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1560 Clemson DrCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1560 Clemson Dr Lot: Block: Addition: Thomas Lake Heights 2nd PID:10- 75951- 220 -01 Use: Description: Sub Type: e - Fumace & Air Conditioner Work Type: Replacement Description: Fumace & Air Conditioner Fee Summary: Contractor: Sedgwick Heating & Air 8910 Wentworth Ave S Minneapolis MN 55420 (952) 881 -7739 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $50.50 Owner: Michael Archer 1560 Clemson Dr Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 Issued By: Signature Mechanical EA076700 02/13/2007 ePermit Comments: Questions regarding electrical permit requirements should be directed to Mar k Anderson, State Electrical Inspector, 952- 445 -2840. Crystal Gemuenden 8910 Wentworth Ave S Bloomington, MN 55420 952- 881 -9000 Crystal.Gemuenden @ServiceExperts.com Final inspection required. I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State          ðîî  ÿ þýý  ðûðûü     úýý üïî ýþ ûëô ó ë  ä   þýö  þýüûúùø ÷  ò  ýûúù  ûúùø ÷  öø÷õùô   ùóý  ò ý òñíýùú ð  þïý î ôù ìô ëëô ïý  ô ü ô ê é  øøù ÿé é ô   ý  ùêòé é ùé  ê ò üôè   ïý üúø  éôúëô ê  îæñåæêê õú  þý ë  çýæñåæêäêä çýñÿê  ôó ö òñ ùù øòù ãöãë ë ääíõÚàòô   ãö ãö áàßä ë üúø ë ëì ë ùù ëëé ô   ôùúøëùùüþ éã þý òúé í  ê ùù÷  ôþ ý  ýúþ ý  CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: _ l, ft ? ,. , 1 i r+t'.??,! Il!? ! At i Ilf 1h1! 1 si 1hf1I PERMIT SUBTYPE: ',CORD PERMIT TYPE: Permit Number: Date Issued: Ntll[I 11 IN?I A;t6'i r . 0rrt/J?I ,,. . ..„ . a. 2-1 ni 0 r k APPLICANT: TYPE OF WORK: rictllr'NTPTItiiV I I I I,+IT tNC;', I I I f r NAt At fi RA,i' 1 tyN KF I4111 1 li iIF i t. ¦ Pamk No. Pwmk Holder Date TNephone t ELECTRIC PLUMBINCi HVAC Inspsctlon Dab Insp. Comments FOOTINdS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIHEPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG Wp DECK FINAL ".?": )WNHOUSS ) . sUILDING PERMIT T? L? rrJ ir ... .. r P (.i EX C1TY OF EAGAN oad, P.O. Box 21-199, Eagsn, MN 55121 PHONE: 454-8100 Recefpt # 7 .S . t vnl' i ?U-, .? ..?.. t: , ? :?L• Dnfe y 2. ---- - 19 Sits Addrea _. „ l,ot ' Block ` ?nub. Parcel No. ? Nwne Addrsis City Phone 42 C. - . _• . ? ,'? Name ? Addrost 1?- Citv Phone NMT1a , . ? ? ?. . _ .. . ? ... a a. Addras 1 hereby xknowledye thot I how rood this cpplication arn tF+e inlormotion fs conect and agree to comply with all Stah of MirxMSOta StotuEes and City. of Eoqon Ordinon Siqnotun of Pem+iftse A Bulldinq Permlt {s isswd M: 1_ f. ? Poll worlc sholl be dorM in actordonw with oll oppliaoble `. OuiWinp Officiol thQt E?eCL 0 OCCUpMiCY '.l.) I Rsmodel ? Zoning L i Repsir ? Type of Contt t Enlarqe ? No. Stories Move ? Length Oemolish ? Depth Grode ? SQ. Ft. . . .. ?-, Aueumsnt Water a Sew. Poliu Fin Eeg. Plonnwr Councll Bidy. Off. ` ?. ! . AFC Var. Dsta iees + Permit ` r (y ' Surci+or9t Plan Heview. {t ? SAC y U i Woter Conn. ? , il ' Woter Meter Rood Unit Total _ on fhe txprm tonditlon thot Cify of Eopon OrdinonuiL Pamit No. Pwmit HoMw Date TeIe hon? ?k PtumbinY F?i' ?` H.VA.C. 4 b`? 1 C-j,- l3 I EbcMc y sohem. (nspection Daa Insp. Other Footinps Foundation Framinq /Yla Rooflny Rou9h Plbp. Rouyh HVAC O S ? insuinio, Final Plbp. .g? 4 B / 3 Final HVAC Final CNt/Oee. Water Deseribe Loeation: IIMe11 Sawar Pr. Disp- ? a? Ropipt PLUMBING PERMIT Ponnit No. CITY OF EAGAN • Fill in numbered aacer ? TYPe or Prinr legib/y 1. Date 2. Installation Cost 3. Job Address Lot ; Blk. 4. Owner _ 5. Contractor 6. Address _ 7. City 8. Building Type: Residential ? 9. Work Description: New 0 10. Describe 11. Fm S/C Tot ? Trect Phone State Zip Commercial ? Add O Alrer O Institutional O Repair O No. Fixtures Water Closet No. Fixtures f C l D i Bath tubs esspoo ra n ield / i S k T Lavatory ept c an f S - Shower tner o W l Kitchen Sink e l Urinal/Bidet O Laundry Tray ther Floor Drains Drinkiny Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rouph Final Inspections: Date InsP. date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Rsosipt (IAECHANICAL PER'MIT Permit Na. ? ... CITY OF EAGAN • ? Fw F flll !n numbered spacss Type asr Print legib+ty ? ? ? ? ' -'l'ot, "i 1. Date 2. Installation Cost ? 'i. _ 3. Job Address ; Lot Blk. Tract 4. Owner 5. Contractor Phone. . 6. Address 7. City State Zip ? ? 8. Building Type: Residential Er Commercial 0 Institutional O 9. Work Description: New 0 Add ? Alter 0 Repair ? • ., : f . , ,? . - - ' " r 10. Describe Fue1:TYPe __ _ _ , ? ?% ? ! ?• ? 11. No. F.Quopnent 8TU - M. Ea. Forced Air - Na. Eauiament CFM Air Handling: Mf9• • ?- - - Boilers E Mfg. xhaust Mech. Unit Heater Mfg. Other Air Cond. ? Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : ? 1 ;, for Rough ? Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. ApProved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. 7? x CITY OF EAGAN Fss Fill in numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. Installation Cqst F?? ` 11'n 3. Job Addres's LotLALBlk. ? Tract 4. Owner 5. ContractorPhone ?k/1 3367 6. Address _ 7. City State Zip 8. Building Type: Residential ? 9. Work Description: New ? Commercial ? Institutional ? Add ? Alter ? Repair ? 10. Describe No. Fixtucss.-- ....,.,,,,..__.. Water Closet No. Fixtures ? Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner ShOwer We I I Kitchen Sink Urinal/Bidet - Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. _ Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 INSPECTION RECORD ? CITY OF EAGAN PERMIT TYPE: I 1 111 N6 ? 3830 Pilot Knob Road Permit Number: G1 Ea an, Minnesota 55122-1897 9 Date Issued: f (612) 681-4675 = ADDRESS: r or ? 24 fstacK , . r t ; 0- 11N dR i tlc:MA'• ?Ak.E FIL it,iii%' 2ND , APPLICANT: 4 n l:' 14 1:: 4u t) b!; (A PERNIIT SUBTYPE: I ; ,3,1 fiMryS E 4 ? ? ?' `e ? . ? . . .. ? ? .. .. . ? I TYPE OF WORK: Of:'yC:Rif'Y 1(?N F'tNA[ At TERArtnN I'll.n Vfr t PermR No. Pertnk Holder DMa Telephorn # ELECTRIC PLUMBING HVAC Inepection DaN Insp. Commonb FOOTiNGS FOUND FRAMING ROOFINd ROUGH PLUMBING PLBG AIR TEST ROUGH HEATW(3 I dAS SVC TEST INSUL GYP 80ARD FIREPLACE ' FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG ?O P7-i1j , /AJSp, DECK FINAL /?• ?(? ' ?& /f'r V ? F-i CITY OF EAGAN ^ ? 'r' . '? ??? , 3830 Pitot Knob Road, P.O. Box 21-199, Esgsn, MN 55121 PNONE: 4548100 s evILcrNa PERMn Rece+pt ? TO M wd le r i'• Esf. Va lue flat e 19 Site Addrem Erect Re Lot Block ?/Sub. model ? ? ? Qcwpancy Zonir?g T Peresl No. Repair ype of Const. Enlarge Move N? . D li h ? ? ? No. Staief Lengtfi th D ? eMO s Addrota Grade ? ep Ft Sq -_ s-- _.: k,•- 1....19 n . . Name ? Addreu Citv Phone D. GR Add?ess 1 hereby ocknowlodyo that I how reod this ap fFw intomwtion is correct cnd oyree to corr Stah of Minnesoto Stotutes and City of Ea Siqnotun of PermittN . A Buildinq Rern+lf is isswd to: ' oli work sholl be daw in acaordantt with oll Buildinp Officia! i_ Assessment Water & Sew. Poliu Fin Erq• PlonrNr Councfl Bldg. Off. APC Ver. Date FNs Permit $urthoroo Plan Review. SAG Water Conn. Woter Mehr Rood Unit 1' . Totai an fFN expnss conditlon thai Sfotutea ord Ciry of Eaqon Ordinoncas. Psrmit No. Pwmk Holdw Dsw Tef? hon? i? Plumbinq H.VA.C. (c o 3 c), C, lo Ebctric 1-01 ) ? ?Lw? so 4,0 '101 Softwwr Irnpsetion Date Insp. Other Footinpt Gi 7??•? Foundation Framiny g ? Roofiny Rou¢? Plbq. ? _ S Rouyh NVAC ? i ? Inwlation Final Plbp. - Final HVAC Fitial Grtf00c. wanr O"eribe loestion: YYell SevKr 'r. Oisp. Ree;eipt PLUMBING PERMIT Pnmit No. ? CITY OF EAGAN FM ? ffll in rwmbered 4pam S/C Type or Wfnt /egidY Tat. ?-- t. Date ' 2. Installation Cost ., ? 3. Job Address LI'-l.ot - Blk. Tract . ,. , 4. Owner S. B. 7. City 8. BuildingType: Residential C7 9. Work Description: New Cl 10. Describe 11. Phone ; , State 2ip Commercial O Institutional 0 Add O Alter ? Repair CJ No. Fixtures Watar qoset No. Fixtures ppl/D infield Cau ? Bath tubs p ra Se tic Tank lavatory p Softner -- ShOwer Well Kitchen Sink Urinal/Bidet Ocher Laundry Tray Floor Drains Drinkiny Ftn. Slop Sink Gas Piping Outleu 12. 1 heraby certify that the above information is true and correct, and I agree to ocmply with all ordinances and codes governiny this type of work. Signed : for Rouyh Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 4544100 I INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ?"" "' "O 3830 Pilot Knob Road Permit Number: "`0•''' l Eagan, Minnesota 55122-1897 Date Issued: 41. (612) 681-4675 SITE ADD , t. IjJWA :SS' ? . c i V-- i +a To a .. r. ? o ? I APPLICANT' • tc?T ; 22 tii.??r:h . !. I t M::;1)14 D17 LAkE NEl'611TS :ND tt+l.1) ?I'l.f?•nE,??+to RMIT SUBTYPE: I • ^i A R K `? : 1ti(..1.IqfS I TYPE OF WORK: k E"PAIR `31Ui146 l 1!.60-0 (1 fyl ;'3) 1r?hi"-•ti ( t i7 i.34 ) i: L F M"•i)N I114 . .i . i1 .I i.- . Y PBrmit No. Permit Hoider Dete Telephono N ELECTRiC PLUMBING ' HVAC ' Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL C3YP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL 5 tDiN rr -«•g , Y OF EAGAN Pilot Knob Road n, Minnesota 55122-1897 681-4675 SITE ADDRESS: , t I : a1r?a1V I?tf ,1;1194A?, i. 6i? f Hf i t+NT ;.'hIh SUBTYPE: I I F 1?4)rj PERMIT TYPE: Permit Number. Date Issued: ?.,.A - ....d-..1. ;?z e t nc * r ; APPLICANT: TYPE OF WORK: i?? .i t• ; i i ? •?r! f [hilil A1 rf aartrnN rehitt3.d docN ? I ? Psrmit No. WnnR Holdsr Data TNephone N ELECTRIC PLUMBING HVAC Inepaction Daft Inap. CommeMs FOOTIN(3S FOUND FRAMIN(3 ROOFING ROUGH PLUMBINCi PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FiREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG AIO f ? • ?IV'SP ? DEC1C FINAL ? ?- ' CITY OF EAGAN 3830 Pilot Knob Road. P.O. Box 21•199, Esysn, MN 55121 PHONE: 4548100 eviLoiNa PUMiT Re«ipt # Nama _ u? Addrep f- citv - Name _ Address I how reod this opplicotion ond ond agrte ro ca)mply wirh oll Siprwrun of Penniftu ` . ,? ... , N Buildinq Per»if is isswd to: dl worlc sholl be done in atoordonce with all euilding offiad ? ? ? ? ZOning P" Type of Cont _ No. Storise Length ' Depth Sq. Ft. Assesvnent Water a Sew. POlIG Fin En0• Plonrnr CouncN Bidg. Off . 2, ts 4 APC Var. Dste Permit + Surcho? ; ? ; 0 Pl8f1 RBVIBW . SAC WatarCax+ 'J l} . Wote? Meter .'J U Rood U?+it _, 7.D C 7 Total . . _ _ on the expross conditbn thar ro Stotures and Uty of Eopon 8?dlnonus. ?. _.?.. --...,._... Repair Pareof NO. Enlarge Move ? Nw^e . Demolish Add?ess t ? ? ? Grede PKmlt No. PKmk Holder pr" Tsls hone ?k Plumbirq H.v.n.c. Eleetric $oitemr Inxwetion Dota Intp. Other Fooeinip Foundation Fnmin9 9 Roofiny Rough Plbg. Rouyh HVAC eArs- 9 G L?. ( Inwlation Final P16y. Finsl HVAC F insl If A Crrt/Qoe. ? WaMr F ?ri? LOCati011: ftil ?1Mf Pr. D'ap. l Pilot Knob Road n, Minnesota 55122-1897 681-4675 RECORD PERMIT TYPE: Permit Number: Date Issued: tsk,I <0 ( N (; 63e j SITE ADDRESS: i a t: 23 1111.0 r° ?; K o APPLICANT: ; • , f , ; r,??,t+? Ojt F4 , . ' r? , t i I ! tt , t r4a,tq >k': tA F k 111 16 N i'i :rN p SUBTYPE: ? I F'm) I t TYPE OF WORK: r-oF'-, c R (I, t 1 a?ri F f NAi Al 1FRA'1'ION f?f'ttll11.11) f.1Uf.K -J .,.Y..? Psrmft No. Pem?it Holder Uata Telephona # ELECTRIC PLUMBING HVAC inspecUon Date Inap. CommeMs FQOTINGS FDUND FpAMINa ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FiREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG dRSAT 1'EST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG ?p ?E, , INe DECK FINAL ? ( • / (o • q? ? ? P UMBI E A P i N Receipt L NG P RR IT erm t o. ' CITY OF EAGAN Fse = Fill in numbered spaces S/C Type or Print legibly Tot. , 1. Date 2. Installation Cost 3. Job Address LotC-?q_Blk. / Tract 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? 9. Work Description: New ? 1 10. Descri be 1 11. Commercial Cl Institutional O Add ? Alter ? Repair O No. Fixtures Water Closet No, - Fixtures ' i Cesspool/Drainfield Bath tubs i Septic Tank Lavatory Softner i Shower Well Kitchen Sink Urinal/Bidet Other I Laundry Tray ' Floor Drains Drinking Ftn. Slop Sink Gas Piping Outfets I 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ( T4WNEiUIiSE ) , 3830 Pilot Knob eU1LDING PERMIT 1 UP 4 Site Add?su ? Lot ParcN No. _ ? Name Addre City _ Name ? Addro ?? City _ Name t W ' City Phone . ._, . , . I hereby ackncwiedqe thot I haw rood this applicction ond staM ehat tM in/ormotion is Correct ond o9ree to comply with all applicablt StaN of Minnesoto Stotutes ond Cify of Eogan Ordinonc,es. Sipnature of Perrnift« , A 8uildinq Pem+it is issuad to: dl worlc shall be dons in ocoordonts with oll oppliaobie Slme of Mlr Buildinp Officiol Blcek 1 Ser/Sub. CITY OF EAGAN ' oad, P.O. Box 21-199, Esgan, MN 55121 PHONE:454-8100 , Recetpf ? 1 Vwl. Erect bJ Qccupancy .<..: Ramodel ? Zaning ` Repeir ? Type of ConK. S Enlerqe ? No. Stories Mo?ro ? Length 4 `f OemOlith ? Depth .: ?- Grode ? Sq, Ft. AssessrtieM Wcter b $ew. Poliu Fin E+W Ploruwr Council Bldg. Off. ' APC Ver. Oste Parmit "" Surchorpe 0 C Plan Review - 5u SAC 0 0 Water Conn. 3 f Water Meter Road Unit ..'? Toal . , , on M+? expreu cadFtfon Ihov ? ond Clry of Eapan Ordinonus. P01111it No. Pwmft Holder DoM TNe hons ?k Plumbirp • H. V A.C. U G -Se C.k eieecric '7,;z SU Softemr Infpettion Date Insp. Other Footin¢ Foundstion Framino ? Roofing Rou9h Plbp. Rough HVA Inwlstion ? w Final Pibq. / p-TS Final HVAC ?i u) Final c«vooe. cy5 U! 41 Watn Doe?ibs locatio : YWII Smwr Pr. Disp. ? L Receipt PLUMBING PERMIT CITY OF EAGAN Pennit No. F.e ? Fill in numbered;paces S/C ' Type or Print IeylbJy Tot 1. Date 2. Installation Cost • 3. Job Address Lot - Blk. ' Tract 4. Owner 5. Contractor Phone 6. Address 7. City State 2ip 8. Building 7ype: Residential D Commercial ? Institutional O 9. Work Description: New 0 Add O Alter O Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Ce l/D i fi l Bath tubs sspoo ra n e d $ T ti k lavatory an ep c S ft Shower ner o W l I Kitchen Sink e Urinal/Bidet h O Laundry Tray er t Floor Orains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : tar Rough Final Inspections: Date Insp. Date Insp, This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 GEO. SEDGWICK H7G. & AIR COND HOUSE HEATING TEST RECORD Vent Size ' KIND OF LINER keguh Draft Hood Filters Size Numkk Chimney Location Insid???' Chimney Construction _n-- ADDRESS :? L U ? 1 r: Y`, •; u^ Or? CITY OCCUPANT. OWNER HEAT LOSS ?- DATE HTG. INST. SOLD BY INSTALLEO BY 'A Electrical Work By Gas Line By TYPE OF HEAT GA_ FA? HW_ STEAM SPACE HTR. UNIT HTR. OTHER_ GAS DE31GN CONVERSION MAKE ?'f?22 J MAKE OF BURNER Model GA7•-+.?o a? ?C oS'o Moiiel Serial & Q}9 ?S6UoZ Max. BTU Rating - --- INPUT MAKE OF FURNACE _ --_-- CONTROLS _ Heat Plug Value Limit C ° Limit Setting ?? 1 O °.e Fan Setting 'PilotType SPuf'k Pilot Make s r' c1c'u ? Pilot Model yo - Pilot Timing L.W. Cut Off "- Pressure -l S Percent COZ Input CFH ` J c- rf? Percent OZ Stack Temp. L) , y << ; ? ?,) % PercentCO ?- NONE ` ? Smoke Bomb Wiring ? Draft ? Test Tag " Door Pressure Lighting Inst. Date Tested Company Testing Name of Tester GEO. SEDGWICK HTG. & AIR COND. CO. HOUSE HEATING TEST RECORD ? ADDRESS ? > C?t.? f`? ? l ? M c? Q L3C CITY OCCUPAN7 OWNER HEAT LOSS DATE HTG. INST. SOLD BY ?? 3 13 1 7-L I? n2 n INSTALLED Electrical UUork By Gas Line By . x TYPE OF HEAT GA_ FA?, HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVEtt?101 MAKE (LC'?1r}ok MAKE OF BURNER_ Model (a16 Q1 - S U Model- - Serial S 88 SAl ! n 98 ? Max. BTU Rat?ig_---: INPUT S a v vU MAX-Etl9FURNACE CONTROLS " ' THERMOSTAT Heat Plug ? Vent 3ize '`-? Valve Cc;,A KIMD OF L111?ER Limit t) /-1; Draft Hood Limit Setting Fan Setting Pilot Type Pilot 114ake Sen Cc n'? "c ` s Pilot Model ? ? ' ??ti L ` ? Pilot Timing - 1-?'7 s741vT L.W. Cut Off - ? Pressure - -? --??- = - Percent COZ Input CFH Percent 02 Stack Temp. Percent CO ??- Fiiters Size Number Chimney Location Inside ''1 Outside Chimney Construction ' -` S _i ):,, Smoke Bomb Draft Door Wiring Test Tag Lighting Inst. -?Date Tested Company Testing Name of Tester (' J -? ? - • GEO. SEDGWICIC HTG. & AIR COND. CO. J,5 HOUSE HEATING TEST RECORD ADDRESS CITY CoJ: OCCUPANT ! OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY Electrical Work By Gas Line By .? TYPE OF NEAT GA_ FA ,X HW_ STEAM SPACE HTR. UI MAKE _ GAS DESIGN !- -~,"blox - WKE OF BURNER _ Model _ G I (I Q3 - s ?__) Model ---- - -- - ' Serial S 19 8 '; e U a 51 5 Max. BTU Rating INPUT S U OUO MAKE OF FU-RNACE ^ CONTROLS THERMOSTAT61^ ;I "', "i - Hea Plug Valve =oL rLC o n C.. Q?-l lr u ? S Limit ?- fi /Y1S I .4 7` Limit Setting dp o/_7 Fan Setting ! {-'• ? °? ? c S a .?. Pitot Type c ? ? Pilot ??ake n +'c.1 . Pilot Model Q?4 (- " 1 Pilot Timing 7 A? 7- L.W. Cut Off Pressure "y • c- Percent CO 2 Input CFH Percent O 2 Stack Temp. Percent CO Vent Size KIND OF LINER ` SIZE NONE Draft Hood `- F'^?• ?a ? 1-'' s. :. ? Regulator !J r? Filters Size Number Chimney Location Inside ? Outside Chimney Construction C. 13 '• !S Smoke Bomb Draft Door Pressure Wiring ? ^ Test Tag 5-1e' s Lrghting Inst. L K Date Tested 'r43 5 Company Testing r? J w ' v,?c f= •"S?.' Name of Tester Z, -GEV. StL)GWicK N I G. & AlnL,:AU. i;U. HOUSE HEATING TEST RECORD ADDRESS CITY OCCUPANT HEAT LOSS SOLD BY Electrical Work By OWNER INSTALLED Gas Line By _ TYPE OF HEAT GA _ FA y HW_ STEAM SPACE HTR. UNIT HTR. OTHER ? _ GAS DESIGN CUNVE?ION MAKE ;?> 7 , ' MAKE OF BURNER L ??, `-• - " ` ` Model y 94 ; f?-•.. j :a Model ., r v? Serial I4 d 60 Max. BTU Rating ?y - INPUT ? t! [) ( ) ci MAKE OF FURNACE CONTROLS THERPJIOSTAT v L? --' Heat Pfug -V` Valve Limit Limit Setting Fan Setting PilOt Type Pilot Make Pilot Model _ Pilot Timing. L.W. Cut Off Pressure > -^? Percent COZ ?' Input CFH Percent 02 Stack Temp. Percent CO ' -' 3 4 /Y_ '7 j F/bU A01 /I Vent Size ? 7ATt -.4-t- KIND OF LINER SIZE NONE Draft Hood . - a- ? ` '\L ti- Regulator A/ ? k- Filters Size _ Chimney Location Chimney Construction Number Inside Outside Smoke Bomb Wiring Draft - Test Tag Door Pressure Lighting Inst. -X Date Tested ? Company Testing Name of Tester ? • • . GEO. SEDGWICK HTG. & AIR GOND. CO. HOUSE HEATING TEST RECORD • ' - ? 4ADDRESS CITY ``. ? OCCUPANT OWNER HEAT LOSST- DATE I 50LD BY I INSTALLED Electrical Work By Gas Line By TYPE OF HEAT GA_ FA f HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSI?I MAKE r ` c' '? MAKE OF BURNER ? Model Model~-- Serial _ ?? p s ?' S?`r' Max. BTU Rating INPUT ? v O 0 MAKE OF FURNACE - Mnrlal ) CONTROLS THERMOSTAT T 44 3 Heat Plug ? Valve Limit S i pmc v Limit Setting a Fan Setting /,I E'ct Pilot Type ` "C r Pilot 11Aake Pilot Model Pilot Timing L.W. Cut Off - Pressure Percent COZ Input CFH Percent 02 Stack Temp. Percent CO - ? Vent Size KIND OF LINER _ Draft Hood '? ' NONE Filters Size Number Chimney Location Inside Outside Chimney Construction ? Smoke Bomb Draft ^ Wiring `. ? ?. `- Test Tag ' Door Pressure - Lighting Inst. Date Tested Company Testing Name of Tester 01?•?? 1?4,1 C'. • ?-. CITY OF EAGAN ?emarks 7S7S/ Z?D D/ Addition 'i'hsnmas La]r.e [ie3aht?Additian Loc lb AL aik ? J Parcel # o Owner st?eec 1560 Clemson Drive state Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, ul. $9 A012172 - 5-5 3 STREET RESTOR. GRADING SAN SEW TRUNK 97 ac,OU * SEWERLATERAL 3']6 i .52 15•05 A012172 5-5-03 WATERMAIN ; * WATER LATERAL 1981 WATER AREA STORM SEW TRK 3 * STORM SEW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PEFi. 02 SAC 525.00 PARK CITY OF EAGAN Remarks ?0%9SjS? - ;w-woAgo O/ Addition 'i'fiemas Lake HeighAddition Loi Weik Ak _/ Parcel #1O Owner street 1560 B Clemsan Drive State Eagan, MMI 55122 Improvement Date Amount Annuel Years Payment Receipt Oate STREET SURF. $ In.8 A012172 - -$3 STREET RESTOR. GFADING SAN SEW TRUNK 73 * SEWERLATERAL 1981 37.61 7.52 - $ 15•05 A012172 5-5- 3 WATERMAIN * WATER LATERAL 981 WATER AREA 7 ?J S70RM SEW TRK 249.91 A012172 S-S- 3 * S70RM SEW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT , $280.00 51992 5 22/85 WATER CONN. 500.00 11 BUILDING PER. 10265-1026$ SAC 525-00 PARK CITY OF EAGAN Rem,a?ks. , . Addition Themas Lake Height . ,?ddition Owner Screei 1567 C1pmgnn I)rive gtaie Eagan, NIN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 56 94 .8 A0121 2 3-5-53 STREET RESTOR. . I GRADING SAN SEW TRUNK 1 3 * SEWER LATERAL g 1983 37.61 7.S2 15.05 AM21Q --8 . WATERMAIN * WATER LATERAL . WATER AREA ? 5TORM SEW TRK " 37 249.91 A0121 P --$ * STORM SEW LAT lqRl CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 500.00 BUILDING PER. L0265-10268 sac 525.00 PARK CITY OF EAGAN 304 Remarks ZgEUc244 Oll - Addition Lot a ?W-Blk Parcel ?1 n Owner street 1562 R C7 emson D_rive 5tete_ Eagan. MIId 55122 Improvement Date Amount Annual Years Payment Receipt Dste STREET SURF. 279 71 55 94 5 ln. $9 A012172 5-5-83 STFiEET RESTOA, GRADING SAN SEW TRUNK 73.. -ig a,4,,,;? * SEWER LATERAL 37,61 7.52 1.05 AOM72 WATERMAIN * WATER LATERAL lqRl WATER AREA /9 y 7 STORM SEW TRK 9.91 A012172 ? 5-5 3 * STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CdNN, 500.00 n n BUILDING PER. SAC 525.00 PARK ,.,_ .. ., ,.. .. ._ _ .,n&-axv'r.i•:s-.w-.6--Y?i.ffsGr°ts,:.s_?,_.?s_._-<_.--'==_: - - - - CIT1F OF EAGAN WATER SERVICE PEItMR 3830 Pilot Knob Road 6260 P. O. Bt,x 21199 PERMIT NO.: Eagan, MN 55121 D/?TE: 6-6-85 2n,im- R3 No. of Units: 1 of 4p] Px New Horizon Homes, - Slte A N b ddress' r 1=U T IIDmpson Plg um e . e: 500 . OOPd ction Chor C Meter No.: y w+ne Acoount Deposir: 15.00 pd Reods No •.11 ), Permk Fee: 10.00 Dd _ I .,m e ro own* .uh a. cnr of ag.. s?,,aroo: . 50 pa Mi? ?? 132.00pd S/C Total: 63.00vd metei Dats Paid: Dote of lnsp.: l^sP•' O - - ? CITY OF ZAGAN SEWER SERVICE PERMR 3830 Pi1ot Knob Rosd P. 0. Eax 21189 PERMIT NO.: `Eagan, MN 55121 DATE: Zoninp: No. of Units: _ f+ x'?:.t•;' _ Ownsr: ' ? - -'"• Address: - - SiM Addrass: 1370 C'? aovnaG Lake Ruts_ Plumber. ?,`.. _ : t u1{? , 'v ?.? I prM t0 ess* wilh !!N G!p of Eela¦ COnnlCtiq1 CFIOroe: ormuseas. Atasunt Deposih Permit Fee: ` 5urcharpe' By Date of Insp.: lrisp.: Misc. Charyes: Total: Date Paid: CITY OF EAGAN WpTER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 ??? ?.: b258 Eagan, MN 55121 DATE: 6-6-85 Zonirg: R3 No. ot Units: 1 af 4 plex pw„er; New Horizon Homes Mdrea: Sit, Addma; 1560B Clemson Dr. Le B1 Thomas Lake HRts. pl„r,ber Thompson P1bQ 500. OOvd Meter No.: 3 C«,nectlon Q+args: Stu: i?/`T ' Aoo,w+t oepostr: 2 S.00 vd Reader No.: Q?W1 g9 F?l Perrnit Fae: 10.00 Dd _ t.fw eo eewyy ..ifL e6. c.ier .f ag.¦ surd,a?fls: .50 ud OnoMna.. Mtm pa,oss; 132.00pd S/I Totol: 63 (1(1p ma+ g ? Dote Poid: Dote of 1 '°'' Irop.' 'o/IS/g5 No.. /o eanply MMb !IN City of Gyow Connection Charpe: 1lccouM Depostt: _ Permit Fee: Surchargs: Misc. Choryes: Totol: Dote Potd: OF EAGAN SEWR SERVICE PERMR . Box 21199 PEkasrr NO.: Eagan, MM 55121' DATE: Zoninp: Na af Units: . i e;? Owner. ??t.;•,c _ ,.t-: ? Ilddress: srte Aadross: i.2 i ? 1 TiYOm.? s Lake Plumber: •, - , I yn? fs aou?Pl?r willi ll?e Cihr ef apm Corw?tdlon Charga: OeJlMnaa. Aeoount Depasit: _ Permit Fee: Surchorpe: ` BY Misc Chorpsa: . _ , L?ote of Insp.: Tatcl: {?, IMP•' Date Paid: TY OF EAGAN WATER SERVICE PERMIT 30 ?•11ot Knob Road 0. Box.21 199 PERMIT NO.: gan, MN 55121 D/1TE: ninp: 3 No. oi Units: ? oc 4'plex ...?.. . :.`Se' 4 .i..-;i? Addrcss: 1560B C1emsau Dr. L2? 3?}. "'htm±as2Lake ?!gts. CITY 3830 Pitot Knob Road P. O S. CITY OF EAGAN WATER SERVICE PERMIT ` 3830 Pilot Knob Road • P. o. Box 21199 PERMIT No.: 6259 Eagan, MN 55121 DATE: 6-6-85 Zonirg: R3 ?, ? Uni? 1 of 4 plex pw„wr; New Horizon Homes Addrsss: Site /ddrem 1562 Clemson Dr. L21 B1 Thomas Lake Hgts. Readsf No.: -IO ZYl ZD ra , 44_ I prw to aanoly whh tM Ciyr oi EMyPw O?diM.or. gy Date of Insp.. CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Rcad P. O. Box 27199 PERMIT NO.: - Eayan, Mk 55121 D/1TE: 6- Zonirq: t?? No. of Units: { c, ? != :? ; pw,,.,. f';,ri.r.r?n Homes llddrosr Ska Ndd.eo: 1562 Clem.,:-cr .;r . L" 1 -' :"zsmr:.a.s ' I.a}.e ? 4. *hnmpanci Plumber. 1NeNr No.: Cannsctian Charpe: ?? U•«4? c? Slze: Acoount Depwtt: 1- * Readfr No.: Pem,it Fee: '?"? 1elM to ee?al Wilb 1M Ghr oF bww Surcharps: OwI...a.. Ivusc. G,oross: 132. 0 i pi? S i C Total: 63.00gd ;r.eter ey _ Date of insp.: Aowunt Depoatt: 15.00 Rd _ Pennit Fee: 10.00 Pfi_ Surcho?ye: Mix. Chargm 132.00p S C Taoi: 63.00pd mete: Date Paid: Date Pofd: )F EAGAN ?m suiv" PERM ilat Knob Road ox 21199 PERMIT NO.: MN 55121 pATE: , - ? Na of Units: ? co? 4- 7 'T t . • u- E.= Address: ,ib"14' Clcmsc,n Dr. L?i F1 Thomsa Laoe Aooount Oeposit: 1 ? - ?j?i r, ?-' Prmlit Fee: SurcFwryt: Misc. Choryss: Date Pold: E. Date of Imp.: Total: CITY OF EAGAN 38s`a Pi:ct Knob Road P. O 3ox Z'S' t98 Eagan. MN 55121 ::onirq: 2 Owner: : ? °.• ; 10 Addross: Sft Addross: Plumber. i' i ? otnn Mehr No.• . Sixe: ? Connecn.on 500, 0 rJ ., ,AoooMrM , 1 5. U0 Permit Feo: 10.00 c Surdwrpe: '' p c Nuw. c.r,orgm s !C Totoi: Dote Pofd: rii'_i+ t,oZ QII }t0 8 ddre?: i?C: 3JI1 ; ? ?? T p•a ir. No.: ConnectFon Chorg@: Aeoount Depoalt: No.: Permit Fse: ? to ee?pof wub !Iw Citi oi !e"" Surchorqe: .: .. 04M Misc. Chorpes: Totcl: ? Date Pcid of Irap.: OF EAGAN Pilot Krob Rosd liox 21199 1, MN 55121 -•----?- l Nm N ae"* wili !M CIly w mww Connectlon C]wrpe: ?2'? •????? QrdiMma& Account paposit; 13. JO yd PrrrnR Fw: ' ? ---) r c11 Surchorpr. . -50 .25j BY Misc. Charoas: Date of Insp.: Total: I ^ap.: Qoh Pald: WATO! SERVICE PERMIT 30?i"'p PERMIT NO.: ' DATE: ' - - ? No. of Untrs: 1 o f 4 p] e} SEWER SERVICE PERMR PERMfT NO.: . D/1TE: No. of Units: Rsad.W No.: t , ? .< 1 qn* te is- olp wllr /M W", ora...e.s. Tht55.e4ves?.wI tl 16 lhs?(mm 6n?9??? L ?,3 i r Request Oate fve No. itough-in Inspectfon 8-1-1985 '-qO1e°z ?ReadY Naw][? 1or'IWh¢o'Readspec- X$Yr.s rI Nn V 3'j[ Gcensed Electncal Convactor 1 herebY requi inspectmn of abova ? Owner elec[ncal wmk installed et SVeet Address, Box or Route No. C.1v 1560 B Clemson Drive Eagan ecuon o. Townshi0 Name or No. pange No. Cwnty Dakota Occupant (MINT) , Moor, No. NEW Horizons Power Supplier Adtlress Dakota Cty. Electric Farmi.ngton Electncal Contractor (COmpany Name) Coaihactor's License Na_ O.B. Thompson Electric Co. A40602 Mailing Address IContractor or Owner Making InsWilatfonV 12201 Mtka,Blvd., Mtka 55343 Author{zed Sienamre (Contrector Owner Making,InstallaiionlP . PM1one NumOer 933°2621 MINNESOTA $TpTE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILI NOT Grigqs-Midway BId9. - Raam N-191 BE ACCEPTEO BY THE STATE BOARD 1821 UniversitV A,ie.. St Peul, MN 65104 UNLESS PROPER INSPEGTION FEE IS PMm 1612) 297.2711 ENCLOSED. . REQUEST FOR ELECTRICAL INSPECTION %? Ell-000011 -94 ' See instruebons for campletifg [his inm m baek of yellow eopY. ? LI, 9 71l?. G)lf a,q (""X" 8elow Work Covered by Thrs Request g Gt rj kwilAddlReP.1 Tvoe ot 8uilEma AooliaMea 1rired EquiDmem Wired ex Butk Mi p Fee ServiceEntrBncaSiie # Fea Feeders/SUbteeders # Fee Cimuits to 200 Am s . 0 to 30 qm 2.00 0 tn 30 Am Above 200 qmps 31 to 700 qmps 31 to 100 An4is Swimmin Pool Above 100_Iknps Above 100_Am - Transformers Irtigation Boorrs .$0 Pattial-'Other Fee aigns apeciaiinspeciion w Re"rks 543.00 TOT0. EE ? ?.? House Rouph-in Date ? a EI ' Ir- ? / J S"/ / ? Inapecbr. ?ereby Wrti1y lhet 1M above Final Dnie gction has bcen Y t 6^40^ OOAB. T" repuesl wla 18 montm tmm This request wid c? K 18 B Tqh?95 ?? L` SD Pequest Date Rre No, pough-in laspecuon ??s? Repu red? ?ReaAy Now ?A'll Notify. -8-1-1985 [7?7[es ?No tor When rteaAy }d,? Lroensed Electrical Conlractor 1 herobY FQOuest ineDection ot above ? Owner elecVical work iratalled at Stieet Address, Boz or floute No. , CitY 1562 Clemson Drive Eagan er.uon o. Township Name or No. flanBe No. Coonty I Dakota Occupan[(PRINT) Phone No_ New Horizons Power Sup0lier Adtlress PEH Dakota Cty. Electric Farmington Electricai Cnntractor (Companry Name) . Caniractor s License No. O.B.Thompson Electric Co . A40602 M.,lin8 Atldress (COnVactor or Owner Making Irelailationl 12201 MtkrE%Blvd., Mtka 55343 /-? Authonzed Signatuee ICbnttactor/Owuer Makirq Installa[ipf Pha N er ' §32521 ? THIS INSPECTION flEQUEST INILL NOT MINNESOTA STATE BOARD OF ELEC7RICRY gE pCGEPIED BY THE STATE BOARD Griggs-Mitlwev BIAe• - poom N-197 UNIESS PROPER INSPECTION FEE IS 7821 UniversityAVe.,St. Pau1,61N 65704 Phnnw 16121 297-2111 ENCIOSE?. .REQUEST FOR ELECTRICAL INSpECT10N EB-°°°°''°° ?j g ' See irtatruetims tor mmpletirg this torm on 14ck of yellav cooY. 4 J 17 9 J f%? ?'"X"" Be/ow Work Covered by This,Request 5 P104Addl Aeo.l Tvoe of 6uiltlino 1 Aootiance. Aired 1 Epuipment Wired 1 ex 1 I Water k Fea ServiceEMfanroSize d Fea Feetlers/5ubfeeders M Fee Circmts q • to 200 qm 5 (b 0 to 30 q 0 25. 00 0 to 30 Am Above 200 qmps 37 m 100 Artips 31 to 100 q Swimming Pool Above 100_Amps A6ove 100_Am{n TransPormers Irrigation Booms Partial.'Other Fee Si gns Specia l Inspection Remarks 5 43.00 TOTAVFfE? House flou0h-in ? : ile D . he ' 7 I'rspectoq herebv J cenity thax the bove final / ?e O ? ' pKtion Ims been ?? ? . TMS repuest vol018 months irom ?C/ lUt This requ?est?void 5(? Pl ?' y i. ? ? al ??r?f?+ i lJ ?-?- `? ?'? I?,? r 1_k !-LS .)- Request Date Fire No. Rouph-in Irececlion ?9u?red? []1leatly Now?Will Notity I?p¢c- 5-1-1985 " J?res ?No 1a1 wne? xeaev Ej[Licensetl Elec[rical Contraclor I lymbv reOresi insPec4m of above ? Owner elec4iml wort incemlled aC Streex Atldress, Bax or Nou[e No. Cip 1562 B Clemson Drive Eagan ecuon a. Townshi0 Name or No. Counly 777 Dakota Occupant(PRINT) Phone No. New Horizons Power Supplier pddress X Dakota Cty. Electric B]p,FdX'mi.ngton ' ElecRical Convactor MOrtapany Namel Cm[ractor's License No_ O.B. Thompson Electric Co., Inc. A40602 Mmllog Address (Coniractor or Owner hlakim Inrsrstaila[im) 12201 Mtkaoffi ? d Mtka 55343 ?. Authwized Signawre/ ontraclar/OwnerYekinp Msmllatiqil f MOne NivMer ?r n f• s9 I 933-2a29 U? ? ??J MINNESOTA STATE BOARD OF ElEC7RIClT'/ TN15 INSPECTION RERUFST wILL NOT Griggs-MidwaY Bldg. - R. N-191 0E ACCEPfED " 1HE STAIE BOAND 7821 University Ave., St. Peul, MN 55104 UNlESS PROPEN INSPECTION FEE IS PMm 1672) 29]2111 ENCLOSED. IEQUEST FOR aECTWCAL INSPECTION % Ea-0aaot? , Sae imtruetions Ior aomobii.g N.:s fam m 6nek of yellor ?4 9 79 fj rjt{??1 ("X"" Be/av Work Covered by 7his Request ?SI ?} ?AdC Reo. TvoeolBU.Mina AooliaKnaMiraJ FA.iomentaired HecViC N Fee ServieeEntrenca5ize p Fee Feedcrs/SuEfeeders k iee CimufN UG • to 200 A s 0 to 30 A 0 to 30 Am Above 200 qmps 37 to 100 Amps 37 to 100 Anrds Swinmin Pool Above lIXl_Mips nqts Above 700_P? Transiormers Irtiption BooRS ,50 PaniaL'Other Fee [ I . . . [$igns jSpecial Inspection iS Pemarks 43.00 TOT FEE ) °..,.,.... - /?/,2 '?'D flou9Min Date , ?he cv' I?pecra. hereb, ih tlrl ihe abnva Finai ? 1e [Aa .?,?.:a.. bs a.. ?ae . ,M.??t Vold 18aX)0,hSfmm ( 56,q,)_ 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan , 3830 Pilot Knob Road, Eagau MN 55122 Telephone # 651-675-5675 Please complete for. single family dwellings & townhomes/condos when pcmuts aze required for each unit P:ta? 3z).0 Date V / L? l yr"? SiteAddress 1560B CLEMSON DR Unit# Praperty Owner pF.(; TH()MAS Telephone #( 651 ) 994-11097 Contractor RON' S MECHANICAL, INC. StreetAddress 12010 OLD BRICK YARD RD Cityl, SHAKOPEE State Zip 55379 Telephone# (952 ) 445-8585 Bond #: Expires: The Applicant is _ Owner ? Contractor _ OWer Add-on or alteration to exis[ing dwelling unit $ 30.00 furnace _Additional _Replacement , air exchanger ? airconditioner _New _KReplacement other ' Stxte Surchargc Q ? a ?? 0 ,L'i ?t $ .50 A 'fotal $ ti^-? • ? ? .. sy I hereby apply for a Residential Mechanical Pemut and acknowledge that the informarion is complete and accurate; that the work will bc m conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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., l-ink `Ter nanc4e r Applicant's Printed Name Applicant's Sign e L_0 f C?? BUILDINC PERMIT APPLICATION .?' CITY OF FAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651•681-4675 New Conatmctfon ReaWnmaMf . 3 registered site suroeye showirg sq. R o11aC sq. R. o( tause; and aA roWed areas (20% matMum IM coverage allowed) . 2 wpies of plan shaxing heam 8 wmd(yw s¢es; poured faund Aesign, etc.) . i set of Enertgy CakWabore . 3 rnpies of Tree PreservafiGai Plan if lot plalled aRer 117A3 . Rim Joist OetaY Options selection sheet (bitlgs wrth 3 or less unRS) DATE SITE ADDRESS TYPE OF APPLICANT t? E:Y? MULTI-FAMILYBLDGtkY _N _ FIREPLACE(S) _ 0 _ 1 _ 2 ?__7 STREET ADDRESS CITY?STATE )N?IP S sy I ?I TELEPHONE # ea IZ -`6bi` - CELL PHONE # FAX # Wa- Vot- 6ab-7 4a41 -eoCa.%\S% ? 7?S$ PROPERTYOWNER -/°7U?"??. ???5 ? ??? TELEPHONE# X3- ""----..""""'-'-'-"""------"""""""'-?-a ' "'-'---""""""""' COMPLETE THIS SECTION FOR "NEW" RESID T AL BUILDINGS ONLY Energy Code Category _ ti[INYFSOTA RULES 7670 CATEGORY I MINNFSOTA RULFS 7672 (J submission type) • Residentlal Ventllauon Cafegory 1 WoAcsheet Submdted ?• New Energy Code Worksheet Submitted • Energy Envelope Caiwladons Submitted Plumbing Conhactor: Plumbing system includes: Mechanical Contractor. Mechanical system includes: Sewer/Water Conhactor. _ Water SoFtener _ ` Water Heater _ No. of Baths Air Conditioning Heat Recovery System Fee: $90.00 Phone # Phone # i ------------------------------------------------------------------------ I hereby ocknowledge that I have read This application, state that the informoTion is ?arrscl.and agree-to coa- ply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ` Signature of Appllcant OFFICE USE ONLY RamadallRewG ReauinmeMf ? 2 WDirsof Atan I . 1 set of Eneryy CalcWatiorw tar healed addilare • t sde survey fw ezterbr adaitiais a decYs . Indicate A home served UY septia epstem far add'dbm VALUATION /,S 77 7, Phone # , Lawn Sprinkler No. of R.I. Baths Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4102 ,\\ X 9az.z ZMSpN °RivF ? 4 ? !•\ p n????,? 0 `No 3I 00 N ?t 0 p ?-•'--? i O £ / 16- o N > N O ?W O O N ?/= S / .O tl ?' ?? OO `, ? \ 1+,1 5po D` ( o V O Denotes Iron Monument a Denotes Wood Stake X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation= (000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation=937.5 IF--- Oenotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 938.0 I hereby certiy that this is a true and correct representation of a survey of the boundaries ot. Lots 21, 22, 23, and 24, Block 1, THOMAS LAKE HEIGNTS 2ND ADDITI01, Dakota County, Minnesota And of the location of all buildings, if any, thereon, and all visibie 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 25 day of APril 19 85 Paul A. Johnson ! gellI Rev:sed 5-9-85 Chonqed Lof 23 fo 96 W/o Lend ? McCOMBS-KNUTSON ASSOCIATES, INC. roNwunG tautut n wo tuerttou w snl rwIM WMMEIMOLR W WTCMIWDM,WMYEiOTA 7430 Minn. ReA. No. CERTIFICATE OF SURVEY - fior ? HOROOi\ HOW5 T, 7985 BUILDING PERMIT APPLICATION - CI7Y OF EAGAN NOiE: ALL CON7RACTORS MUST BE LICENSEp SIITH TRE CITY OF EAGAN TowµN«.«E UNIT INCLUDE 2 SETS OF PLANS . 3 CERTIFICATES OF SURVEY > 1 SET OF ENERGY CALCULATIONS To Be Used For: RESiDft/CL Valuation: Date: Site Address: 0Jp4 SaA & OFFICE USE ONLY ? Lot: aLl Block j Sect/Sub Zje~A[, Er. Erect X Occupancy R-3 ?fN03 Remodel Zoning PD , Parcel 0 Z r Repair _ Type of Const S? Enlarge 0 of Stories Owner s Move Length 44 Demolish Depth 2"1 Address 100. Box_ 131#7 7 Grade _ Sq Ft , City/2ip Code Z-4 EIr. /l7.,v.?. .TSyf/O ' -------------------------- ------ Contractor s,¢,,,ff- Address City/Zip Code Phone $ Arch./Engr P. cR,swoLd Address Phone # 413.r- 7S2y APPROYALS Assessments Permit Water/Sewer Surcharge 29 °= Police Plan Review I 53. Fire SAC 5Z5 °° Engr Water Conn SoC>.S' Planner Water Meter Council Road Unit 280. V Bldg Off ? Parks APC Treatment P1 132 = Variance o i 4?• 5 Z) / r rn . / (TOSaNxousrt) CITY OF EAGAN ' , No_ 10267 , 3830 Pilot Krab Road, P.O. Box 27•198, Eagan, MN 55121 PHONE: 4648700 <-/ Gf y'L_ BUILDING PERMIT Receia # To b. ,n.e f,. 1 OF 4 PLEX Est. Vcd,,, $58.000 pate MAY 23 , 19 85 Site Addrm 15625 CLEMSON DR ereec QC oca,pancv R3 `°` 24 Bbek 1 S THOM LK eclSub HTS 2NDR°m°ael ? 7Aning PD . A?,r o TY? ? ?n.t. %7 Parcel No . Enlarge ? Na.Staies Mme ? Lengtn 44 Name NEW AORIZON HOMES INC Demolish ? Depth 27 ? Add,e„ P.O. BO X 1367 G.ade ? su.Ft. cny MPLS p?ne 420-39 00 inmil ? SAME Neme -..,.._._.. ? Address Assessment City Phone Wahr 8 Saw. Name D. GRISWOLD Police Fi W n I? Addreu Erq. ciri Phone 435-7524 plarww, Cauncfl I he'eby ackrowladps thot I hova rcad fhls application and irote 1Fat Bldg. Off. 5/22/5 S fhe inlormotion Is corcect and ogree M camply with oll oppliwble Sroro of Amnnesoto Sroruej!?City of Eagon ?ncat + '? Var. Date 51{pnoWm of Peimitta?X /o?---.? t w 8uudiny vemir is iswed ro: NEW ] dl work zhall pe doro in xcordance with all hu Permft ?307AQ Surc1,,,y, 29.00 PIm Raview 153. 50 yAC 525.00? WOfRIcOM. 500.00I WaterAAeter 63.0 01 Raad Unit 280.00 '9,p . 132.00 7otal $1, 989. 50j _ an tha exprou eadfebn ihot ord Gry of Eaqon Ordlnoncea BWINnp Offkid 1985 BUILDING PERlSIT APPLICATION - CZTY OF EAGAN NOTE: ALL CONTRACTORS HUST BE LICENSED 1{ITH THE CITY OF EAGAN TOwiJ NOUSt, ' `I Q INCLUDE 2 SETS OF PLANS UN l j 3 CERTIFICATES OF S URVEY - 1 SET OF ENERGY CALCULA TIONS ? ? To Be Used For: _ pF vw Valuation: c,Q Date: I(o Site Address: Is(ao Qjfirncn ri i IF OFFICE OSE OHLY Lot: 22 Block _L Sect/Sub o,.H. Et Erect ? Occupancy (?-3 HC?J'Sy3 Remodel Zoning pp _ Parcel 0 ?L N? Repair _ Type of Const SL Enlarge 0 of Stories Owner /tilo."1 /,?o,¢?zo,? ,?/onsrs Sv?. Move Length Demolish Depth 27 Address Pp, Bo x_ 131#7 Grade Sq Ft _ City/Zip Code ZU O?r. a -------------- ----- -------- ----- Contractor APPROYALS Address City/Zip Code Phone # Arch./Engr p. GR?s")oLd Address Phone 4 813,7-- 7-'r2y Assessments Permit °? W1 Water/Sewer Surcharge ea Police Plan Revieu g' Fire SAC 5Z5,°° Engr Water Conn 500. °-° Planner Water Meter (9,?, °° Council Road Unit Z&3, o_o Bldg OffS r z Parks APC Treatment P1 I-2iZ. Variance ro S d / yf y rnL . , , fTocar,?14 i,ssj 4 58 SittAddreas 1560 CLEMSON DR Erect g] pca,pency R Lot 22 elxk 1 e.ySub. THOM LK HTS 2ND Remadel ? 2oning PD Parnl No. Repeir ? Type of Conrt. V Enlarge ? No. Staries ? N=, NEW HORIZON HOMES INC Move 1:1 Length 44 I A?? P.O. BOX 1367 DB"'ol'?' ? ?utn 27 ? cky MPLS pnone 420-3900 Grade i ? ? ? Sq. Ft. l nzta ? Name SAME Avaro.a4 Feas ?u VSp ? CITY OF EAGAN (?Ja 10265 3630 Pilot Knob Ro?, P.O. Box 21-199, Eagen, MN 55121 PHONE: 4548100 BUILDING YERMIT HeCe1a Addren Phone jW Nema D. GRISWOLD x? Addresa u I(W iCitY Phone 435-7524 Assessment Woter 3 Sew. Police Firo Eng. P r CouMil I hereby aekrowiedpa thot 1 how rcad this eppliwtion cnd stote thoi Bidg. Off . 5 22 85 the inlormotion h correct and og e ro comoiy with all applicoble A? Stob of Minnesoto Stotut ify of qon OrdirqrKe3, Var. Date , $ipnaturo o( Permiltea w eutlduq venncr is iswed ro: NEW HORIZON HOMES INC oll work sholl be dona in accordanee wlth all oppl bla Sfota?6f??Ml nneson I BWIdinO Offklol Permit + ?. 00 5,,,cha,y, 29.00 Man Review 153.50 SAC 525.00 Water Com, 500.00 warar AAerer 63.00 Rood Unit 280.0O T.P_ 132.001 Total 1, 989 . 0 1 an tM exPmu corditlon thot Srotures ond City of Eopan Ordirwnces. .. ? 1 4p a a6 e 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONiRACTORS NUST BE LICENSED WITN TF1E CITY OF EAGAN ToW t-l NouhE L?N l T ??o INCLUDE 2 SETS OF PLANS , 3 CERTIFICATES OF SURVEY /I 1 SET OF ENEftGY CALCULATIONS (o F ?t Fa Coo- !e To Be Used For: RFS.ofvc.t Valuation: _ Date: 16 -Mg4 85 Site Address: 1$(„p$ 9f„Mcnn Lot: -2.3- Block j_ Parcel Q OFFICE U5E OM.Y Sect/Sub 7"y,o,,,,,.? ?EtErect ?Np rS Remodel Z ? Repair Enlarge X Occupancy fL-3 ` Zoning p p _ _ Type of Const 6 of Stories _ Length _ Depth u, _ Sq Ft Owner N° ") //oRizo.? f1o.?,es 5,.?? Move Demolish Address _ PO. $ox_ 131y7 Grade a City/Zip Code ` ------- Contractor s,Q,,,ff- Address City/Zip Code Phone 0 Arch./Engr _ p. G2PsWoLd Address Phone 0 y3S 7.0r2y APPROVALS Assessments Permit 301. °= Water/Sewer Surcharge ZS, Police Plan Reviea I SD.SD Fire SAC 525, Engr Water Conn SCo. 09 Planner Water Meter c03.°= Council Road Unit 280,°-` Bldg Off?zL Parks APC Treatment Pl 132 '° Variance ? y7?, S o iorAL ? _ ( TOWtei:Ot1CF. ) CITY OF EAGAN N 0- 10 2 6 8 3630 POot Knob Road, P.O. Box 21-199. Eagan, MN 55121 PHONE: 464-8100 ) cy 9 BUILDING PERMIT 1 OF 4 PLEX RCCeipt # e $56,000 p,r, MAY 23 ly85 1560B CLEMSON DR ? ? ?p"?' R3 S?? THOM LK HTS 2NDpe"'°d°i ? 2 3 1 Z°"i"9 pn ? gy?{ c.y-le. b. pepyr ? Type of Caut. y Pe No• EMarge ? No. Stmia NEW HORIZON HOMES INC MO1e 0 ungn 44 I I ?c Nm?e Demolish ? DePih 26 , ? pddraSS •. X Grade ? sa. R. crty rnwm 420-3900 lmraii ? ? SAME ' A°°'°'°b ti°' ? Nema . AssessmeM Dermit 301. ?u ? ress Woter 5 Sew. $urcFnrpe 28.00 City Phone ? 0 • S O n Review Pl Police _ a D. GRISWOLD Firo 5AC 52_9-00 Nam ndd Erq Woror Ca?n. ?0 0 rew x3 W C? p?m 435-7524 . q? WurerMater 63.00 i Carndl aoca UNr 280 _ OO 1 Mmby aekrowledps rtwt 1 hova mad thts epplicotan ord smte thoe Btdg. pry. 5 2 2 8 5 T. P. 132.00 Nr inlwmation is conect and o9ree b camplY with al l appliwble APC Totnl $1,979. 5 0 rdiwntac O Sroh of MimKSOto Stotutes(d Gry of Eagon V r Dah ? / l . a ? $ipnofurs of PemrffN ? ? A Buufirq Ponnct is issued ro: N an tM a?res? conduwn thot dl work shall he done in aocordonrs with dl applimbh ,§14te of Mf ? ?StatWft md OtY of Eopan OrdinanceL BWldinp OffidW ?1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOiE: ALL CONiRACTORS MUST BE LICENSm 1TZ?H THE CITY OF EAGAH Tol..1N l-Ic)rjSe u" iT 69 I oF ¢ To Be Used For: ??s.oE?uL INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS Valuation: ? Date: ?to O? Srj Site Address: 15(02 Uf&nS07t _bk? Lot: 2? Block Parcel 0 OFFICE USE ONLY Sect/Sub L.*,Ft- Erect )C Occupancy Q-3 ?ti(dsys Remodel Repair Enlarge _ Zoning pp , _ Type of Const _ 0 of Stories _ Length q-? _ Depth 21 Sq Ft Owner Np .) ?t,lo?¢izc,? f,ln,"es S?e.. Move Demolish Address PO. eox. 1367 Grade ? City/Zip Code -...... Contractor s 9- APPROVALS Address City/Zip Code Phone A Arch./Engr V. GK?scJoLd Address Phone # y3.r- 71-2S/ Assessmeats Permit Hater/Seuer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Off r? Parks APC Treatment P1 Variance iOTAL _?Q7, !5? I r73, so 525, °° r ,m 132.°= 9fy5 p =VIP , ,- ? , ?- ?/ _ ??? 3. ? 0 ?? ( TO iIN FiOU SE) CITY OF EAGAN No- 10266 ' 3830 PiIM Knw6 Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 4548100 RKe+w # S" i y 9y- Te 6e mwd f« 1 OF 4 PLEX Est Volue $58.000 Date MAY 23 - 19 85 1562 CLEMSON DR Erect IX Oceupanev R3 SitaAdNep 21 1 THOM LK HTS 2ND Rd"°del O Zoning PD elcek Lot Se,/Sub. Rapeir ? Type M Conrt. V Pmcel No. Enlarpe ? No. Stories NEW HORIZON AOMES Move ? Lenqth 44 ? Z Name P O BOX Demolish Depth 27 ; . . Adoruss Grade ? Sq. Ft. a ?ity MPLS Phme 420-3900 Install ? As.I. s... • Nsme SAME ? Address • City Phone Name D. GRISWOLD Address city Pho,K 435-7524 1 hereby xknowledpe tMt 1 have read this application ord storo thot the inlormotion is corred ord agree to mmply with oll opplicaWe StnM of Minrosoto Srotut Gfy of Eoyy? ino`-ces. Sipnorure of PermiMnL ?^-/ ? - -- A euilding Permir b lssued ro: NEW HORIZON HOMES dl work shall be dona in acoordanea with oll appligo¢le Stote o/(W. Assessment _ Wafer R $aw. Police Firo 6q• Piovier Cauruil emo.orr.5 22 85 APC Var. Data vermir a ?v i. v ai S,,,d,,,y, 29.00 Plan Review 153.50 yAC 525.00 Water Conn. 500.00 WaterMetar 63.00 Rood Unit 2$ 0- n 0 T,k,F . 132.00 7otal $1,989.5 0 a+ ths axpress cadltlon ehol Statutes erd Clly of Eogon Ordinoncai BWldirp Offidd ?'`?? •-?? ?'ti??E Z'c?e?1 ? ?ic? o ?e ? B ?ea -?a (? C?,,?„? ? HEAT LOSS CALCUlAT10NS HEATINGB AIR CONDITIONING CO. 0 fii? v :Vj q tj N-t7f 2t,, -7 71 MINNEAPOLIS, MINN. Wafltharstnps A.S.H.V.E. Cwistruction No. , Insulanon Windpw5 DoorS Guide Fiefwence Ou[. Wall Int. Wall Cefling ROOf Flpor Kind How Applied Yes-No Yes-No 19_ length Width Heipht l FI. &pROOm LenBth '-Y, O W4&h 4. Height Vdi ndows a nd Doors- Cracka ge and Are a ? Windows an d Doors- Crecka ge and Are a No. W, d, h ol ane He?Oht of pane No. of h hts Lineal R, of crack Area sV. ?t. ?' ??' ,?, ?j ? N?' Witl?h of ane Ha?ph? of ene Nn. al b M1?s Lmeal h. of c?ack /•?ea sC• ??• 2 2. a /, ?zti zi 17 ry 9 Coet 8W Coef Btu , Infiltrali0n "S Intiltration 2 ? 3 ?:l ? _ Glass 2q Glase (? ?.L? " :}f Exp, wall Exp. wall x ?t$ Net ezP. wal I 31.1 Net exp. wa? ?• ?-? ? -fn.T"w8tl- ?O'r 1 l1'j 2 2,2 Int. well Ceiling 'A %2 Celling ZO(p ??? ? ?e floor Floor Total 8w. TMeI Btu. Required sq. It. E.D.R. or sq. ins. W.A. Leader area ReQUired 6q. 1[. E.D.R. of sq. ins. W.A. le9dar area Fi. pa°m Langth `3 Widtfi Het9ht 2+111cdn Length I5 Width iO Heiyht ii FL 166 Windows and Doors-Crackage and Area Wi ndows a nd Ooors- Cracka ge and Ar ea No % tltn of ane He?Aht ol ana No. ol h hre eal h. of cr ek A?ea ??• NO' ?y??tn ol an e Hxiqht of ane No. ol b,Qh?e Lmeal It. Of • Ck Aree f4 fI. r p ? 2U Z Z 1 Coef 8 tu Coef 8 tu In}iltre[ion 2.Z4? InfikraLOn 3 ?, q -IT Gfa6s ? SQ Od Glass Exp. wall Net exp. wall , Exp. wall Net exp. wall E. ) ^-1> I nT. wal i lnt. Wrll R _ Ceiling 1 1<?l ? 2•S Ceiling J ? Flvor Floor ? E_1 O `! ?1 U iotel Btu. S Total Btu. J ? Required sq. (t. E.D.R. or sq, ins. W.A. Leader erea Reqwred aq. tL%§PK . n5. W.A. Leeder area _ I FI. Room Length WiMh Windows and Doors-Crackage and Area Height ? fl. Room Length ? Width Windows end Doors-Crackage and Area Height 7? Np. Wid, p of an He,9ht Of OAne No. ul h hIS lmeul 11. of crack A•ea sa. 1L N?' W?ih ul ? en Hy?plq ut Pnn No. nl b hl4 L?neel fl. of G,aCk Aren a. fI. g Caef Btu ' Coef Btu InfiltraUOn InliltrAtion Glass GIasS Exp. wall Ezp, wnll Net exp. wall Net exp. wall Inl. wall Int. Well . - Ceilmg 1 si?. :4. I Ceiling ? Floor ?F In(x towi Bw. 7otel Btu. _ .'=k " `,,i Heyuued sa. iL E.D.R. or sq. ms. W.A. Leader area ? Q Required iq. ft. E.D.R. or sq. ins. W.A. Leader Brea "HEAT LOSS CALCULATIONS 7t°• H EATING & AIR sed94S4 CONDITIONING CO. MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E. Construction No. . Inaulation Windows Doors Guide fieterente Out. Wall Int. Well Cailing Rooi Floor Kind How Applied ves-No Yes-No 19_ FL _? Hoom Length ?Q Width NeigFrt FI. Room Length Width Height YJi ndows a nd Doors- Crecka ge and Ar ea Windows a nd Doors- Cracka ge and Area Nu. H'?dth ol ane Neiphl ol pane No. 0f li his L?neal h. of crack Area sq. It. N?' WIAth ol ana Neiqht al ane N0. of li Me Lineal ft o/ creck Area ••??• ?`. . 2 2 24 Ifv Coef Btu Coef Bm Infiltration 71.111,Q In/iltreum Glass Glase _ Exp. wal I Exp. wal l Net exp. wall s(a 2 Net axp. well _ lnt. wall Int. wall Cailmg Ceiling Floor (,p-7 Floor Total Btu. 7otal Btw Ro4uifed sq. ft. E.O.R. or sq. ins. W.A. Leader area Requirpd sq. tt. E.D,R. or sq. ins. W.A. Leader erea PI. ?-?,v.,; Room Length )_ Width HeiBht PI. Roan Length Width Heiyht Windows and Doors-Crackage and Area { Wi ndows a nd Doors- Cracka ge and Ar ea NO' W.drn of ane Neipht of ane No. ol h hte Lineal Iv of crack Area s a• ft. NO' Wi?y?h al ene Me'ph1 ?f ann No. u1 h hta Lineal fl. ol cr ek Aree sa. 4. 'a Y 9 ^ .{ Coef Btu Coet Btu Infiltrauon ' 117 2223 Iniiltration Glass Q OOO G1H8S Exp. wall Enp. wal I Net exp, wpll 292 4.1 Net exp. wall '°• .. '?'? ? f 2 _10 2-24io Int. walt Ceiling Ceilinp Floor Floor total Biu. Total Btu. Hequired sq. ft. E.D.R. or sq, in5. W.A, Leader area pequired sq. ft. E.D.R. or sq. in5. W.A. Leader area ? FI. ???7 3 r.ri Pom Len9th 1 Wid[h HeigM FI. Room Length Width Height Windows a od Doors-Crackage aod Area W indows a nd Doors -Cracka ge and Ar ea N? W?tlrh of ana He? ht o1 oena Na. ul li Ms Lineal t4 ot crack 4•eo sp. it. NO' W.6"n ut nne He:iqh? uf xne No, al b hts l neal I1. of c•ack Aren sV• ??• Coef Btu ' Coef 8tu Iniiitrat?on Infil[rAtiOn Glass Glaes _ Exp, wall Exp. wnlt Net exp_ wall ?:K{j S{? ?•? ??? Net eMp. wall Int. wall Int. well Ceil-ng '- Ceiling ?-- _ ?--? Floor S ? •..?{ ? ( •S - 9 ? rIM)r ^ 7otal 6tu. Tptal Btu. Reqwred sq. ft. E.D.R. or sq. ms. W.A. Leader area Required sq, fL E.O.E. ar sq. in5. W.A. Leadet area , ... . PERIVIIT x CITYOF EAGAN 3830 Pilot Knob Road PERMITTYPE; BuzLozNc Eagan, Minnesota 55122-1897 Permit Number: 030261 _ 7 (612) 681-4675 Date Issued: 06 J 17 /Q SITE ADDRESS: 1560 CLEhiSON DR LOT. 22 SLOCK: 1 THQ14A5 l.fll<E HESGHTS ZIVII P.I.N.: 10-75951-220-01 DESCRIPTION: (SIDING) S'r (IM TSC. ) REI'A7R A39 AIT. R E ,TOE PITTRL , t g % ?4z ?.1 Bs7ilding..,Perm.it: Type Type e fIs Us C?+d ? V . REMARKS: INCLUOES 1550-8 (LO"C 23) 7562 (LOT 21) 1562-8 (LOT 21) CLEMSON DR FEE SUMMARY: VRLUATION 8ase Fee Surcharge Tota1 Fue $249 . 75 8.50 y:G5S.Z5 $17,000 CONTRACTOR: -- A p p 1 i c ein t- OWNER: NELSON, KEITH 14206550 HOM[OU1N[iR5 ASSDC 1'5511 86TH PL N CLEMSON DR MAPLG GROVE hIN 55311 El1GAP! MN (612) 420-6550 i , . - Z hereby acknowl•edge t3??C X #io'va rt*sd rk1'3?s' ar€2ts?at,&` tha?r'Che ini'ormatinn is carrect aind agres tts compty with_ -s11 ?&pp2icsble 5tata of Mn. S?atutes and City of Eagan qrdittartces. ? ,._. .?: • . - , IL --- APPLICANT/PERMITEE SIGNATURE AM.n R oi,r .( I?t,(_ ISSUED Y: GNA RE 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) -tIJrO'JS 3 olu CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681rt675 New Construction Reouirements R?madeUReoair RanuiromeMs ? 3 registered site surveys • 2 eopias of plan ': • 2 copias of plans (inGude beam & window at¢ea; paured fid. deslgn; em.) • 2 site surveys (exlerror atltlitions 8 dedcs) • 1 energy calwlations • t energy calculations for heated add'rtions ? 3 copies of tree preservation plan A bt plaHed after 711/93 roqulred: _ Yes _ No ' DATE: 7 CONSTRUCTION COST: ?7 , 6 DESCRIPTION OF WORK: ?C?IGDIAJZ W IJ-H UINY (_ S' 10;d19' STREET ADDRESS: LOT 11-2? BLOCK PROPERTY OWNER CONTRACTOR .29 z 2 .? SUBD./P.I.D. #: ? Name: Phone #: Street Address: City: 5tate: Zip: Company: K? i?I't-I l?S? Phone #: Ll. ?L, 53 6) Street Address: L License #: City: YM/9"?I,?? 6/?? State: Zip: ? ARCHRECTI Company: ENGINEER Phone #: Name: Registration Street Address: City: State: Zip: Sewer & water licer.Red plumber (new construcdon only): . Penalty applies when address change and lot change are iequested once permft is issued. I hereby acknowledge that 1 have read this application and state that the infortnation is co ct and agree to eomp with all applicable State of Minnesota Statutes and City of Eagan Ordinances. SignaWre of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes - No - Not Required FERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE Permit Number: Date Issued: Bl1ILDING 030370 07/17/97 SITE ADDRESS: 1560 CLEMSON DR LOT: 22 BLOCK: 1 THOMAS LAKE HEIGHTS 2ND P.I.N.: 10-75951-220-01 DESCRIPTION: rebuild deck ermit Type pECK qt"k Type ALTERATIOPJ ????E< 494 ALT. RESIOENTSAL IY ' [ P Y ?dr, s "re.ni?°-FA `iv??mw: (. ? ? i??t vN, m. u: ? REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Subtotal $50.50 .A}§d IEiv 4-6. A ?_?Yi5rv iWwl. 'aa ?P PA" 'F ryjE ? ?°? '` ??? ysl??nie: fC4 c= 4uv01 µ"8i?9'r8i ?Slno iSg 1'fvryGe}$jµ ?y tg?u?-., ?{v S(v' coaaes $2.00 Total Fee ? $52.50 CONTRACTOR: - Applicant - OWNER: NELSON, KEITH 14206550 BEAUDIN SWANE .18511 86TH PL N 1560 CLEMSON DR MAPLE GRQVE MN 55911 EAGAN MN (612) 420-6550 r _ " u r ^• 4 "i . zF, ?? ' e ?-s? m£s ? ?s i_ r? i? -=, ??"? +cs ?' ? E?fj ^r- an t` 5 ?s,?x rok°?i i r???`?"_ etlye 4h4;t_?4', C??? i n 1`'ti.r'iFra?tl a n i s:. e,tk r r. 5,tatut's`s-,-arid, .C;ty . 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) cirr oF Er?caN 8830 PILOT KNOB RD - 66122 ? 6814675 ? New Constmction Reauirements RamodeUReoair ReauiremeMs ?j ? 3 rogistered aite aurveys 0 p cpPies pf plan ? ? 2 copies of Dlans (inGude beam d window aizes; poured fid. design; etc.) ? 2 sita surveya (eMerlor edAitions & Eedcs) ? t energy wlculatlons ? 1 eneryy caiculatlons tor heatetl additions ? 3 oopies oitree preservafion plsn if lot platted after 7/1/93 required: _ Yes _ No ' DATE: IaFr7' ( ?'- / ? CONSTRUCTION COST: DESCRIPTION OF WORK: -E BU ) C-(? ID X Z4 l? ?-IL STREET ADDRESS: ? S?c) 4- 1 Em S d 'o 02 LOT -,jj- BLOCK SUBD./P.I.D. #: IDY4& ??- `?? ?n?'? PROPERTY OWNER CONTRACTOR Name: bmu?, I nmo. Phone#: WM nnc* Street Address: City: State: Zip: Company: ? 1 M ?d drtJ Phone #: '4 Zb 6 STO Street Address: ) 'i'S? I t?b ?ff AJ License #: City: MO/ E: G4d ?C- State: 1?'N Zip: SS? ?? PA&&?R .'ao0-4i z-7 - ARCHITECT! Company: ENGINEER Phone #: Name: Registration #: Street Address: City: States Zip: Sewer 8 water licer.ned plumber (new construction only): . Penalry applies when address change and lot change arc , equested once pertnit is issued. I hereby acknowledge that I have read this application and state that the information is cortect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE ONLY rRECEIVFT? Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _, Yes _ No _ Not Required JUN 16 1997 / x q.32 Z u (q31.5; &8 000 ?n , ?o 3 Z ` ?ao O ? / cl:?'D \ Q q SO. ? ?j ° N ? `/J,O No o i9A, I~ i > I b?( 28 RF?v??o E,?sr ' /Zq.9?/ ?'?/ S??/,i S 30. /I/? ?/ f.° $ L1? •71?01`O 31.0° OdW b 0 0 Denotes Iron Monument ° Denotes Wood Stake X000.0 Denotes Existing Elevation Proposed Top oi Foundation Elevation= (000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 9375 If-- Denotes Direction of Surface Drainage Proposed Lowest Floor Eievation= 938.0 I hereby certify that Mis is a true and correct representation of a survey of the boundaries ot Lots 21, 22, 23, and 24, Block 1, THOMAS LAKE HEIGHTS 2ND ADDITION, Dakota County, Minnesota And of the location of all buiidings, if any, thereon, and ail visible encroachments, if any, from or on said Iand. It also shows the location of the stakes as set for a proposed building. As surveyed by me or under my direct supervision this ZS day of April 19 85 Paul A. Johnson s v Rev;red 5-9-e5 cnonqed Lof 23 fo 96 w/o Land Surveyor, Minn. Reg. No. 10938 ? "RTIFICATE OF SURVEY fO/ I McCUTSON ASSOCIATES, INC. t4wntuerno?t9 tittrw.t*s L?A/ LY?1?.(7/'!?1 lX1?ETC? ?=rr r-ii.?r?ac.?fiv r?aj;v?c? July, 1997 Re: ??? ? ? I -cm s61"1 O(L City of Eagan Eagan, Minnesota To Whom It May Concern: The holder of this letter is hereby authorized to build a deck up to a total area measuring 10n20 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 inspecUon of such when work is completed. Please feel free to contact me with any questions or concerns. Sincerely, Horizon Hills Home Owners Association ? YJ Barbara Koob, CMCA Property Manager, Member-At-Large cc: File P.O. BOX 21423, EAGAN, MN 55121 (612) 688-0695 HORIZON HILLS HOME OWNERS ASSOCIATION PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: 1560 CLEMSON DR UNIT B LOT: 23 BLOCK: 1 THOMAS LAKE HEIGHTS 2ND P.I.N.: 10-75951-230-01 DESCRIPTION: .. Buildin ,Bu,ildin r"Census a . f - ,.Vt REMARKS: REBUILD ?.,,Permit Type Work 7ype ode` `' ,. °t ? DECK DECK ALTERATION 434 ALT. RESIDENTIAL fJ G_.. FEE SUMMARY: Base Fee $50.00 COPIES $1.00 Surcharge $.50 Total Fee $51.50 Subtotal $50.50 PERMIT TYPE: B U I L D I N G Permit Number: 030371 Date Issued: 0 7/ 17 / 9 7 CONTRACTOR: NEkSON, KEITH 18511 86TH PL N MAPLE GROVE MN (6Y2) 420-6550 - Applicant - 14206550 55311 I OWNER: DUBISAR 1560 EAOAN WILLIAM CLEMSON OR B MN I hereby acknowledg,e that S,have r:ead this,appl3catf,A:n and,.. state thatthe inforRra"Cion ie cQi^`rect Eand agr'ee t`a`c omply wit hi-`4i11 a"pPlicAbte 5t-ate srf Mn. Statutes and City of Eagan Ordinanees. _.? APPLI NT RMITEE SIGNATURE ? - IS$JED BY. SIGNq7URE 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)? I CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681-d675 New Conatruction ReaWrements ? 3 rogiatered site surveys 0 pcop" a{ plen • 2 eopies oi plans (inGude beam & window sixes; poured fnd. design; em.) ? 2 ske surveys (exterior addiUons & dedcs) • 1 eneigy calculations ? 7 energy eakulations for heated addkions ? 3 copies of tree Preservatlon plan N Iot platted aRer 7f1/93 required: _ Yes _ No ' DATE: b- I (° -t -7 CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: / LOT BLOCK ?"0 < 1 - P e60) c, 0 ! 2> C:) ez-/C- 1sc, a Q (t. ? --)IrS a,0 'D 2' SUBD./P.I.D.#: -?Aa' IAL 1n-P 2 ? PROPERTY OWNER CONTRACTOR N8rP12: AXJN.1.11hU ?AJ[??IZ41'I , Phone#: u., mn Street Address: City: Company: 6? L?? k) E-Z-!? a rtJ Phone #: State: Zip: GI Zo c- s--;, - 0 Street Address: US// S 4- t`' 1°L License #: City:&iV/L- &%01E- State: /2 /t-/ Zip: TS?? // ARCHITECT! Company: ENGINEER Name: Phone #: Registration #: Street Address: City: Sewer & water licer.sed plumber (new construction only): and lot change are iequested once permft is issued. Penalty applies when address change I hereby acknowledge that I have read this application and state that The infortnation is correct and agree to comply with all appiicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY RECEIVED Certificetes of Survey Received _ Yes _ No .I UN 6 1997 Trce Preservation Plan Received _ Yes _ No _ Not Required BY: State: Zip: x 432 Z / C? ?MSpN Q ? ? q39.5) y,?', ? , N°??? o ? o'` 00 , ?233?r ? N -c ? v ??'i.f Z \ t? - ? ! ? ? RF 60IL-0 ) ox IIo / 6 CIFmSato D2 ?x5r p etK NA5 tox,D CrsvEtio PoRc*S 4- SCkcE7J" ? ? O ? O ? ? O / ?Q- O /Pw ?n O ,p vio n?ar- ¢L 6µ ltv ?7 n q 3 Pp ?`,N 0 ExsT CoVEitO Potc-N 0 Denotes Iron Monument ° Oenotes Wood Stake X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation= (000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation=937.5 0- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 538.0 I hereby certify that this is a true and correct representatbn oi a survey of the boundaries oY. Lots 21, 22, 23, and 24, Block 1, THOMAS LAKE HEIGHTS 2ND ADDITION, Dakota Countp, Minnesota And of the location of all buildings, if any, thereon, and all visible encroachments, if any, trom or on said land. It aiso shows the location of the stakes as set for a proposed building. As surveyed by me or under my direct supervision this 25 day of April 19 85 Paul A. Johnson ?ev.sed 5-9-85 Changed Lof 23 fo 96 SLAA MMmw cCOMBS-KNUTSON ASSOCIATES, INC. ?ft?'?)?? ceasutmc un??ut ? wa tu?rno?s ? srtt ruuus '"'?•?? ?OMIFA?OLIS W INTCNI1tC1M.M111ECOTA Land Surveyor, Minn. Reg. No. CERTIFICATE OF SURVEY . for ,E? [? HORiZON HOWS 7430 ?•?? ?....?-- July, 1997 Re: 561j D? City of Eagan Eagan, Minnesota To Whom It May Concern: The holder of this letter is hereby authorized to build a deck up to a total area measuring 10ac20 on the propeRy 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 concerns. Sincerely, Horizon Hills Home Owners Association 44-'J? -1 " Barbara Koob, CMCA Property Manager, Member-At-Large cc: File P.O. BOX 21423, EAGAN, MN 55121 (612) 688-0695 HORIZON HILLS HOME OWNERS ASSOCIATION PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: BUILDING 030373 07/17/97 SITE ADDRESS: 1562 CLEMSON DR UNZT B LOT: 24 BLOCK: 1 TMOMAS LHKE HEIGHTS 2N0 P.I.N.: 10-75951-240-01 DESCRIPTION: REBUILD DECK Bol.?;:4Ti'kkP e r m i t T y p e D E C K 0011tl:,in;q?Ef*qrk Type ALTERATION "C e n;? tt4;; :C&dv'°=` 434 AL T . R E S I D E N T I A L , Z ? ? ? .,' • ? P b ? {, . " a+ fl ':4? : ? ? a v ' ?- ' - ? _ _ TSTtrv3? _? e eli.?• , . . ti!N aFx?...?7 7"ifA?R°8 rRr.a . ??•v ?Ffli`` v? a ' ffi? e ??i-, i l ?.^iSnn'4"K r Ae REMARKS: FEE SUMMARY: Base Fee $50.00 COPIES ? $1.00 Surcharge $.50 Total Fee $51.50 5ubtotal $56.50 CONTRACTOR: - Applicant - QWNER: NELSON, KEITH 14206550 GANGk J05EPH 18511 86TH PL N 1562 CLEM30N DR B MAPLE CrRqVE MN 55311 EAGAM MN Q612) 420-6550 ^? ^b VIA{W?li ?{?iR???????? 411M4_.l ll?-???g?¢'A???IIF???t(3[r?,??Ya?y"IICAVV????sl?i?????GuG?M}dE6?iF?y?.}L]el?a3p? 1R"F.-d:? ?r?`f?n??;s ?Qrr,?c? L.aJ?W????31 M?4P_4tF??] Ye?i ??.???l?k ?Ifr??IS?YkII??"S A?y 'Ix .Y H YL,y-t "?b ?"-k? I tt .. "t'Y dY?dIFS?Y hR'a??VGP?dligt '?f?gKt? CWI?fl$.t _ t..x .. _,._?? _ ... ?.- _.._,?.r%.:.`_ z'.,Cme.?+ -e . Wwcrc.-_.i'4 t....f w , ? } ?a??.?o-`?x ...3 "d? w..e ? :? ?.. ?i£:b.4C. L ppppp- , 1997 BUILDING PERMITAPPLICATION (RESIDENTIAL) J? 7? CITY OF EAGAN 8830 PILOT KNOB RD - 55122 681-4 675 New Construetion Reauiremenfs RemodeV?neair Reauiremenfs ? 3 rogistered site surveys ? 2 copiag of plan ? 2 eopies of plans (inGude beam & window aces; poured hW. 0esign: ek.) ? 2 s8e aurveys (exterior etlAitions & dedcs) ? 1 energy calwlatfona ? 1 enargy calculations for heated additions ? 3 eopiea ottree preaervetion plan H lot platted aRer 7/1/93 required: _ Yes _ No - DATE: (2o - )(--q7 CONSTRUCTION COST: DESCRIPTION OF WORK: - R a? 4 L' ic, ? Io X 1 o 'LZK-- STREET ADDRESS: C= 1??S a?U ID ?Z- 11-? LOT BLOCK SUBD./P.I.D. #: A -L`m?.V LAn1/tbb Lk PROPERTY Name: _.Jn O, ?It1DAh, Phone#: OWNER ,,,,, „,,, Street Address: CitY: State: Zip: CONTRACTOR Company: _Kp_ , ?h'w N tZ ?Aj Phone #: Street Address: /$r-l I S'V?` /9G License #: C, led-)119- 5tate: 1?1/t? Zip?f? ? t ARCHITECTI Company: Phone ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer 8 water licer.sed plumber (new constructlon only): and lot change are tequested once permit is issued. Penalty applies when address change I hereby acknowledge that I have read this application and state that the infortnaGon is correct and agree to mply with all applicahle State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ? OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received RECEIVED ves No JUN 1,6 1997 _ Yes _ No _ Not Required BY:= ' x 932.2 / C???t?ISp? 1??2 ?3 c»msb? ?2 731.3 ??. 93L.? ?0 H145 IvX ID ?5 ?xRr?N?D q-cou?9-Q P62c, t-+ ? ? Q???ui?p tXfT Dt?c o I (9oO?•0?pp ? t? ? ? 31-00 ?N 6? N ?C' O??o ??• O ?O g?l m /A/-? Q? 1q' r i. -r- (Z mo / O Z C? e^ N ? ? ? r 1•L'?3 ,' ??•pO / `I't) ? c,uF?n PaKc bl b E7C?j7 1 0 O Denotes Iron Monument ? ?by- (0 0 Denotes Wood Stake ? X000.0 Denotes Existing Elevation a%polroposed Top of Foundation Elevation= (000.0) Denotes Proposed Elevation C(u proposed Garage Floor Elevation= 937.5 Il-- Oenotes Direction af Surface Drainage proposed Lowest Floor Elevation- 538.0 I hereby certity that this is a true and correct represenTatbn of a survey of the boundaries oF. Lots 21, 22, 23, and 24, Block 1, THOMAS LAKE HEIGHTS 2ND ADDITION, Dakota County, Minnesota And of the location of all buildings, if any, thereon, and all visible encroachments, it 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 25 day of April 19 85 Paul A. Johnson ? e evised 5-9-85 cnanqed Lof 23 fo 96 W/o Land Survayor, Minn. Reg. No. 10938 monsomm? 40 IALF McCBUTSON ASSOCIATES, INC. WO fVIIYlY0t3 0 iltf lq ? [1?7430 CERTIFICATE OF SURVEY . for KE1 • HVW-ON ¦ rVIN&S July, 1997 Re: I '?(' 2 jl C I? SbN _Z) `L City of Eagan Eagan, Mimiesota To Whom It May Concern: The holder of this letter is hereby authorized to build a deck up to a total area measuring l Ox20 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 concerns. Sincerely, Horizon Hills Home Owners Association Barbara Koob, CMCA Property Manager, Member-At-Large cc: File P.O. BOX 21423, EAGAN, MN 55121 (612) 688-0695 HORIZON HILLS HOME OWNERS ASSOCIATION r • CITX OF EAGAN 9830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMITTYPE: auzLozNG Permit Number: 0 3 0 3 7 2 Date Issued: 0 7/ 17 J 9 7 SITE ADDRESS: P.I.N.: 10-75951-210-01 DESCRIPTION: 1562 CLEMSON OR LOT: 21 BLDCK: 1 THOMAS LAKE HEIGHTS 2ND REBUILD DECK B,.u3ldiftn, Permit Type DECK BuildIe+g Wprk Type ALTERATION -Census Code?'-?, 434 RLT. RESIDENTIAL ':,-- ? ?? - `ti.? "i ,?'o,1v'^• Y ?r t",,::???-. ?Nzva`?Zza?i???m,?['t??.?Ad ? REMARKS: FEE SUMMARY: Base Fee Surcharge Subtotal $50.00 COPIES $.50 Total Fee $50.50 $2.ee $52.50 CONTRACTOR: - Applicant - OWNER: µELSON, KEITH 14206550 BAKER ALICE 18511 86TH PL N 1562 CLEMSON DR MAPLE 6ROVE MN 55311 EAGAN MN A(612).420-6550 {e . - e I hereby acknowledge that F,have read this?applidation and state that the information is correct and agree to ,comply:"wxth 'all'appl3cable State of Mn. 9tatutes. and City of Eagan 0 r-d3nana*s., c LY: SIGNA RE APPLIC / RMITEE SIGNATURE I ED B 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) 5-o ciTr oF eacaN 72- 8830 PILOT KNOB RD - 55122 881-4675 Naw Construdion Reauirements RemodeURaeair Reauirements 7/ ? 3 registered site surveys ? 2 copies of plan ? • 2 copies of plans (indude beam & window sizes; poured tnC. tlesign; etc.) ? 2 site surveys (exteria adtlitiona & Eedcs) ? 1 energy calculations ? 1 energy Ceiculations for heatetl additions ? 3 copies oThee preaervation plan If lot pletted after 711183 required: _ Yes _ No „ DATE: fn" ??o `"P 7 CONSTRUCTtON C05T: DESCRIPTION OF WORK: 1 U x I G OR.IL STREETADDRESS: _IS (o z- C, ) E)1'I_ aj LOT ? BLOCK J_ SUBD./P.I.D. #: PROPERTY Name: Lkcn, rILl. Phone #: OWNER .?, M. ' Street Address: City: State: Zip: CoNTRACTOR Company: ?(Q Phone #: Street Address: License #: City: jKn1m1E- 61ee(V-o- 5tate: /*y Zip: SS-7 1// ARCHITECT/ Company: Phone #: ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer 8 water licer,%ed piumber (new constructlon only): . Penalty applies when address change and lot change are, equested once permit is issued. I hereby acknowledge that I have read this appliCation and state that the informatia is cortect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY RECEIVED Certificates of survey Received _ Yes _ No J U N 16 1997 Tree Preservation Plan Received _ Yes _ No _ Not Required BY:??_ x 932 2 ? C4.,?MSON f ? ZO0. `ro ? ? )ox???? RF6oi?o ?xsr pnw,u s ( ox 20 I ? ? o r'e ? o ? o N ? w/?/ ?;c $? o!? o N ? :- y2 33' ''1 ? N ?23 ?I•00 ?•o ? 1.00 W ?b ( o Y 0 Denotes Iron Monument 0 Denotes Wood Stake X000.0 Denotes Exisiing Elevation Proposed Top of Foundation Elevation= (D00.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 9375 1i Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 938.0 I hereby certity Mat this is a true and correct representatan of a survey of tfie boundaries ot Lots 21, 22, 23, and 24, Block 1, THOPSAS LAKE HEIGHTS 2ND ADDITION, Dakota Covnty, 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 25 day ot April 19 85 Paul A. Johnson 2ev;sed 5-9-95 cnonqed Lof 23 fo 96 w/o Land Surveyor, Minn. Reg. No. 10938 ? r4 McCOMBS-KNUTSON ASSOCIATES, INC. couutnNo E1u"ius 0 wc suenroRi M tm ruNkus 1l? { MMiC.?fOllf wl MLITCN?MbN.MIMftOTA J?(,Z ClCmS6N 0R CERTIFICATE OF SURVEY • Io1 WY Y Tli.JiliL.ON f WiY1G5 July, 1997 Re: I 5?' 2 C?Eh'N S6 I`) D (?' City of Eagan Eagan, Minnesota To Whom It May Concem: The holder of this letter is hereby authorized to build a deck up to a total area measuring l Ox20 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 concerns. Sincerely, Horizon Hills Home Owners Association 440 Dur/ Sarbara Koob, CMCA Property Manager, Member-At-Large cc: File P.O. BOX 21423, EAGAN, MN 55121 (612) 688-0695 HORIZON HILLS HOME OWNERS ASSOCIATION (o "'4`;`I S I --) --? o o a CITY USE ONLY SUBO. e? ?5 ? nd RECEIPT#: 3 J ? RECEIPT DP.TE: j -1 q, PERMIT# -:!) I 7?-)-f;> 2000 PLUMBTNG PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT IQdOB RD EAGAN, t1NT 55122 , 651-681-4675 ?? Please cOmplete fpr: sinale amilv dwellinos ? townhomes and co ermits are required for each unit ? backflow preventer for underground sprinklersystem FIxruRes EACH # TATAI Alterations to existing dwelling - minimum fee Describe: , $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet ' minimum - t 3.00 x' _ $ Hot tub/spa 3.00 x $ Kitchen sink 3.00 x $ Laundry tray 3.00 x = $ Lavatory 3.00 x ° _ $ Septic S stem newlrefurbished • requlres MPC Iic. 75.00 x; _ $ Septic System abandonment 30.00 x = $ RPZ new installation/repaidrebuikl 30.00 x = $ Rou h o enin 7.50 x = $ Shower 3.00 x $ Underground sprinkler rfdwelling is under construction 3.00 x = $ Under rounds rinkler rf existingdwelling 30.00 x = $ Water closet 3.00 x S = $ Water heater 3.00 x $ Water softener If dwelling under coostruction 5.00 x" _ $ Water softener Nexisting dwelling 30.00 x = $ 30,60 Water turnaround 30.00 x ' - _ $ State Suroharge .50 -> -> -> $ .50 rotal _> -> -> --a $ v Reminder: Cali for inspections of alterations, i.e. water heaters, water softeners, etc. • ------°-------------------------- - I hereby acknowledge that I have read this application, state that the info ?6on is g rrect, end agree to ? py with all applicable City of Eagan ordinances. tt is the applicenPS responsibility W noti/y the property owner that the C? of Ea n assumes no liabil' for any damages wused by the City during its nortnal apereGonal end maintenance activities to the facildies consWcted under this permk within City propertylright-of-way/easement. SITEADDRESS: /h61013 6LE'J?)5 6 ril OWNER NAME: : 'Tpvvl Rl_vN.-MC TELEPHONE 4a loel `6b 7O (AREA CODE) INSTALLER NAME: ?&ladLl %JrpTnr TELEPHONE _(y?7 STREETADDRESS: 9?19 -//d6?` ; //i/LJ, (AREA coDe) cirv: STATE: zi ? SIGNATURE OF PERMITTEE ? (? --- ti 1 ? . 2/84 ? CITY OF EAGAN APPLICATION FOR PER?'IIT SESJER AND/OR WATER CONNECTION (PLEASE PBINi) 1) PP.OPEF2T`! ApDRFSS: rFraI. D:..?GRInTICV: (IotBlocJc/Sutdivisicn or Tax Parcel I.D. NL:.oer) T'r S'!'o.CG^?JRE. D?.T 0_°' OcZT.Gi^.]tli. uiIL.DLNG -_-'S: iJJLCiM1?: PPESL.: 7^,`JTia':/??OPOS'?'J' CS: ? R-1 SitiGL-. FP3+4.Y 11 R-2 GUPL....? (7.i0 C::I2'S) . CI R-3 2Yx•,?sCCU5E (TY_n= + L-Ii?'S) ( Wi I"_'S) [3 ?-4 t`,2,'yR„"`:T/CC:ThC.?•iI2?tii ( iJ+iI'SS) - ? CQ?S-IEFCZIL,/RE".AIL/CF'FZCE Q --rL\CliST-tI.3L Q ?.VSTI:S,TIC:laI./G^v4???'?'?T 2) A??ISG=:iT (PLEASE PRiNP) NAb1E: ? PcoREss: S crrr, sr-.=, zIP: &U,J c- ? PHONE: q- . ?.. _. 3) PLL:ffiEp. (PLEASE PRiHi) ? FOA CITY USE ONLY ??• TNnMON PLUMBING C0. INC. ADDRESS: 12201 MINNETONKA BLVD. -" PLU!!BERS L SE: -' . ctire CITY, STATE, ZIP; Expire P??= PIUMBER LFCENSE Not f Rec rd '- ' r nina 4) OC)M7PPil]T/CSvT:Ec2 ` l?'?tast rKirIr) I NPME: 2?- PDDRESS: CITY, STATE, ZIP: PHC?^tE: 5) ENpZCATE :dEiICH PERhLiT IS BEIriG RDQUESTLp: • IM] GC:]:VECrION 'IC) CITY SaiER EM COtaNEcfIG.I 'Lt7 CITY Sip,TEt ? U.'IIER (PI.tr'1SE DFSCRIBE) 6) • ? PL:1SE F?OID APPPOVFD Pgt^^ST F04 PLC1:-L? BY O:JE OF AS(',SJE .?? PLE'-Sc_:7LIL APP!?t7VID PFF:•tIT TJ 1. 2. 3; 4 AFAtTE ' --(Ci:c2 J - - - 7) sicazt,-n: naTE- C) i •? w aa?r?o?r y. ? e? ??:ie.?s a ra.r.ca • 1 '' '' F O R C I T Y U S E O N L Y PcRMIT " ISSUED FEES : $ $ 5 $ $ $ $ .SiZ.?.chU $ $ $ S $ , S SE::L.fl. °E3MT_T (I`IC.LviZ JUP.CLPyP.CL) WATEZ PERAtIT (IPICiuDE SliRCHAZGE) WeITER METER/COPPERHORN/OUTSIDE REnDER WATER TAP (INCLUDE CORPORATION STOP) SE:vER TA? :c=nu:._ .,..:csi= - .._7.=-1 AC.^_OUDIT D.F.POSIT - F7ATER td'nC SP.C TRliVK tJATER ASSESS:!E:IT TRliNK Si.WER ?SSE.SSME:iT L.`-aTE°.AL SEDIEFIT/TRIINK St.:•::?'R I.aTE:2AL SEVEFIT/TRU.IK ZIATER WATER TREATMENT PLANT SURCHARGE oxxEx TOTAL }LMOUti'T PP,Z'D,/,gEC°I2T DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUSLIC RIGHT OF WAY? ? YES IF YES, THEPI A"PERMIT FOR WORK WITHIN -PUBLIC ROADWAY" MOST BE ISSUED HY THE ENGINEERING DIVISIOtV. LIST AS A CONDI- ? TICN. SUEJECT TO THE FOLLOS4ING CONOITIONS: APPROVED BY: TITLE: OATr: 'ew-w W'W fr nr?Mwwww?m wM ?c? rt? w?w? sr? wr+ wt W sa =:M @1+0 NcWw%sw w r Y ,I ? ;?• ? 2/84 CITY Ot EAGAN APPLICATION FOR PERMIT SES4ER AND/OR WATER CONYECTIOiN (PLEASE PRINT) 1) PP.OPEI2T!' ADDRESS: ( I v? rFraz. D:sCRItirzc:i: ?J Qeze?1 (iat/Block/Si::.ciivisicn or Tati Parcel I.D. NL:.wez) I'r' 51'O.L'CP.,*:tE . DAT' OF Ci2T_GiAL u;IL^,L`:G ==-'i, , \ ? y a P?rSL:P ..^.:JI:x:/PrOPOSE GS: Q R-I SLYti. P?MSLY - 94 R-2 VUPI r: (?':O L^:ITS) . ? i2-3 TCSttiT?MTS-E ('!'!-LpW + =1S) ( EN2'?'S) ? ?-ti ? CG1•nfE4CLu/REr'-LiI?Cr'?'I ,C?'-y Q ?'CL'SScLL?L Q ?STI'IL'PIC?L?L/Cxr"C??itiTM'?T 2) AaPISC:Pr (PLEaSE 'r'tx' 1 ADD:tESS: I S 6 l`-11L Alrt CTT`!. Sum, ZIP: ? LCJIVIY?OO C?( o f ll II?./ ?7 /`?7V ? PHO?: ? ' ?X? . 4 j) pu;.IBEP. NIIVME= 1PLE„SE PAtHTJ . YNOMPSON P?UE2EfNG CO., VNo FOR CITY OSE ONLY ADDRESS: 72201 MIIVNETONKA BLVD. PLII!!eERS lIC YSE: ' • ?M1I0IN 5534z --=-ARthITdETA4dl{dI C ve r ' CITY, STATE, ZIP; Espir PFOVE: G? PLU:NBEP LFLE95E q o of Reeord - -- `_ _- . ntcsa 4) O=?P1N1T/G!-;tNIEfZ N (PLEASE PRiHT) Pl`?: ADDRESS: CITY, STA'IE, ZIP: PFiO:IE: 5} INjICp,TE WHICH PERi•liT IS BEING RF.OUESTID; iM CL':.'.IECPION TO CITY SEYiER 11 CC91N=IOY 'Il7 CIT1' S4p,TER ? diIm12 (PI.PASE DFSCRIBE) O) liUr GVic C::L: 7) SIC-;'ICRE: ? P*.=ASE E?OID APPP= Pg2•+ST FOR PIC'iC-GP SY C.1E OF AfiOVE ?PLEmiSt :•'r1IL c1PPROVm PEF_•LLT T"J I; 2: 3?' 4AEOfv'E - (... ''^ -- - -? °_)` - DAT°; - ? ., r! R Of:R+YlfsJS! w ef l?:aTCa ! f.t /+t ?r-a iYa? a? s s?c?a?i:? w?e ?aw4Jra?+fsfw f? ?1 re! aa ?sg? F O R C I T Y U S E O N L Y Pc?'4IT '-` ISSUED F_E S: yS `.:':LD TJ S M11'i (INr C r i:. SU? ? R r .' l '. G) . . .. . ..: l .. . . _ . i $ IU-5u WATER PERPlZT (IriCL'uDE SliRCHARG'n) WATER LIETER/COPPERHORN/OUTSID : REi,OZrZ $ WATER TAP (INCLUDE CORPORATZQN STOP) $ SEWER TA? $ : _cC.i::._ :_?0SI= - c_:.33 +S ?Swe ACCQGNT DcPCISIT - WATER $ _s--oo. C,?ej wac $ sa.r?, v sac $ TRUVK WATER ASSE552?Z.IT $ TRli:QK SETdER ASSESS:?E:iT +S L'nTER.1L BE:iEF2T/TDU:IK SE:•:ER $ L.-I:ERAL SEVEFIT/TRU.`IK S4AT°R $ WATER TREATMENT PLANT SCRCEIARGE $ ulJ OTHER: - ? . S TOTAL $ o)l`f'c TCJ P,M0C'::T PAIDJRECEI2T i-r DOES UTILZTY CONNECTION REQUIP.E EXCaVATION IN PUSLIC RIGHT OF WAY? ? YES ZF YES, THE:I n"PERMIT FOR 'AOR:C WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERID]G DIVISION. LIST AS A CONDI- TION. SliEJECT TO THE FOLLOLdING CONDITIONS: APPROVEO BY: - ? TI:LE: ° DAT_° : New&" wi. r ? ? ?w ?? ?a ??? ?? w ? w +?? w? ?t+? ?t? w ?.? ?.s? a+ ae ? sa ?.i.r w+a ?e? sa ?+w ? ? ? ' 2/84 j CITY OF EAGAN 11111 APPLICATI^vN FOR PE?'?1IT SEWER AND/OR WATER CONNECTION (PLEASE PPIHi) 1) PROPII7I7 ADDRESS: r.FraS, DE..?C?tT°TT_CV: (LocBlock/Su:divisic or Tax Parcel I.D. NL=7er) IF W:zS711:c s7_MUc^_?=, nAT o° oRIciM;, rUzTIr.?c PDFCL±^ Zr772r-/P?OFOS= ? Z-1 SLtiGL : FP?.ILY IE R-2 DUP= (7NO L^IITS) ? R-3 TCF.,.I?S?CCIcg (771m_= + L?IITS) ( G.II':'S) 0 3-4 P2_,RT=1r/CCMC-1I_NI7_M ( tI,IITS) ? CCi-L?I??CZaL/RE^.AIL,/OF4'IC:: ? S?i'CuS=L ? L?;STI:LTZ0NAL/GGV?-2:`i'CT 2) APP_T.IC=11P ?F?EaSE rair?r? tUU'IE: ?I ? ?? SY?t D?? ?1? '? . . ? zDDT?Ess: L) P)OX I_?Yr"1 CI'SY, ST :T'y', ZIP: ! (Y' PAOVE: 3) M,;.L,pEm, ASE Pfl NT) NPA.E: FOR CITY USE ONLY ADDRESS _?? , PLUHBERS CENSE•r 1 Active CZTY, ST ATE, ZIP: 0 Ezpir d PHOMlPlU ? HNBEA LICE45f N ti r? of Record 7 / ' a C :nltta 41 (XS=A1N7T/CSV-'.IER NAME: IYLtASt PH114T) ' ki ??- ADDRESS: CITY, STATE, ZIP: PfiO:IE: 5) INDIG",TE WI-IICFi PER•IIT IS BEIIvG RFQiIESTFD: ? CC.:VECPIOV 'RO CITY SEWER ? Cb."".?'ECrION 'Iq CITY T•7A= ? CI"t M2 (PL,EASE D&SCRZBE) 7) SICATl,FcE: ? PT..Z`,SF FiOID r1PP?,OVm pg2,"sST FOR PICn-U''t SY ONE OF ABCVE ? PLEASE ,LaIT, ppPROVM PEF:lIT TrJ 1, 2. (3) 4- AFOVE . -- _ _ " (Circle one) - - DA'Ir: ? L? MR w o?atiwfe?o ? r? ?.a.+i a-a a? m F 0 R I T Y U S E O N:, Y PER.`1IT " ISSUEO r FYEs: $ /?_S v $ $ (2 $ $ $ $ $ Zo $ saS:?-?, S S $ S $ . $ $ - ??e sa y . Sli°C?'r.RCc) WATE'l PER^tZT (IL:CL=E SuRC?irli2Gc) WATER METER/COPPE4HORN/OUTS:DE REi,DER WATER TAP (INCLUDE CORPORATZON STOP) S: ;dER TAP Z-._.czV::? .:?..?T AC.^_G:iN'i' D`POSIT - WATER WnC sAc TRli`I:C WATER ASSE55:.=.:T TRli:QK SEWER aSSE55::F.NT LA1Z; ?,L BENEcZT/TRII:IK SE;:ER La':ERaL BENEFIT/TP.UNK T•7AT°R WATER TREATMENT PLANT SU'RCHARGE OTHER: TOTAL A:".OliNT PAID/REC°=?^ ; DOES UTILITY CONNECTION REQUIP.E EXCIVATION IN PUBLIC RIGHT QF WAY? L, YES ZF YES, THE:] A"PERMIT FOR W0R?: WITHIN PUSLIC ROADWAY" MUST BE ISSUED BY THE O ENGINEERING DIVISION_ LIST AS A CONDI- TION. SUEJECT TO TFiE FOLLOWING CONDITIONS: APPROVED SY: TZTLE: ?--? ' DAT_°: 2"am "rs w"Afto"m 11-116 RESIDENTIAL MECHAIVICAL Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please complete for: Single Famdy Dwellmgs & Townhomes and Condos when permits are required for each unit 13 ? l ? , Dare ? kf??- 1 -Dr' ?C Sit Add U i # - e ress n t i- Property Owner Telephone # Z, 0~ CiCX)Q VVohlers Southside Htg. & Air Inc , . Contractor 6950 W. 146?' St., #106 Apple Valley MN 55124 , Street Address - ros2) 431-7099 I ,,? City State ??? Telephone # ( ) Bond #: PL-, L_ C)?)W-j G 8?7 Expires: The Applicant is _ Owner ? Contractor _ Other Aon, modification or alteratian to eaisting dwelling unit $ 30.00 furnace replacement air exchanger _ air conditioner _ New YReplacement other ? State Surcharge $ .50 T l g ota ? I hereby apply for a Residential Mechanical Perrnit and acknowledge that th ?formatio n is complete an accwate; that tLe work will be in conformance with the ordinances and codes of the City of Eagan and m at I understand this is not a permit, but only an application for a permit, and work is not ro start without a pemrit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. DCi t"l 1e I -?? • ?-?'11?1'? crp [n1i '? LLV? ApplicanYs Printed Name AplicanYs S gnature 2004 RESIDENITAL BUILDING PERMIT APPISCATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ? -(D New Conshuction Reoui2meMS RemodeVReoair Reoui2ment5 Qffice Use Onlv 3 registered site surveys showing sq. R of lot, sq. k, af house; and all roofed areas 2 copies of plan CeA W Survey Reai _ Y_ N (20% marimum lot coverage allowed) 7 sef of Energy Calculations for heated addi4ons Trce Pres Plan Reoi _ Y_ N. 2 copies of plan showing beam & window sizes; poured found design, etc 1 site survey for additions & decks Trea Pres Required _ Y_ N 1 sel of Enefgy Calculations AddiUon - indicafe rf on-site sepfk sysfem On-site Septic System _ Y_ N 3 copies of Tree P2servation PWn if IM pWtted after 711/93 Rim Joist DeYail Op6ona seledion sheet (bldgs with 3 or less units Date ? l 2 `'3 I V l Construction Cost Site Address 1,?(? 5ci? ?j?( UniUSte # C4174,) Description of Work kj57A2(- Multi-Family Bldg _ Y _ N Fireplace(s) _ 02 Property Owner s,btb-5 Telephone #(?5/) Contractor r' ( K•L: ,?7? (Jl._C ? ? (? aaares5 r cicy State Zip '5;6'j7 ? Telephone # (9i 2?)?gv'"d7?d COMPLETE TNIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Cateeorv 1 _ • Residential Ventilation Category 1 Worksheet (J submission type) Submitted • Energy Envelope Caiculations Submitted Have you previously constructed a building in Eagan with a similar plan2 _ Y fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( N If so, 25% plan review Telephone #( D Telephone #( f I hereby apply for a Residential Building Permit and aclaiowledge that the infom that the work will be in conformance with the ordinances and codes of the City Stahxtes; I understand this is not a permit, but only an application for a permit,/ilg permit; that the work will be in accordance with the approved lan i e case'o approval of plans. ?3?0 ` ApplicanYs Printed Name Applicant' Signature A NEW BUILDING Minnesota Rules 7672 • New Energy Code Worksheet Submitted of Eagan and the State of MN d work is not to start without a prk which requires a review and aoo4 I0° ? ?Q?J? '4996 RESIDENTIAL BUILDING PERMIT APPLICATION D? ?V• ? City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ? Telephone # 651-675-5675 FAX # 651-675-5694 New ConstNdion Reauiremenls RemodeUReoairReaui2ments Oifice Use OnN 3 registered site surveys showiig sq. 8. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd Y _N (20% maximum lot cove2ge allowed) 1 set of Eneryy Calculations for heated add'Nons Tree Pres Plan Recd _ Y_ N. 2 copies oi plan sfwwing beam 8 window s¢es; pourad found design, etc. t sde survey for additbns & decks Tree Pres Required _ Y_ N 7setofEnergyCalculatlons Addition-indicakifon-sdesep6csysfem OnsfleSeptic5ystem _Y _N 3 copies of Tree Preservation Plan rf bt platted eker 711193 Rim Joisl Detall Options seleclion sheet (bu0d'ugs with 3 or less unRs) Date Con ruction Cost SiteAddress IK ?Q h'/ dl'?- l???[? 114, mN UniUSte # -? Description of Work Multi-Family Bidg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property Owner ),u v-- i Yy Telephone #((?? )(p??'??s5 d? 10 Window Concepts of Mintmtd Inc. Contractor 06 t1 I n nv?'ERri 77 Address VV V • ?114 City State _ ?d app MN 5o1? Zip Telephone It ( ??? ) `7O?"OfOS YN ??Yr? ? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Cafegory 1 Worksheet . New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a masTer plan2 _ Y _ N If yes, date and address of master plan: Licensed Plumber Telephone #( Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and app 74 val of p?lans. Applicant's Printed Name Applicant's Signature ?---------------- ir.,? i . ; Pemuc#: ?L.• 75? Permit Fee: ?' -6v ? DateReceived: I ? Staff: 7 ?----------- ---- 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 0(o Site Address: I,ori Seavers Tenant: RESIDENT 1 OWNER I Name: CONTRACTOR TYPE OF WORK PERMIT TYPE Address / City. Name: Addres 1562 Clemson llr+ ?e- Eagan MIV 55122 65]9059838 _ Phone: Suite #: City: _LY_LV 1 S , State: _tyw Zip: 55 D PhoneIMM W ' T033 Contact Person: JeJ S M1tew _ Replacement _Repair _ Rebuild _ Modify Space _ Work in R.O. W. Aion of work: RESIDENTlAL X Water Heater Lawn Irrigation (_ RPZ / _ PVB) RESIDENTIAL FEES: _ Septic System New `Abandonment -Water Softener Add Plum6ing Fixtures ? Main _ Lower Level) Water Turnaround $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" mefer is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, duchvork, etc.) (includes $.50 State Surcharge) 50 TOTAL FEES $ SQ. ?' I hereby acknowletlge that fhis information is complete and accurate; that the work will be in conf ance w'rih the ordinances and codes of fhe City of Eagan; that I understand this is not a permit, but only an applicafion for a permit, and wo s not to start wljpqut a permik that the work will be in accordance with th4 approved plan in the pse of work which requires a review and apprOVII of pl / p// X1, )ehF? L, • m oYbl am. X_ 2T! ApplicanYs Printed me Appl' anY? s Signafure SEDGWICK HEATING & AIR CONDITIONING CO. "E"r"G 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLI , MN 55420 •(952) 887-9000 TEST RECORD FEB 8 B 2007 AOOAESS + 6W CITY `r OCCUPANT ? ? NER E SOLD BY INSTALLED BY MAKE v ) MODEL `L(J' ` ???? /ln SERIAI Nn <S? ?? /I7I ? INPUT ? c ` / o 0 THERMOSTAT LIMIT ca LIMIT SETTWG FANSETTING PILOTTVPE IGNITION MODEL PILOT TIMING e PRESSUFE 'pERCENT COz ? INPUTCFH 7U PERCENTOz F ? .__. °` b STACKTEMP PERCENTCO FORM2%(REV 11199) 1/ VENT SIZE TVPE OF LINFF ? " - 9 ? ? ' LWER SIZE ' ? ? ?? ? FILTERS. SRE NUM6ER WIRING TEST TAG LIGHTING INST. DATE TESTED ? COMPANY TESTING? NAME OF TES7ER FOPMDISTBIBWHITECOPY - JOBFILE MELLDWCOPV - CITY .-q7v JOB NO t 1 73 • • Use BLUE or BLACK ink I For OfRce Use ! i ! ~q of E*n I Permit I Permit Fee: -1 1 - '45 3830 Pilot Knob Road I ! Eagan MN 55122 i Date Received: A Phone: (651)675-5675 Fax: (651) 675-5694 1 Staff. I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: k--EL- 13 -Site Address:6~*, 81f. 3 Name:' 11 e4M rePhone: ~-2• 72L_ Mtf Resident/ Owner Address / City / Zip: _ Applicant is: Owner - Contractor Type of Work' Description of work: _ SMQ F Construction Cost: - zp'.-71 e0o _ Multi-Family Building: (Yes _ No Company: e_ S 7-,e 414 /t7'!✓---- Contact: J L~1 e.CZ Contractor Address: O3 _a _ ~?calia. _ City: MineQS State: INv Zip: 555yo Phone: 642 - W-1-5506 License #:Ar - - 19 Z o 6 2-- e Lead Certificate _.Ir - 2 V?X 7 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 ` th# information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade swets. CALL. BEFORE YOU DIG. Cal! Gopher State One Call at (851) 454.0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gophemitaleonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinaries and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. r X1 ! ~LGtf_Tr? C I'3 G~! ~I') X_ ~a Applicant's Printed Name ~J Applica s Signature Page 1 of 3 Use BLUE or BLACK ink I For OfRce Use ! i ! ~q of E*n I Permit I Permit Fee: -1 1 - '45 3830 Pilot Knob Road I ! Eagan MN 55122 i Date Received: A Phone: (651)675-5675 Fax: (651) 675-5694 1 Staff. I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: k--EL- 13 -Site Address:6~*, 81f. 3 Name:' 11 e4M rePhone: ~-2• 72L_ Mtf Resident/ Owner Address / City / Zip: _ Applicant is: Owner - Contractor Type of Work' Description of work: _ SMQ F Construction Cost: - zp'.-71 e0o _ Multi-Family Building: (Yes _ No Company: e_ S 7-,e 414 /t7'!✓---- Contact: J L~1 e.CZ Contractor Address: O3 _a _ ~?calia. _ City: MineQS State: INv Zip: 555yo Phone: 642 - W-1-5506 License #:Ar - - 19 Z o 6 2-- e Lead Certificate _.Ir - 2 V?X 7 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 ` th# information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade swets. CALL. BEFORE YOU DIG. Cal! Gopher State One Call at (851) 454.0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gophemitaleonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinaries and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. r X1 ! ~LGtf_Tr? C I'3 G~! ~I') X_ ~a Applicant's Printed Name ~J Applica s Signature Page 1 of 3 % r • V For Office Usee �i -.1 k PI e /� eo rr � ::: EAGAN O J. e: !o.D`6 7 ✓ Date Received: IL° 1 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1610 , (651)675-5675 TDD:(651)454-8535 I FAX:(651)675-5694 staff: buildlnoinsp8ctionsOcltvofeagin.com t_ 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3/15/18Site Address: 1560 Clemson Drive Unit#: .-27,-+,--1-4. fr 'i I} i Mike and Christine Archer 651-259-2288 R fr},n'r:EPr^5 �.f W h ` Name: Phone: ;iu`'a,•'.1,c.,,u,„•li'7`Iii ii� ; Address�City�zip: 1560 Clemson Drive, Eagan, MN 55122 rvi "r",' "'-,1,.,i,_Crire r,-i „,,%1 €1{1 i;,?-,fall; , ,,{,- x,` Applicant is: Owner X Contractor i;71'i 7 r �����ii ,; „A'41�fl{V "fel Desc,; Bath update - direct replacement of fixtures, flooring • r Description of work: 1 k ***\`4ra4' ,, ,'� $5709.00 X 4 u , w t,;,�; Construction Cost: Multi-Family Building:(Yes_/No ) ��4� ”' K2 Bath Design . Damon Lee µ 4 � � � it �r�f Ia1 (,F^���.q $: � r��"��";�4�',,, �'^ � Company: Contact. d,�i 4 �, „ ‘,'-.,:..,.,2,-,- a44'„r-, 2710 Urbandale Lane N City: Plymouth R f�i r r x �;? Address: 11' r4 ;,.: ?'":4.'•'''-:, ', ji�} i T�` MN 55447 612-226-4442 dlee@k2bathdesign.com rh t ,3 ,v,,, ,r State: Zip: Phone: Email: t �,, �'� „, ” License#: BC638895 Lead Certificate#: NAT120063-2 If the project is exempt from lead certification,please explain why: Built in 1985 'f 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: .c:17-1-;',"'i 1 '-",":7 '',;-F. ,. J 'p- 1' 7 N 4 ,j17}."[J R �)J ilf t 111 x{ 11f1 J',� 1'J� _ �,{��� � j i ��" Jo t y'.I i1 � . -n--4� � �h, JYi i�. �, i ;.,T' n . l :',. ... r,".(.,,:t.,_ . , Ji �i.,�r..�a, 1 ', 'z_,,..�.t 'int',., 1 .,a' l�...li.7 __�'5 ,.,,,,, ' � 1 ' ,�I�jr�i . �Y a i�x i� . I �..,... � �}Ci"L(r, 11.1.:::, � I_ C£ {f—.:7 (.,�t r �— 2h1�1�1� '� � ,r i � {. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cltvofeaaan.comlaubscribe. Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher state One Call at(661)454.0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooheystateonecan.orq I hereby acknowledge that this Information Is complete and accurate;that the work will be in conformance with the ordinances end 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 anti a val of plans. y Digitally signed by Demon Lee x Damon Lee 'Damon Lee:, o 01803.1516:47:02 Applicant's Printed Name Applicant's Signature Y DO NOT WRITE BELOW THIS LINE / 3�� CC14(na� hal`j�5��� 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`Plea _ 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 11 al)00, Occupancy (-- 3 MCES System Plan Review Code Edition Pic' 2-0)c SAC Units (25%_100% ) Zoning ' City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V /) Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings(Deck) Final I C.O.Required Footings(Addition) Final/No C.O.Required Foundation Foundation Before Backfill ?o 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 `C' 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: / !) •'4 7 ,Building Inspector RESIDENTIAL FEES Base Fee III ,> 41 /2 f� Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 For Office Use : e ' : C20 tiC Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspections(a?citvofeagan.com L / 2018 RESIDENTIAL �.PLUMBINGlPERMIT APPLICATION Date: 31.2./2�/8 Site Address: /S O a e SAA A rive- Tenant: / rt&tr /N f IC,C. r►ts'�c`.tL Suite#: _.. Resident/Owner Name: /- t ke + �. '�{r�.�.t. )4•/'�itfy/ Phone: 8� Address/City/Zip: I S 60 C.�Cir►t w� (a1Prt'€. i 4, cast IS(A.) S r 13 3. Name: K r2 t�. 4'D^ License#: Pftt e 67 3 62 I Contractor ', Address: 710 �4+� ��e_ x City: Y M�1 Osa�{� State: �N Zip: T ' 7 Phone: 4( - gig Contact: �. (-e.L Email: —t L�.� 'Z +�'!'ic�2Scs 4. 0-44A NewReplacement _Repair Rebuild _ —Modify Space Work in R.O.W. Type of Work — — J Description of work: L otwcr Ie..veI 104 t r4'1 o d-� RESIDENTIAL Water Heater Water Softener Lawn Irrigation(_RPZ/—PVB) Permit Type Add Plumbing Fixtures( Main/—Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.co.m/subscribe. 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. r _ tek M x w` L-t✓..e. x �/� Applicant's Printed Name App icant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test _Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: PERMIT City of Eagan Permit Type:Building Permit Number:EA160645 Date Issued:03/31/2020 Permit Category:ePermit Site Address: 1560 Clemson Dr Lot:22 Block: 01 Addition: Thomas Lake Heights 2nd PID:10-75951-01-220 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Michael Archer 1560 Clemson Dr Eagan MN 55122 (651) 688-7226 Window Concepts MN 291 Eva St St Paul MN 55107 (651) 905-0105 Applicant/Permitee: Signature Issued By: Signature