
? 3 copiea of tree preservaNOn plan 'rf lot platled after 711193
reqWred: _ Yes _ No
? 2 copies of plan
? 2 site surveys (ezlerior additions 8 decks)
? 1 energy wlculations for heated additions
DATE: I -D e' I -r CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: J _
LOT 9
BLOCK '
SUBD./P.I.D. #:
PROPER'T1r Name: 1,0. ann) Phone #:
OWNER us+ nss*
Street Address•
City: State: Zip:
CONTRACTOR Company: 1? e. ? ??"V e r?E?? O-C' Phone #:
Street Address: ZM1 c'"aF 421?- License #:
City: " /YI < `? State: 41 Zip:
ARCHITECTI Company: Phone #:
ENGINEER
Name: Registration #-
Street Address
City: State: Zip:
Sewer & water licensed plumber: 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 infarmation is corcect and gree to compiy with all
applicable State of Minnesota Statutes and City af Eagan Ordinances. -44c
Signature of Applicant:
OFFICE USE ONLY
e,.
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received Yes No
CLA1M VOUCHER - REFUND REQUEST
CITY OE EAGAN
MAKE CHECK PAYABLE TO: e ; 4 N e Is v n
ADDRESS: 19511 S(v '4" P lG CC. li
Mup)e Orove M(U 55311
LOCATION:
RECEIPT # / DATE
REASON FOR REFUND
/545 0.)e.Ynson f?? LaS, ??, /hJmas 1,.uJ<e Fle:al??s a`
?Ic?U/ CJ - W19 197 VALUATION
s
/d'4D
TYPE OF REFiJND ELECTRICAL PERMIT 3211-9001 $
PLUMBING PERMIT 3212-9001 $
NECHa,NICaL PERMIT 3213-9001 $
BUILDING PERMIT FEE 3210-9001 $
PLAN REVIEW FEE 3422-9001 $
SAC (MC,n,vS) 2375-9220 $
SAC (CIn) 3866-9379 $
SACiADMIN 3446-9001 $
WATER CONNECTION 3865-9220 $
SEwER PERMIT 3743-9220 $
WATER PERMIT 3713-9220 $
ACCOUNT DEPOSIT 2252-9220 $
WATER METER 3716-9220 $
ROAD UMT 3860-9375 $
WATERTREATMENT 3868-9220 $
SURCHARGE 2155-9001 $ .60
UTILITY ACCT OVERPAYMENT 2250-9220 $
CURB BOX DEPOSIT REFUND 2253-9220 $
CONSTRUCTION METER DEP REFLJND 2254-9220 $
WATER USAGE CHARGE 3711-9220 $
TOTAL
$ 0
50 `
I declaze under the penalties of law that this account, claim or demand is just and that no part of it has 6een paid.
Signature Dat? cLniM.vou
., ,
. CITY OF EAGAN
" . ;
APPLICATION FOR PERMIT
SEWER ANDlOR WATER COtVNECTION
^7DT?: PAYMRNT OF Fk'E AT TIlNE OF
APPISCATION I%lES P1CfP CODS'1'L7iJ1E
APPRUVAL OF PERMIT.
INseDCriorr oF sEwM Arm/CR vuM3a :
nOrAtZATIoNs w.¢z NOr sE scHEn--
ULEn orrra. PERMIT Ms aEEN
1PPxovFn. •
ti4; 1) PROPERTY ADDRESS: ('', - .. • .
LE6Ai. DESCRIPTION:
Lot B ock Subdivision or Tax Parce ID )
. _ .,.:?e..,=
?i,q: N??p • q •"i ? . .? / +?4?F??.:?d ? ?
`?'°"4..y • ?' _+?J111W ?4.V.?Vf?G? YA1G ?F VAIVllYf1LI A". MJLV.f O1.cY'u.1 ISSUL1LNr.Ei
IM.. O . ...
..5?fz5?b ? ' _ , ..._. _".i,-v • 1 t°.. ??. : ,'. . S???-el". :. t {L'Ln 1ear . ..
ZONAVG T
/PROPOSED? LSE: . ..... ?i=?' v
.;?:dF ;?._.'?Ctr4..-? `? ?•tYx 4r ,.•:.??., -.???i?`[???'?
t"e.? ; ^. . .;..? `?•_, ? ?'.h? , ?,?,5 ? r? az x k!2?-i
?'? .?" ri
/OFFICE R 1 SINGLE FAMILY
. .cs? ? z ....? x .
w'tlb: ?{?y 7?'?I}?TT* ? t R- 'P
\ ',r. -x a d w 1 ?E .
{1 p 2?}TM ImWV Tr `?`L?^/
??T a MILWVJ1Ll?J?n ?.,? ?.,ya r? 4?a'!n....1;Q S YSVC? `1 f"aiY-
? 1?? ???{ /?/?????• ??t•?- ?Y! ^yy rt ?:??: . . .
?11OlYtfL1/VVVSdLLW'°'.^? -???`•s? ? 1 Yi
R 3 20W[?i0L5E (Three + Units) (?[7lll.ts}
,Y
?
R-4 ? ARTP'ENT/CAPIDOMZP1ILTi
4 - ? '? ,.° ?,? , -- ' ' . , •
.
2) , Y. . . . ' ? . :•?. ' . . _ _ ,„.??, x,--._.
ADDRFM' ? . , . " .
'
cmr -S?? VTaIP: ?
55440
- -- _ = at."- PH?: • - -: - -
., :..3) ??: y • For C1ty Cse .
- NAME: Plunbers Li.cense:
14DDRESS: ' a Acti.ve
• - - - • I i bicpred
! :;_? - =---CIT7t?- STBTEF2IP: - ? - H Not- xeCOrded
--
_ PHONE: MASTER I.ICENSE# St? tial '
' ???4?-_ ??r • ia• . . -,,, ? .. -- -?- -
,.;:,,
xn??y??+ `SS?R ?q.syz
.. ..Wm? -smiG/ [µpi
PHONEi . _ . . . . . ' ' ' _ " _
•5) ? :. v ? ? r ? ?- : ? • o. ?.
• - ?? CONNECTION T0 CITSC SEWM ? CONNDC.'fION RO CITY WATFR O'1HER , ..
6) ?? ?• .??. Q PIEASE EiULD APPROVID PERMIT FOR PICK- BY ONE OF ABOVE -. --•- --
? PI.EASE MAIL APPROVID PEEtMIT ZO 1r 2.? 4. AHOVE .. . :
- i • (Circle one)
7} r. .- u• • ? V
• 7' • 1' Y'I' M ? '• ? ? I" •? • ?• 0 1:1• •? P Y?7•
'?1' • ']? ?' •?{
?^ •? • 10. •?• 1 y f M:I•,(Y>? 1 1 1 ' pl` ?•• q' • 1 11 Y• : t?? '
. ... . . . _ - . , . . . r. .....wu? .
wm•
.??'`., t•"_ _ -- ' - . . .. . ? . ._ . ' . ,.. ? - ._. ._ ... _ - _ .
.?FOR CITY USE ONLY ? ? ?• ?
.M,:.?..' - . • . '.'-?s,i. .
-PERMIT # ISSL'ED
.._, ;?,..
;4•.?%.;: . .. . "y;;?_i. - ?; ??`..? :'?,'€?.*+;r . . ,
' Pd w/Bldg. Permit FEES:
dk ' , 4 . : YPt'_ -
$? 58WER PERlQIT •( INCLLDE ST-IRCHARGE j
...:. -R;F??_
$ f? -?LT WATER PERMIT ^( INCLUDE SURCHARGE ) , . .
?$ l?i? -??"??' •w'?$ " - WATER METER/COPPERHORN/OCTSIDE READER ?
77771
- »?„<$?-,'?:" .?" '°??_'.. ??. ???-?. _.. ; ?'??r?? ._??, .,,.._,.. ._•?.. _ ..._= .
WATER TAP (INCLL'DE CORPORATION STOP) }V
0?e°??t$ t
5"' ???6?,:rzZ ?? ti!
? ? -.
r,??` 7 SEWER TAP s.;s?f "?
.w ?'
?Y'Y F""a.' .,'?„ , %y?L`v,, ? ' ?3"' .•
.L
fi? DEPOSIT SEWER
,? ?6
ACCOL?NT DEPOSIT WATER
????? s ti WAC? • r ?rn' T ' .nz? ?, ,
ra , t iray
/y
.F ? lal 1 ? Y ? V , .er$ .a . . ? ko .YSAC ' '?! ? _ ..Y i? ? . ?l?N' ??.N ?RY.??`?t•F d +t'?( iwY?'?w?.A3/'Y K +t -?
? ? p ? y CPE 5 $ . ae' ?
-'_l?Y"^'x1t4a-i
'$ ?T12LNK WATER'.ASSESSMENT
T. ? . ? ITAL?NF(-`SEW?? A,,,S aEqSMENT
.ki.f:f,i-.
?LATERAL, 7prNEF'fT/T120NK SEYJER
?.
,?.'-tirC,= -9: . ' - _ . _.. _"? 'i,.,.p ,?- ;.-..-'rn??. -.,? • "' >'.?'3?'? :??_ -?,_,RV.a? ?_r ?..,rYF
z«. ATE E
EFIT/:PRL a . :
L _ RAL N ?NK WATER
`?
?
?.+'" =: = - -. _ ;, ?;_ _ _ _ . _ . . • . - - - -- ' '?
?.;WATER.REAPMENT.rFLANT SURCHARGE
>a.aE::.
,.r `,?.x ? x .. K.s , }..t' ..Ya : . ? t?- rr'Yi?,,. rl???.?.. .
FOTHE&'e
^. . ir- ?t,' : p._• 4r>` ? ??`i'T ? ?
TOTAL ?:i :.°?+>;';•`` ?
?? ". ';.
+
H aw
?
..
?
'
RECEIPT
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RECEIPT . ` j`
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,
x ..- _
- ..
.
?_DOES LTILITY,CO NNECTION REQUIRE EXCAVATION
IN PUBLIC RIGHT OF WAY?
" a YES IF YES, THEN A"PERMIT FOR WORK WITAIN PLBLIC^
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
?
NO
DIVISION. LIST AS A CONDITION. Y
SCBJECT TO THE FOLLOWING CbNDZTIONS:
APPROVED BY:
TITT
?+E? ? -- ....
. ,• . .
'D.4TE:. AYy•. _ y-'/I?l?'? .. ^. ..f->' _.
. .._ ...,... i :.. . , . ? ? ^ 3?1i.. .
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,
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. . _
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ki.. ?_ . _ .. . ..
_ .;..
. CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
PROPERTY,ADDRESS:, I?-5
•?
? LEGAI, DESCRIPTION: '2-
:. .. Loi
r.}*,. ;•?.
' =-g' E7I5"1"ING STRCCZL'RE.. DATE OF C
,
, ,-,?:.? •. .
PRESE= ZONING/PROPOSID L'SE-
s,
pATWI: pAYMFJJr' OF FEE AT TIlM OF
APPI.ICATION DOES IV(7! CONS1'I7tT1E
APPROVPiL OF PII2NIIT. .
nvsrnczzorr oF saWx Arro/ox `WAIEz
2tsSmar.r.amtONS WIId. NOT BE SCHED-
t7iED UNPIL PERMIT AAS BFEN
APPRCfVID.
,.
: --
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? CONNECTION R0 CITY SEWER ? CONNECrION M CITY WATII2 Q 0THM
6) '' r• ••?' [3 PLEASE EiOLD APPROVFD PERMIT FY)R PIQ{-[? BY ONE OF ABOVE
, ? PLEASE MAIL APPROVID PERMIT 'PD 1, 2,??f 4r ABm7$
(Circle one) ..
7) r r• u• -
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F'OR CITY USE ONLY
: • PERMIT # ISSCED ? _ . , .
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DOES L_T.TILITY CONNECTION REQLIRE EXCAVATION IN PCBLIC RIGHT OF WAY?
' . . . cR.:^:.-': .-
Q YES 'IF YES, THEN A"PERMIT FOR WORK ?VITHIN PCBLIC
---?-- - ROADWAY" MUST BE ISSLED BY THE ENGINEERING
? NO DIVISION. LIST AS A CONDZTION.
SUBJECT TO THE FOLLOWIN6 tbNDITIONS:
"' •, ;1, : ?: -:,;
APPROVED HY: ??•7 -X--l
? r TIT7?£r
r. :?` .?,: L .y ,, y ?., -- ?-- - _ _'_' -• ?:5.. ..
- " 'DAT$:. .
?.
?=r•, _,
. . ? . .?. . ..... " i' __' •_-.:_..._ =? ?
FOR CITY USE ONLY
PERMIT # ISSL'ED
Pd w/Bldg. Permit
$
$
$ ? 3- 5-D
$
$
$
$
s SG1,0-0
7.5--GG
$
s ..
$
S
S
$ / ,57? - (:` IJ
$
s 147v--,5-o `
RECEIPT ?
FEES:
$ SEWER PERMIT (INCLODE SC'RCHARGE)
-WATER PERMIT (INCLUDE S['RCHARGE )
s
$
$
$ 15-1OZJ
$ ?.J • (J ?
s
S
$
$
WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP (INCLL'DE CORPORATION STOP)
SEWER TAP
ACCOLNT DEPOSIT - SEWER
ACCOONT DEPOSIT - WATER
WAC
SAC
TRL^'NK WATER .ASSES.SMENT
...v.'.;: . .? ..
sTRUNI{ tSEW?},2 AS;3E3SMENT
< <:i.t
. {,_.•, . ?,
LATERAL'S'90'EFIT/TRCNK SEWER
$ LATERAL BEN°FIT/TRONK WATER
$ - WATER TREATMENT.PLANT SURCHARGE
_ . y... . . .? .
n TOTAL, • - „ • •
RECEIPT
DOES UTILITY CONNECTION REQOIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LZST AS A CONDITION.
SUBJECT TO TAE FOLLOWING CZ7NDITIONS:
APPROVED BY:
TITLE:
DP:TE :
r'.
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*tOTm: PAvIETTI' OF FEE AT TIME pF
aPPLscATIoN noFS c= mxsriTUTE
APPROVAL OF PEEiNIIT.
naspnMox oF sLWM Arm/at vuMR
INSZ'ATTATTQjQ$ WILL WP BE SCHED-
vrM urna rERmIT H+s sEM
APPROVID.
1) PROPERTY ADDRESS: 'Fj L}'J Gl?m? ?I?• '"
LEGAL DESCRIPTION: y& 2 "
_ Lot Block Subdivision or Tax Parcel ID )
I£ EXISTING S1RCCMME, DATE OF ORIGINAL BUILDING pERMIT ISSL'ANCE: '
PRFSENP ZONING/PROPOSED USE: (I•bn Year)
Q CONIINERCIAL/RE,TAII,/OFFICE
Q INIDLISTRIAL
n INSTI'I[.'TIONAL/G(77ERbAg,'TpP
? R-1 SINGLE FAMILY
Q R-2 DC'PLEX (Rto IInits)
? R-3 7UWNHOUSE (Three + Units) (_4 L?nits)
? R-4 APARTMENT/COrIDOMINICTM ( Units)
2) ••• v?
AC
CITY, STATE
3) • u c?• NAME• For City Use ..
P1umUers License:
ADDRFSS: ActiVe
A
CITX. STATE, ZZp: fScpired
R Not recorded
PHONE• MASTEEt LSCENSE#
St?f Iz11t1a1
4) .. . NAME. ? (rN 0 ap ? 2
_ ADDRESS: •
CITY, STATE, ZIP:
PfiONE: .
5) ? vi a• •?• : o - a-
,
? CONNEGTION TO CITY SEWER ? Cp[CTION M CITY WATER Q ORSER '.
6) 0 PLF.ASE HOLD APPROVFD PERMIT FOR PICK- BY ONE OF ABOVE
? PLEASE MAII, p,PPROVID PERMIT SD 1. 2,? 4, AHOVE
??? ???/? (Circle one)
7) r• u• • 1.t/J//? ? Y/I!/.lAd/" mrzv.,.--,. 1IIArn ? l21
.. ??
APPLICATION FOR PERMIT
CITY OF EAGAN
SEWER AND/OR WATER CONNECTION
*IOT?': PAYMFNC OF tEE AT TIA1E pF
APPLICA7ZON DOFS NOT OONSTI7VTE
APPROVAL OF PERhIIT.
INSPFXTION OF SEWFI2 ADID/0t 41ATgt
INSTALLATIONS WIIS. NOT BE SCHED-
ULED 0tUII, PII2MLT HAS BFaI
APPROVID.
x-
P ease Pr1nt) F; F
1) PROPERTY ADDRESS: Irjq-7 Pj
?..?
LEGAL DESCRIPTION: 2-7 Z. ••-
_ %LC,Lialocx/,?unaivision or Tax Parcel ID #)
IF EXISTIA7G STRCCii'RE, DATE OF ORIGINAL Bi,'ILDING PERMIT ISSL'ANCE:
' PRFSE[11' ZONING/PROPOSID C'SE: (1`bn Yearl
q coHIMcIAu./xErAIL/oFFzcE
[] IbIDC'STRIAL
n INSTI2L'TIONAL/GpVERNNIE'N'r
2) ?
? R-1 SINGLE FAMILY
? R-2 DL'PLEX (7t.o Pnits)
R-3 TUWNiOC?SE (Three + I]nits) ( Units)
R-4 APARTmENT/CpNIDpININiLly ( Units )
NAME= New Horizon
A[)DRESS: 13805 86tfi Ave: No. .
CZTY, S"rATE, ZIP: Minneapolis MN 55440
PHONE: 420-3900
3) NAME: Thompson Plumbing For City Use .
Plumbers License:
ADDRESS: 12201 Minnetonka Blvd. ? p,ctive
Ekpixed
j CITY. STATEP ZIP: Minnetonka MN 55343 Npt iecox.ded
PHONE: 933-2521 MASTER LICEr1SE# 1763M
Steff Intial
4) -
.•• • ?
NAME; Same as #2
ADDRESS:
CITY, STATE, ZIP:
PHONE:
•5) ? r• i r • ?• : a a? • ??
? CONNF.CfION 1q CITY SEwIt c,6cpNmDurION TO CITY WATER Q pmm_.
6) '? •'??' ? PLEASE HOLD ApPRptJFD PEE2MIT FOR PICK-LTP BY ONE OF ABOVE ---- --
? PI.FASE MAIL APPROVID PERMIT ZU 1, 2, p,gpVE . ?
I? (Circle one)
7) r r u• a?,/n ? Jn_/n. . ?-?.-? C-- 1 6?
F'OR CITY USE ONLY
PERMIT # ISSCED
2V;1 S?/45? 6
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SDRCHARGE)
$ $ /G" S G WATER PERMIT (INCLUDE SL'RCHARGE) ..
$ ? 3 S? $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOLNT DEPOSIT - SEWER
$ $ ?,?j? (r7} ACCOUNT DEPOSIT - WATER
$ ?? ? ' trZl $ WAC
$ ?75o---b $ sAc
$ $ TRLNK WATER ASSESSME[VT
$ $ TRLNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BEN°FIT/TRC'NK WATER
$ / ? (O• ??'i $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ ?? ( Y• S-6 $ TOTAL
7-1 7,2--
RECEIPT RECEIPT
DOES UTILITY COIVNEC TION REQLIRE EXCAVATION IN P[JBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITAIN POBLIC
Q
NO ROADWAY" MLST BE ISSOED BY THE ENGINEERING
DIVISION
LIST AS
O
D
. A C
N
ITION.
SUBJECT TO THE FOLL OWING LONDITIONS:
APPROVED BY: /00-007-0
TITLE:
DATE :
lqv I.
2006 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB 120AD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residentiai dwellings.
?10'
ol C, w- v-
Date?
/?/
_
Site Street Address C'k'i'Yl Sof) Unit # 1"T
PrapertyOwner a\ C?,SSer 5 YY'1 I Telephone# (6-5I') 33U-?O`LQ
651"365-1340
Contractor. Sf70 C1oddRd. *100 Telephone # ( )
Address Eagan, MN 55123-1339 _ Ctty State Zip
The AppFicant is: _ Owner ?Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 16.00
Alteratians to existing dwelling $ 50.00
_ Add plumping flxtures. This fee inGudes ins[allation of a water softener and/or water
heater at the same time. lf you are installing on a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are insta[ling.
_Septic System Abandonment
_Water Tumaround (add $130.00 if a 518" meter is required)
,
Other:
,//W
t
r Soft
e
a
ener _ Water Heater $ 15.00
_ new ?replacement
_ Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .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 pfumbing codes; that I
understand thiS is not a permit, but only an application for a permit, work is not to start without a permR and work will be in
accordance with the approved plan in the event a plan is required to be reviewed and approved.
LobPa- ]AitD
ApplicanYs Printed Name
Signature
? p m 0 d I
AUG U 3 '2007
• al
B
TanZ � 4 yb,
Use BLUE or BLACK Ink
For Office Use
i I b°I33
~q of Eapn I Permit
3830 Pilot Knob Road Permit Fee: A
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 t I
_
Fax: (651) 675-5694 1 staff.
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1.6-11-IS Site Addrsss:Zq 1.5~.S9 , isy"1. molo ~~~1^ gn~`~•
Resident/ Name: L~n _ 1 t l ~4/n h r#m S Phone: (V-2- 721- 5* YD d
-
Owner Address / City l Zip:
Applicant is: Owner Contractor
Type of Work Description of work: ~,35°IS
Construction Cost_ 1 Mufti-Family Building: (Yes ! No
Company: S._ - ~T Contact: t 670eA
Address: r7 Q 3Z- M ianeYle City: Min wZL'S
Contractor
State: lam! - ~
Zip: d Phone: S6i - L Z- 556c
License 23e - 19 Z Q 2- 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
Me. ihformation may be classified as non-public if you provide spechic reasons that would perm/t the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 4540002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.gg ftrstateonecall.om
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 wit, 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 whin 180
days of permit issuance. r
X_ E/t'Za ieYA L- X
Applicant's Printed Name Applica s Signature
Page 1 of 3
RECEIVED
riXr
� JAN 2 0 2017
Gtlu
"Simply the Best for Less"
Window World Twin Cities
2211 11th Ave. E.#130 • North St. Paul, MN 55109
(651) 770-5570 • (651) 770-0495 Fax
Dear city of Eagan,
I am writing to you to let you know that we have tried to contact
homeowner, Karen Waldron, at 1545B Clemson Drive , permit number EA136321
numerous times to get the required smoke and carbon monoxide detectors installed
and schedule a final inspection with them. They havebeen unresponsive in getting
this scheduled. We are now requesting your assistance in getting this permit closed
out. If you have any further questions contact us at 651-770-5570.
Thank you,
The Window World Team
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use % %
Permit #: j / / < 7
Permit Fee:
Date Received:
Staff:
L
2017 MECHANICAL PERMIT APPLICATION
❑ Please submit��rtwo (2) sets of plans with all commercial applications.
Date: ?iJ—. , Site Address: f g L. 7f)/3446
Tenant: Suite #:
Resident/Owner
Contractor
Type of Work
Permit Type
Name:
�� Je /vie e
Phone:
0-7s-6sc.
Address / City / Zip:
Name:/�a^ 6!r'K.P•�' e License #:
Address: f �S 1 / -5 + •r Cit f /'' 1-44/ Cr�I7 " /j X -
Y
State: 04i- Zip: Sg077 Phone: 637- v1 a7- 3 9 s r
I I // �
Contact: c56 /411 (S 4� Email: h 6,T/ "6 117 0 Ma ell MCav''
New kiReplacementt Additional Alteration Demolition
Description of work: //'Ce a` a /Wife- e
NOTE: Roof mounted and groin d mounted mechanical equipment is required to be screened by City
Code Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL
)4urnace
Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under/Above ground Tank ( Install / Remove)
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge = $ TOTAL FEE
COMMERCIAL FEES
$60.00 Permit Fee Minimum
$75.00 Underground tank Installation/removal, includes State Surcharge
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge
Contract Value $ x .01
$ Permit Fee
= $ Surcharge
_ $ TOTAL FEE
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 wilt be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
P> L\ i 5 6Applicate),
Printed Name
x
x_
Applicant's Signature
FOIA OFFICE USE
Required Inspections: Reviewed By:
Date:
Underground . . Rough In Air Test Gas Service Test In -floor Heat Final HVAC Screening
Use BLUE or BLACK Ink
For Office Use
441‘a City of
Permit#: 'T�, /�JU� ! (� fir(
RaQaflPermit Fee: "l [ ,��i
C ,,
3830 Pilot Knob Road
RECEIVED Eagan MN 55122 E `E Date Received: —7/ !/ j
g - �
1/110
Phone:(651)675-5675
Fax:(651)675-5694 JUL 1 4 2017 Staff:
,�
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7//3/17 Site Address: IS 7, Unit#:
�j
Name: O N dT L- S /670,4vAnfrie Pho e:
Resident/
Owner Address/City/Zip:
Applicant is: Owner X Contractor
Description of work:j&p i
Type /Wr c
Construction Cost: 6Cy Multi-Family Building:(Yes )C /No )
Company: Ayr ^ :rely 2pe- Contact: Pii`umr
Address: /574)- 2 E. /4 - City: 190 Le ii9�t
Caractor ;;
State: iv/ Zip: 557J-if Phone: '7 WY6-Yfo/ Email:iftti-e9Afreo'friedtaY�'r'pstvs
1. License#: 6' 224f ZZ Lead Certificate#: ks-T F/1
If the project is exempt from lead certification, please explain why:
Alakv-0 41444 7971.
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:
Fire Suppression Contractor: Phone:
NOTE:'Ala;
the informer**
irleoft
.. ,! a gi,/.
9 ', ' _;rm,�r, ` .5 sr
v �
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.gooherstateonecall.oro
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 - e Building Code st be completed within 180
days of permit issuance.
Ado
x L iii.. fileyr x r
Applicant's Printed Name Ap Ficant's Signature
Page 1 of 3
1(54c aliAmcin
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family)
Single Family Garage Porch(4-Season) Exterior Alteration(Multi)
Multi Deck Porch(Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building _ Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation 3, 06:4E) . Occupancy -T 2C-3 MCES System
Plan Review Code Edition 04/4 Z015' SAC Units
(25%_ 100%? ) Zoning P,7> City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length v Fire Suppression Required
r
Type of Construction 13 Width Z
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) y Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: 7—T ✓)1 in; tit , Building Inspector
RESIDENTIAL FEES
Base Fee / • D'D 59- /4fi
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146555
Date Issued:10/31/2017
Permit Category:ePermit
Site Address: 1545 Clemson Dr
Lot:25 Block: 02 Addition: Thomas Lake Heights 2nd
PID:10-75951-02-250
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
David Moe
2843 Bridgeview Ter
Eagan MN 55121
(612) 790-8658
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature