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
úýýüïî
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
öòñ
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