1571 Clemson Dr? GEO. SEDGWICK HTG. & AIR.CONQ. CO..- 7 ?
HOUSE HEATING TEST RECORD
_ ? ??t??? ??? • ,?%
. ?
ADDRESS ? - CITY -
OCCUPANT "" OWNE R - _?'•-r'r u`I ?c.• ? ?. c?.? ?c?r?? `_.
HEAT LOSS ---"-^ DATE HTG. INST. -
SOLD BY ?? - INSTALLED BY ? %- Dr_, .•_ 5?< K-
Electrical Work By Gas Line By _ ? -_ -• =? - ? ??
TYPE OF HEAT GA _ FA % HW_ STEAM SPACE HTR. UNIT HTR . OTNER
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER `--- ----`
Model Model '-"-?--?
Serial ? ? C?Cc ? (q L) CcS Max. BTU Rating -
INPUT MAKE OF FURf1fACE
Model
CONTROLS
THERMOSTAT ? Heat Plug
Valve S x 3 W4 N:?c
Limit TC-: I Lt
Limit Setting --2 SD ° fr
Fan Setting ? d C) c ?-
Pilot Type ??E?: C7 lS L
Pilot Make ???C,;? K ( V , t- C- t4
Pilot Model 14 SC 1
Pilot Timing ? ?J 5 1- 0,1 ?J !'
L.W. Cut Off
Pressure -Percent COZ
Input CFH Percent O„ '
Stack Temp. ?`Eo 0 F Percent CO? J 0/
Vent Size :p
KIIVD OF LINER `" SIZE NONE
Draft Hood fr-Jou [_C'?? Regulator
Filters Size Number ?
Chimney Location Inside Outside
Chimney Construction
Smoke Bomb Wiring CK
Draft Test Tag y E- ?-
Door Pressure Lighting Inst. C.''C-1
Date Tested `?
Company Testing
Name of Tester Cc-? ?l IZ i?r?
GEO. SEDGWICK HTG. & AIR COND. CO.
HOUSE NEATING TEST RECORD
, ,? ?/J ?) ??
ADDRESS 7-E, GL-cm`>cN 1J R' v? CITY
OCCUPANT - OWNER-t?IyrLtl
HEAT LOSS DATE NTG. INST
SOLD BY
Electrical Work By C-t Gas Line By G,- .,, ?. " •? ? C_ «-
TYPE OF HEAT GA_ FA _2? HW_ STEAM SPACE HTR. UNiT HTR. •OTHER_
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER --"
Model ?`'1 `-E C-, ! bf:; C-1 Model "
Serial 51g 5 A 7 S(o 84 _ Max. BTU Rating '---?
INPUT n;2 vor? MAKE OF FURNACE ?-
INSTALLED BY ?Q_ bC, L?+rC-K
Tp z? CONTROLS
THERMOSTAT Heat Plug Vent Size ?2
Valve Sx 3/,(SC X--:2- KIND OF LINER `~ "-- StZE NONE
Limit ST tZi 12 L4?> Draft Hood 'N c- Regulator
Limit Setting Filters Size Number ?
Fan Setting Chimney Location Inside ? Outside
Pilot Type Chimney Construction
Pilot Make
Pilot Model K S C ? Smoke Bomb Wiring ^ F'
PilotTiming f iv ST 0,9?v I Draft TestTag :4 a_ ?
L.W. Cut Off Door Pressure Lighting Inst.
/
Pressure !,;- S r ?J < c , percent CO ?4-, Date Tested `A S - ? -7
Input CFH ?4 7 Percent 02 cl- Company Testing G?_?s? c cL
Stack Temp. Percent CO ?^? C-L Name of Tester
HTG. &
FIOUSE HEATING TEST RECORD
ADDRESS' ? 5?? CITY
OCCUPANT
HEAT LOSS
50LD BY _
OWNER
INSTALLEDBY C-, I , <«
Electrical Work By Gas Line By _ S??'•,?r?s C E--<
TYPE OF HEAT GA_ FA-?HW_ STEAM SPACE HTR. UNIT HTR. OTHER_
GAS DESIGN CONVERSION
MAK E ,D fe vlg /\l 'T
Model 39`-l C`a iq iti U,.;,. 4 c, S ,?)
Serial tA Go6 1 9?7Q
INPUT '5 Of oc b
CONTROLS
THERMOSTAT? ?-' Heat Plug ---?
Valve s u 3 t-4 -S - 1-
Limit S-ry- iti? Co J
Limit Setting a ?o o +~
Fan Setting f 1 c? c
MAKE OF BURNER -----
Model
Max. BTU Rating -
MAKE OF FURNACE
Model
Vent Size ?
KIND OF LINER - SIZE 1110NE
Draft Hood -, u,k c Regulator '
Filters Size Number Chimney Location
Pilot Type CL L- E= C T 0Z -? "l ( <- Chimney Construction r b.,4 <' , ( E5
Pilot Make 5 P/) R K 1? nl r'?Dlz
Pilot Model
Pilot Timing I ^4 S7 LL" T
L.W. Cut Off --
Pressure =?' ?? ? I-J•'G • Percent C02
Input CFH 4? -/ Percent 02
Stack Temp. ?/t? f- Percent CO %? ? ?J C--
DATE HTG. INST
Smoke Bomb
Draft
?r Outside
Wiring
Test Tag
Door Pressure "Lighting Inst. 4 i-
Date Tested `-? - ! - ?J -
Company Testing ? E 0 Y.k r cL,
Name of Tester _S o 1-,, F: +a e?
M GEO. SEDGWICK HTG. & AIR COND. CO. d
HOUSE HEATING TEST RECORD ??
??'? y l? v??''?- ' ?? o?.?i
?
ADDRESS .?
C- _
CITY J
OCCUPANT - OWNER 1-I En,J ?lc? IQ ? Zc: ; ?1 ? , c »> ?_^>
HEAT LOSS ` DATE HTG. INST. --'r
SOLD BY INSTALLED BY
Electrical Work By. - ?`?--!-, ?-- Gas Line By t?-
TYPE OF HEAT GA _ FA>< HW_ STEAM SPACE HTR. UNIT H TR. OTHER
GAS DESIGN CONVERSION
j -
-
g-?,
MAKE ? X ,%,
,
! t' MAKE OF BURNER
Model 3 4 i-!: L t,U, U?? C> ? C: Model -
Serial ? ?2,?- A 1`jsL4,;L Max. BTU Rating
INPUT MAKE OF FURNACE
Model
CDIVTRO LS
THERMOSTATUV-bNO-IrHeat Ptug "
Valve 34S t-a ?o x - ?-.
Limit
Limit Setting • ?SC?b 17-
Fan Setting -L--7
Pilot Type ? L-CL-T KC'.zl,,l I G.
Pilot Make ?PAKS<
Pilot Model 14 ?L ?
Pilot Timing - !t-4 s t r'tnlT
L.W. Cut Off
Pressure -? - ? ? J • C- • Percent CO
Input CFH L4 7 Percent 02
Stack Temp. -13 2- ?(':' Percent CO
Vent Size
KIND OF LINER S12E NONE
Draft Hood ? r?l ??•.' ?-E-i? Regulator
Filters Size Number '
Chimney Location Inside -7'' Outside
Chimney Construction C 1 t-1Sr,
Smoke Bomb - Wiring C?
Draft - Test Tag
Door Pressure Lighting Inst. _ C? fC
Date Tested
Company Testing
Name of Tester -
MW '?1TY OF EAGAN ` ? r n ? ? 711rJ
• ' 383 Pilot Knob RoaP.O. Box 21-199, Eagan, MN 55121
_ PHONE: 454-8100
BUILDING PERMIT Receipt#
To be u.ea ro? „ A nT "y Est Value -ttz_nn n Date *1- L 1 d 86
???.._..
Site Address • Erect ? Occupancy
Lot- _ Block ??Sec/Sub. 1Remodel ? Zoning
ParcePrvol Repair ? TypeofConst plj
Addition ? No. Stories
¢ Name Move ? Length 44
Demolish ? Depth
o Address F?? ? Int. impr. ? Sq. Ft Z 13,67
City r- Phone - 2 Install ?
Z o Name APProvam
00 Address y Assessment
~ City Phone W3ter & Sew.
?
W W Name -
? ? Address ? • G:37 S'?1?T?
i W City Phone
I hereby acknowledgethat I have read this application and state thatthe
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of
A Building Permit is issued to:
all work shall be done in accc
Building Official
iit .0
harge 30.,0
Review j5p. 0
Eng. Water Conn._5g.g . 0
Planner Water Meter63p
Council Road UnitS? nQd -'
Bldg. Off.:9 10yV Tr. PI. t c6 no
Var. Date Copies
Total
, 08971110
on the express condition that
Statutes and City oi Eagan Ordinances.
' Permit No. PsrmH Holder Date Telsphorn M
Plumbinq
iI.Y.A.C.
El.ctrts S - ?2 ?-
sonene.
Inspectfon Date Inap. Commenls
Foodnysl
Footlnyall
Foundallon
Framinp
poofing
Rouph Plby.
Rouph Htq.
Insul.
Ffreplace
Flnel Hfg.
Flnal Plbg.
Bidp. Final
Csrt.Oec.
Dock Ftp.
Dock Frmp. 5/-
Well
Pr. Dbp.
.:?
/ .
y
PLUMB{NG PERMiT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAI
PHONE: 454-8100
PERMIT # ?n
RECEIPT #
MN 55121 DATE: '
Lot ---l' 1' Block
?-
?o
r
c Name
Address
Clt
y
L
c Name ?
Address, ?-"
O CitY
FEES
COMM/IND FEE - 14/o OF CONTRACT FEE
MiNIMUM - RESIDENTtAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
l I FOR: CITY OF EAGAN
BLDG.TYPE
- Res. 7' 2?\
Mutt
Comm.
- -' Oth@r
WORK DESCRIPTION
New ?N
Add-on
Repair
- $1.50
TOTAL
? -
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL•
FIXTURES
Cioset - $3.00
- W.w
- $3.00
Sink - $3.00
Wet - $3.40
Tray - $3.00
sins - $1.50
PERMIT #
MEYHAAAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE - '? '-
CONTRACT PRICE PHONE 454-8100
Site Addre ss -
? ? BLDG. TYPE WORK DESCRIPTION
Lot
Block Sec/Su
R
N
Lf'
u
' ew
es. JG?
m Na •
?
' `
- l
''
1
?
01 `
? Mu
t
Add-on
Address C
M
N omm. Repair
c `
City fpone p
ther
Name - FEES
?
c Address ? RES. HVAC 0-100 M BTU -$24.00
p City Phone ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK ?
<•.%?G GAS OUTLETS - 1.50 EA.
Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIQENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/1ND FEE - 20.00
Air Cond. _•?L_ M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PFiICE GOES
Vent CFM BEYOND $1,000.00)
Gas Piping Outlets # ?
Other
FEE
?
r
, /:, r) ??,/ k:. :6Lfr . • .
S/C: ; j,, ?
SIGNATURE OF PERMITTEE
TOTAL•
FOR: CITY OF EAGAN
. ' ' . W . ... ' . . . . . . CtTY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1,;
PHONE: 681-4675
BUILDING PERMIT Receipt #
To be used for z. , r Esi. Value Date FEB 3 , 1942
Site Address 1571 CLEMSUN DR
Lot 3 7 Block 2 Sec/SubTiiOMAS WUCP HTS
Parcel No.
Nanie noucz.As B LARS4H
w pK{dress 1571 CLE14SOh DR
? C?, E?cM M Zp 55122
a: Name 4'mr-
0 Addf2SS
City Zp
Phone
? License #
I hereby acknowlege that I have read this applicalion and state that the
info(mation is correcl and agree to comply with all applicable State ot
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permitee "
A Building Permit is issued to: DOUGI.AS B LARSON
on the exprass condition that all work shall be done in accordance wilh all
applicabla State af Minnesota Stalutes and City of Eagan Ordinances.
6uilding ofricial ?_---_ _......._ _._._......_._.,??...._. ?......_?e.?.?........?.,_....__.. _.?. ?.?.....
Occupancy
Zoning
fActual) const
(Allowable)
rY o+ s?ories
Lengih
Deplh
S.F. To1al
S.F. Footprints
On Site Sewage
on sice we+i
MWCC System
Gry water
PRV Required
Boostet Pump
APPROVALS ,
Planner
CounCil
OFFICE USE ONLY
skig. Pem,it
SiaCFiarge
Plan Raview
SAG City
SAC,MCWCC
Waler Conn
Water Meter
nca. Deposic
SNV Permil
SIW Surcharge
Treatment PI
Road Unit
Park Ded.
Copies
TOTAL
FEES
35.00
.50
ss.so
Permk No. Permit Holder Date Telsphone #
S/1N
PLUMBING
FIVAC
eLEcTRIc
ELECTRIC
Inspsction Qate Insp. Comments
Footings I
Foundation
Framing 4-'117.2 U,,1
Roofing
Rough Pibg.
Rough Htg.
IsuL
Freplace
Final Htg.
Orsat Test
Finel Plbg. Plbg. Inspecta - Notity Plumber
Const. Meter
EngrJPlan
Bldg. Final ? 3 .
Dedc Ftg.
Dedc Final
weu
Pr. asp.
;
;
i.
BUI&NG PERMI
CITY OF EAGAN 1179
3630 Pilvt Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
T Receipt # '4 PLFX Est value sF; t _ onn Date nP'-? i T. 1 d . 19 -D-L-
Site Address 57,1_ GLE[dSON DR IVE Erect C]{ Occupancy R.?r.-
Lot-_ 3&- Block 2 SeciSub. 7`H0M A-S LAKE Remodel ? Zoning p...(?
HEZG
Parcel No ATS 2 Repair ? Type of Const ?T
. Addition ? No. Stories
¢ NES
f10RIZON HOME S Move ? Length 44
= q
Name Demolish ? Depth 2-7
o Address P. O. E?X 1367 Int. Impr. ? Sq. Ft
City MPLS Phone 420-390 0 Install ?
rc
.o
z?
o?
U¢
?
W W
F W
V?
Qz
t W
Phone
information is correct and agree to co
Minnesota Statutes and City oi Eagan
Signature of
A Building Permit is issued to: ivr.w nvnl zvra n%i
all work shall be done in accordance with all applicab(e State of
Building Official
City Phone Water & Sew.
Police
Name D. GRISWOLD Fire
Address r.,,,
13 5-7 524 Planner
Council
this application and state that the gldg. Off. 4 f 7 118{
mply with ali applicable State of ___
Var. Date
Permit 316 _ Qf)
Surcharge 3 f) - S?
Plan Review 158 _ QO
SAC 53751.00
Water Conn.-504L?W
Water Meter 63 _ 5(1
Road Unit 29 n.()?
Tr. PI. 156. nb
Parks
Copies
Total
2,089.
the express condition that
I I PwmR No. I Parmfl Noldsr I Deis, I TNephone M 1
Comments
Plby.
Htq.
Piby.
FNuI
Occ.
Disp.
CONTRACT PRICE ? ?? ?rU f
SiteAddrQss
Lot Block ?
Name ` !L l'.i111J1\ 1tLNltf
m
_
171
Address ,3
?
c Ciiy ?
- ._..._
3 Address
O CitY
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping OuUats #
Other
Lf ? 'Iy,l / PERMIT #
MEONAAACPERMIT RECEIPT # 6230 2C)
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE ? d?Phone
? M BTU
M BTU
M BTU
M BTU
CFM
/
FEE
S/C:
TOTAL•
TYPE WORK DESCRIPTION
BLDG
.
:.-
R
N
ew
es.
A
d
-on
Mult
d
R
i
C
r
omm.
epa
h
O
t
er
FEES
RES. HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AlR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000•00)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
.`
3830 PILOT
PLUMBING PERMIT
55121
PERMIT #
RECEIPT ;
DATE _
BIDG. TYPE WORK DESCRIPTION
? Name
? Addre
c City -
Res. ' New Mult Add-on _
Comm. Repair
,. Name
c Address
p City Phone
FEES
COMM/IND FEE - 1%OF CONTRACT FEE
MINIMJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMMIIND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYONQ $1.000.00)
FOR: CITY OF EAGAN
NO. FiXTURES TOTAL
Water Gloset - $3.00 $
?
6ath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whiripool - $3.00
Gas Piping Outlets - $1.50
Softener - $5.00
Weli , $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL- `=-?
•, CITY OF EAGAN r r r
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 `' -
:
' PHONE: 454-8100 j'
BUILDING PERMIT Receipt #
To
4 PLF.X
Site Address 1575 CLEMSON DRIVF
Lot-39-Block 2 Sec/Sub. E
^----•- HE Gc ???i ? Z-
W ?vame NEW HORI LON HOMES
3 Address P. n• BYO 1367
° Citv MPLS) Phone 420-3900
o Name SA$E
0 < Address
l'- City Phone
°C D. GRISWOLD
F W Name
? ?-y Address
i W City Phone 435-7524
11793
Erect mK Occupancy R 3
Remodei ? Zoning ^^
Repair ? Type of Const AX
Addition ? Mo. Stories
Move ? Length dd
Demolish ? Depth 24
Int. Impr. ? Sq. Ft
Install ?
Approvals Fees
Water &
I hereby acknowledge that I have read this application and state thatthe gldg. Off. 156.00
information is correct and agree to compiy with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. APC
Signature of
Var.
Permit 316.00
Surcharge 3D.50
Plan Review-J..!`AL-00
SAC 575.00
Water Conn.--SD{L.-00
Water Meter 63 _ 50
Road Unit 29Q-04
Tr. PI, 156 _ OU
Parks
Copies
Total 2.489.00
A Building Permit is issued to: 1VEW HUK I.LVPJ riU171k;5 on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and.,City_af Eagan Ordinances.
Building Otticial _ , '- -
I ' - I PermN No. I PormH Holdsr I Dob I TNophons N I
o?(1 S,
t t
Htg.
Plbg.
Occ.
Fty.
F?my.
Dbp.
.?
MEOMAN&L PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
PHONE: 4544100
Res. t/
Mult
Comm.
Other
BLDG.TYPE
? Name _
?o Address
c City -
?
aD
c
3
O
Name _
Address
City _
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outleb #
Other
Phone
M BTU
M BTU
M BTU
M BTU
CFM
?-
FEE
S/C:
TOTAL•
RECEIPT # `n?3(') 7n
DATE:
WORK DESCRIPTION
New ?
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU
-$24.00
ADDITIOI+IAL 50 M BTU - 6,00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 19'o OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHAAGE PER PERMIT - .50
(ADD $50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE v
FOR: CITY OF EAGAN
' • PLUMBING PERMIT
• CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
Site Address
LotBlock
m Name
? Addre;
c City _
? Name
c Addre
O Cih+ -
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MiNIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GDES
BEYOND $1,000.00)
SIGNATURE OF
FOR: CITY OF EAGAN
PERMIT #
RECEIPT #
DATE ?
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
N FIXTURES
? TOTAL
Water Closet - $3.00 $
P
±Bath Tubs - $3.00
,
Lavatory - $3.00
Shower - $3.00
ZKitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Orains - $1.50
Water Heater - $1.50
Whirlpool - $3,00
Z Gas Piping Outleb - $1.50
Soitener - $5.00
Well - $10.00
Private Disp. - $10.00
=Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL: ' ?
.?,.- .. ,?
.?. .
BUILDING PERMIT
CITY OF EAGAN
3830 Plot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Site Address 137?JS CLEMSON 1)!:I JE
Lot -4 0- Block 2 Sec/Sub. ???r;j;;.?,?
Phone
o Name SAME
0 i Address
cc C:ifv Phnnn
tvame p. GR I SWOLD
Phone
N 2 117S1
Receipt #
Erect
Remodel QI }t
? Occupancy R3
Zoning *+?
Repair ? Type of Const. Z-2
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth 77
Int. Impr. ? Sq. Ft.
Install ?
A pprovals Fees
Water 8 Sew.
Police
Fire
Eng.
Planner
Permit 31600
Surcharge 36.50
Plan ReviewI 5$- 40
Water Conn.50Q,ad
Water Meter 63.50
Council Road Unit 2g0.UU
I hereby acknowledge that I have read this application and statethatthe Bld . Off. d?? ??Q Tr. PI. 15 6. UO
information is correct and agree to comply with all applicable State of 9 '-?7"?r°
Minnesota Statutes and City of Eagan Ordinances. APC Parks
- Var. Date Copies
Signature of Permittee ' Tatal 2,089NEW HC?R I ZOtJ HOP?!?S 00
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official -
? Pwmk Ma. Pwmit Hdder DsW Telephone N
Plumhinp 7 7 !
H.Y.A".C.
Eleehk `SC ?
4
So11ew
ImpeeHon Dab Insp. CommMts
FooHngs I
Footlnys II
FoundaHon
Frsminy _ ?j ?? •
Rooflng
Rouyh Plby.
Rouph Htq. f 1 aqv ? YA, Insul.
Ffreplaee ?j11
Ffnsl Htq• 14/
Flnal Plby ?, tR _ f,
Bldy. Finel p
Cert. OCC.
Deck Fty.
Deck Frmp.
WoII
Pr. Dlsp.
, • ?j - ? (
? i `>? ? • PERMIT #
MEGHANICA'L. PERMIT RECEIPT # &3C29D
CITY OF EAGAN C
3830 PILOT KN08 ROAD, EAGiAN, IVAN 55121 DATE:
CONTRACT PRICE: 01 G? ? U PHONE: 454-5104
Site Ad cQSS '' ti ' BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Su . Res. ? New ?
Name :' U. t\L ?, ? M ,:, n , _?.?. . .. .
NIA _. Muft Add-on
m Address 10;1 ) E A
c City , S',?{i ne ?mm. Repair
, Q Other
m
c
3
0
Name _
Address
Ciry -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
?-M BTU
M BTU
M BTU
?Z M BTU
CFM
?-
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 8TU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - iai6 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FEE
S/C: SIGNATURE OF PERMITTEE Li
TOTAL:
FOR: CITY OF EAGAN
PERMIT #
' PLUMBING PERMIT
' RECEIPT # CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
Btock Sec/Sub
m Name
? Addre
c City _
Name
c Addre
O CitY -
FEES
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMtJM = RESIDENTIAL FEE
MINIMUM - COMM/IND FEE
STATE SURCHAFiGE PER PERMIT
(ADO $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
BLDG. TYPE WORK DESCRIPTION
- Res. New
Mult Add-on
Comm. Repair
Other
TURES TOTAL
F
- NO.
IX
Water Closet - $3
00 t
.
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
'
$10.00
20.00
50 Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
Soitener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE '
FOR: CITY OF EAGAN
STATE S/C:
GRAND TOTAL•
'
PERMIT # --
MECHANICAL PERMiT RECEIPT #
CITY OF EAGAN
3830 PILO T KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address L?0 TYPE WORK DESCRIPTION
BLDG
?.
S
S
b
' .
x
Lot' ?T Block ec/
u ? .
` ?
? N
ew
es.
Narc' " Add
X
M
m . -on
ult
? Addr - R
i
C
?
' epa
r
omm.
c City , o?e
' Oth
-7 ? er
Name FEES
?
c Addr RES. HVAC 0-100 M BTU -$24.00
p City P hone ?? ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL 6 M BTU _ 6.00
GAS OUTLETS 1.50 EA.
Forced Afr M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Bailer M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond M BTU STATE SURCHARGE PER PERMIT - .50
. (ADD $.50 S/C IF PERMIT PRICE GOES
Vent ? CFM ??- BEYONQ $1,000.00)
Gas Piping Oullets #
Other
/ J / ) /
e -
FEE./"
-
a
, _
A
S/C:: : 5J SIGNATURE OF PERMITTEE
. TOTAL:
y
FOR: CITY OF EAGAN
7
PLUM8ING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, I
CT PRICE: PHONE: 454-8100
??...?..-..v.,?.o?.._..?.-,.._.?
PERMIT #
RECEIPT q
55122 DATE:
Name
City
Phone
v1/IND FEE - 1% OF CONTRACT FEE
3LDGS - COMM RATE APPLIES
JHOUSE 8 CONDO - RES. RATE APPLIES
4UM - RESIDENTIAL FEE - $12.Q0
4UM - COMM/IND FEE - $20.00
E 5URCHARGE PER PERMIT - .50
$.50 S/C IF PERMIT PRICE GOES
SIGNATURE OF PERMITTEE
CITY OF EAGAN
BLDG. TYPF? WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
nw. r?wa. vn?r - vvmr?ccnc
NO. FIXTURES TOTAI
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kicchen Sink - $100
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1 50
Whirlpoal - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
.?Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL:
11NSYE(.'1,I()N RECORD
CITY OF EAGAN PERMIT TYPE: '"''' '` t r'(i
3830 Pilot Knob Road Permit Number: 0 40'; ?4
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 '
SITE ADDRESS: APPLICANT:
? 41rtM??, s<?f t }IF TCiNTS ?!!O
PERMIT SUBTYPE:
TYPE OF WORK:
Ilf' {yf:RIF''T Fl1N
I f(lf) T I N?iRi
?
L_
i'iNAI
;_.?. ., ? .. ? ,. •? ? . ?, ?
,
. ` ?
pomn No. P.m,n tioid.r data Talephona •
ELECTRIC
PLUMBING
HVAC
Inspectlon Dete 4?ep. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FlREPLACE
FIREPLACE
AIR TEST
FlNAL PLBG
FlNAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG AIp F,7-,; . `j(f?jP,
DECK FINAL { I • ( (e I ?? ,
INSPECTIUN RECC3RD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued;
(612) 681-4675
SITE ADDRESS: APPLICANT:
1' '. ? I f M'-, uN ?;1:
flt' TN,MT 4-1 :'Nf'!
PERMIT SUBTYPE: TYPE OF WORK:
r3l TE RA f ION
PFHI{Ilp txFCK
INSPECTION D. . .A
, .•,..; ?,.??, , ?,, ,i
;
?
- - - - - - - - - - - - - - - -
Pertnit No. Permk Holder Data Telephone N
ELECTRIC
PLUMBING
HVAC
Inspecdon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG Q
? Y
DECK FINAL
INSPECTION RECO
CITY OF EAGAN PERMIT TYPE: ??? 1? t? i w?;
3830 Pilot Knob Road Permit Number:
I Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: ? 4a." APPLICANT:
t li t: t9 Ic1. rJi v.
fM`?f)N C)it t.??
i:I??MI?•. EAt 1 NC TGfilpc, :,?NEy i r? 1. ?,?,•,.,
PERMIT SUBTYPE:
TYPE OF WORK:
{lf.''.? C Hxf ' t f (lH
I I , 1't I i 1NH`•.
('iNAI
ni rfkarr:)M
Ixr e+uri.c) c+rc ?
?
PertnR No. ParmR Holder Dab Telephone #
ELECTRIC
PLUMBING
HVAC
Inapectlon Dsh Inap. Camments
FOOTINGS
FOUND
FRAMINQ
ROOFIN(3
ROUGN
PLlJM81NG I
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIHEPLACE
AIR TEST
FlNAL PLBG
FINAL HTG i
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FlNAL
DECK FTG ff ?? , ??tJS P.
DECK FINAL
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
I ! ?M•;r?AI (?k
°???MkS l1?KE WF ItiNFa ?MU
PERMIT SUBTYPE:
:CORD
PERMIT TYPE:
Permit Number:
Date Issued:
40 IrLocK t APPLICANT:
Ft iir I ;?; •: 1 I I?
( b1.' hu1,e
TYPE OF WORK:
IiI , i. P I' 'r 1 'a?a
Afl:i 1 (? f MC
A.3A?tPf,
lil TCRAi 10M
RF8U11 U l)Et'K
INSPECTION D• • D•
? . , . ,
?F-
i
?
L
....?..
Pamft No. PertnR Holdar Data Telophone #
ELECTRIC
PLUMBING
HVAC
Inspectlon Dito Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FlHEPLACE
AIR TEST ?
FINAL PLBG
FINAL HTG
ORSAT
TEST '
BIDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTO /,10
DECK FlNAL
?
j% INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK:
? , . ,..
I--)_?i -q-7 I I)In?
i1,r p r)
?
Permlt No. Pertnit Holder Data Telephone #
ELECTRIC
PLUMBING
HVAC
Inspectlon Date insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SNC
TEST
INSUL
GYP BOARD
FIFEPLACE
AIR TEST FIREPLACE A A? ?°? 5? I oe T_" r
FINAL PLBG
FINAI HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN a Remarke JAA& ?-
Aadition T1'?omas Lake Heigh Addition Lat •ij R,k f 1. Pefcei #10
Owner st,eet 1571 Clemson Drive 5tate Eagan, NIN 55122
Improvement Date Amount Annuel Years Payment Receipt Date
STREET SURF. 111.8 A01212 -a
STREET RESTOR.
GRADING
SAN SEW TRUNK /?73
*SEWERIATERAL
1981
-37.61-
7•52
5
1.0
a01a 2
--8
55
WATERMAlN
* WATER LATERAL 9
WATER AREA 136.51 27.30 5 4+61 AQ?.21? `? -'8
STORM SEW TRK 312.37 ZO HZ 1 249.91 80121 2 5- -83
*STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN Remarks
Addition ThniMa g Lalca-He?tUtiOn Lot M ?XLBIk ? 92al. Parcei #IQ
Dwner Street 1573 Clemson Drive state Eagan, NQ1 55122
Improvement Qate Amount Annual Years Payment Receipt Dare
STREETSURF. ].L'L.B A0321 Z - -$
STREET RESTQR.
GRADING
5AN SEW TRUNK
7
*SEWERLATERAL 37.51 7.52 1 .0 A0121 2 -8
WATERMAIN
*WATER LATERAL ggl
WATER AREA gj 1{•(1 A0121 Q --8
STORM SEW TRK 3 249.91 A0121T2 - 83
*STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. _
9UILDING PER.
5AC
PAR K
CITY OF EAGAN Remarks '
Addicion Thomas Lake Height , dditian Lot ?--3F Blk = a'16= Parcel 010
Owner • J stteet 1575 Ciemson Drive scate Eagan, NW 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 221.8 AO 2 --B
STREET RESTOR.
GRADING
SAN SEW TRUNK ct7
SEWER LATERAL ff.Z 37
61 Z
?? , 1.0 A0121 2 --8
? L
WATERMAIN
* WATER LATERAL
WATER AREA 4.()1 OZPZ 2 - -S
STORM SEW TRK 249.91 AOLLZ P - S3
*STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
V4fATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN Remarks
Addition ''homas- Lake Heigjt ddition Lot • Alig Blk = -t Parcel #10
Owner • Street XSMPS` Clemson Drive as scate Eagan, Mn 55122
1575 B
Improvement Date Amount Annual Years Payment Receipt Qate
STREET SURF, 111.89 A0121't2 5-5- 3
STREET RESTOR.
GRADING
SAN SEW TRUNK
*SEWER LATERAL a 37.61 ']. $2, 15•05 AOl 1 2 -
WATERMAIN
,tWATER LATERAL
WATER AREA
S?ORM SEW TRK
2
9.91
5-5-83
*STORM SEW LAT 1981 _
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
6UILDItdG PER.
SAC
PARK
GITY OFEAGAN `X;)3*00 VYATHt SERVICE PERMR
3M Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 551?c'? D/?TE:
Zming: or zon ..o?es N°. °f Unlts:
Owrrr,
Addrass:
Si» Addross: 1571 C emson ._ r ve .. ., 7 _1 toraa s,j, -<Plumbm r. .ur.;nson , uribinn am"
NAalsr No.: (on1(a'??'(??[]y1R?i?a , .
Siaooa. No.: efore
1.Iw. to a.w»IY wilb Nn GeY 0f169 5u `ITR
Onii n
N c ?
? Totai: , .._ `'p:. - et er
RG
B Dote Puid:
Date of Irap.: InqL;
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Z°^i^0' No. of Units:
Owner: ,.
/lddrrss:
Site Ihddflg: ' ? - - •- 4 V:. - . ' - ? . . . . .-
Plum{7ef: _ -?ilnr,aAri
I MeM te ew* wll6 !1s CIIy of yMa ComKHon Chorpa:
OldiN¦o?s. Aooount Deposit:
Perenit FN:
Surdwrpr.
ey Misc. Cho?qm
Doce of Insp.: Totol:
Irnp.: Dah Peid: a
CITY OF EAGAN
3830-°ilot Knob Road
P. O. Box 21199
Esgan, MN 55121
Ionirq:
Owrwr.
Addross:
Site Address:
PltJIT1beI: ? .•0:4T`,` .1 ?'' ll'. '>.
MNftr No.:
51ze:
Rsader Na.:
1sow !o eawPlp wldl tM CMr of iaNs
OdiMnoM.
A..
DOFQ Of IrISQ.:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
. No. of Units:
COf1f1lC'riOf1 Ch0fg0:
Account Deposit:
Permit Fes:
Surchw?ye:
Misc. Chorpm
Total:
Doft Paid:
Iflsp.:
P. 0. Box 21
E+gan, MN !
Zoninq: _
Owrwr:
Addross: _
Sft /lddress:
Plumb+r: _.
Meftr No..
Slu: SCLll
¦
LJ.?_'l!
10.Q0
I .p« te es.rh? .Nb +b CN-
%0&"OE. • ???a n : ? ? . 5 G] a
u1R ' 0:)pd '1:",
Otal: F;? 5r'1PC? iLet:2r
BY Dob Paid:
DaRe of Insp.: ? Iroo.: - - --
i?' T IL/
? CITY Of EAG.4N
3830 Pilot Kn
b R
d WATU SWICE PStM
,
o
os
P. O. Box g1199 PERMIT NO.:
Eagqn, MN 55121 DATE:
Zoninp: No. of Units:
Owrnr:
1d
/
Jross:
5ft AddIlSf: 1575
Plumber: - "^r `•?. "?t,
Msftr No.: Conr+ecfion Chorpr.
Sixe: Acoount pepcslt;
Reod@r No.: Pertnit Fee:
1SaM 1o eesep1p N116 1he Gfq oi Eqpm Surchorge:
OemNser. Miw. Chorpex
Total:
BY DOta Pbid:
Oote of Insp.: Irop.:
CITY nF EAGAN SEVM sunrkz PowR
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 p^TE. -
Zoning: -' Na of Units:
':._ w
OM//Mr: '{iI'.
AddR'35:
Site ^ddI
Plumber.
I N- bam* wil6 tw Cky af gypw Connsctlon Charpe; _
Oh/iwsa?. Atcount Depodt:
Prrmit Fae:
Surcho?pe: -
By Misc. Chorp?s;
Dat?e of Insp.: Totoi:
Insp.: Doft Paid:
? CASH RECEIPT ?
•-? 'CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122 ?
DAITE
RECEIVED
`
AMOUNT $
- --
FUN
COD6
AMOUNT
Q U
• / l
Thank You
N_ 61455
White-Payers Copy
Yellow-Postinp Copy
Pink-File CoPY
D?LLARf
?sa
? CASH [I CHECK
CITY OF EAGAN ??
_..J
3830 Pilot Knob R 2
WATER SERVICE PERMIT
P. O: Bux 21799 PERMIT NO.:
EryW, MN 55121 DATE:
Zonino: R3 Na of Unlts:
pw„er, New ?Iorizon tiomes
Addrom
Sit* Address: 1575R Clemsc+n Prive i„t! r,-21 ' I~hor:a:: Lake 2
Plumber. " ?loirnsen
Meter No.: 3?•'Z/5 a.3 `?0?;. Ji)„c;
Stu: 15. ?)u d
Reade. No.asn> 5 a35 . ? ,?.,,,
.?, ,.A ?w c
?
a ??R EV
??
,
Total: • ,
8y Dons Potd:
Dote of Irnp.:
kvmy
WATER SERVICE PHtMR
Addrcss: 1 `75i. ,
iber. - - - - °'
r No.: Conrnctian CJ?arps: 29 . n!)?d
Acoount Depostt: S-
Ior No.: Permit Fee:
rr te ae-/Ir w4r 00 Cifp oi EMPw Surcharpe:
MDoM. Misc. Gwrges:
Totol: - -
Dote Paid:
of Inap.: o
Irup.:
OF EAGAN
Pilnt Kno6 Roed
Box 21199
i, MN 55121
ro eo00? willi !r. Cily of ayss
SEWER SOVICE PERMIT
C.anrwctlan C]wrga:
Acoounf Deporir -
Paeenk Fae:
Suniwrps:
Misc. Chorpm -
Totol:
Doh Pbid:
CITY OF EAGAN ??0-2
3830 Pil,,2'Knob Rosd WATER SHtVlCE. PERMIT
P. 0, Sox 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
:
Zoninp. No. of Units:
. - - . -
Owrwr, .. .)r. iaan Hom es
Add? is 73
SitA Addf!!i' r i Cl S OT2 _
' •T 1V L ? :S2 T OLR$ S L? T
P .,m ,
PINfl'1bQf: n
Meftr No.: 9
?
Siu: 'I rf'oc!
? jj6rW .')9-3Q
1 NM to amply wMh Nw Qry • ! i 6. 00 nd l"
ro?s:
Totol:
B Dote Poid:
DoM of Irap.: Irnp.:
g-cf
3830 Pil6t Knob Road
P. O. Box 21199
Eagan, MN 55121
Zonirp:
Owner: _
Addnm:
Sitr /lddnss:
Plurrber. .-
Mohr No..
Slze:
Rsodsr No..
1 Nm fo omply wft !IN Cilr Of [qpn
Or/iWweM
By
Dars of I rup.:
CITY OF EAGAN Sftm sgnria pumR
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 pATE-
Zonirg: No. of Unih:
Ownar: _ . ,
Addrm:
S1te Addross:
Plumber.
1 Nr" 1r weepIr wi!b Nw phr o! Rosen
Oai
By
Dote of Irisp.:
WATER SERVICE PERIIAIT
PERMIT NO.:
DNTE:
No. of Uniri:
J ?
ConnecNon CFw?gs:
Ikoount Deposit:
Pisrmit Fae:
Surchorye:
MiDc. Charos: ?.
Tocol: -
Daft Patd:
Irop.:
Conrwctlon Chorpe;
Aooouwit Depwit:
Permn Fn:
Surcharpe:
Misc. Cipepm
Tatd:
Oah ?dd:
This request vond
18 momhs 4om f?
C 1216 0 L L1 A,}'? :5 ?r -
Request Date
p-/
I Pire No. RouPh-in Inspection
fi q rted, °
?ReaAy Now Will Nol
rty InsOe
o
?-?
V V ?es ? No n
lur Whe Reatly
'Lucensed Electncal Conlractor I hareby request msoacifon ot above
???wner electncal work instelletl et
Str et Address. Bo or Route No. ? ?
S S, CL1.s`oni k?t Cnv ?
?.`??
emmn o. Townsh, Name or No. Fanye Nn. C?o/un?j y /J
K/4 U I
Ocwoam (PRINT) A!r
10W 90 ?'?V Phone No.
Powye?r Suppher
lJf? , E ?/Q/G AAd
Elecirical Contra.mp nV Namel , j
.%bYY? ? <r / ?G
liiJ //•Y G?i-? Gonvar.lor's License
MaJinO AA?ress lConvacror or Owner Making InstaJauonl
, "'Y" G
4%
llauon)
Author¢ed Signarore,l onvaMOr O r M
" ' Phone Numberr?
'
: ! 1
- .
. , ....
/..
MINNESOTA STATE BOANO OF ELECTNICITY
Griggs-Modwav Bldg. - Room N-181
1821 UniversrtV Ave., SC Paul, MN 55104
Phone 16121 2974111
TMIS INSPECTION NEQUEST WILI NOT
BE ACGEPTED BY THE STATE 90AND
UNLESS PPOPER INSPECTION FEE IS
ENCLOSED.
`5- (2-XCrAEQUEST FOR ELECTRICAL INSPECTION Ee-oaai.oa
/ See instmcOOns br comOlB4nq tbig iwm on beck of Vellow copy.
? ?`? 1 (;n "%" Be/ow Work Covered by 7his Request i„ c)
M"r,eei nau.1 rypa of euiimng ? AoP16ances Wirea I Eqwpmam Wired _ I
ce
ce
E
L_ I I I Industnal Bldg. I?el Air ConAitionek?4.(]0 I I Bulk Milk Tenk I
p Fee Se1viceEntrenca5ize H Fee Faeders?Subieaders p Fee Cvcwts
b to 200 Am s 0 to 30 Am s 0 tn 30 Am s
Above 200 qmpy, 31 to 100 qmps 31 to 100 A s
Swimming Pool Above 100_Amps Above 100_Am s
Transiormers Irngation Booms Partial, Other Fee
?9s ppeciai inspecuon ? r
Nerra.ks S ? J TOTAI FEE
? <
flough-in Date
I, the Elentrmil?
? Yl? lnspector, hereby
Final
v? .
D??e
2kX` certAy Ihat the above
inapection hes been
made.
1ma requeaivmo ia momm rrom
Thiq request vmtl {?J18 months fmm
? 12..1_59
t Date F?r¢ No.? Roueh-In?sPer.?ion? ?/
R q retl? ?ReadY Now ?y?Will No,y Inspec-
` Ves ?NO 7\.lor WhendfleadY
Electrical Contractor
?'Jwaer I harebv repuest mspactmn ol ebova
Street Atl ress, Boa or PoWe No. V .? aC?ty?
S J' CLEisn,v Ail? ZgKAI/
Secunn o. Townshio Name or No. A?nBe No.
Counly ,
Occupan[ IPBINTI
Phone No.
Power SupO?ier
/,/?/?y d 4tltlress
!? /7 ? / l ??j
?
??
EI¢,tncal Convactor ICOmpan,Y?'N?a?m?el ?j??
M
l N
C,h r?Q Lwerse No.
ai
ine /+tlJress ICOn[raclnr or Owner Mabng Instailabonl
?
A?- -
nature (Centiractor/Ow Mnking, Insta I lationl
/
Phone,Number.
MINNCSnrn e . _ __"...- ?. ???.......I..
Grigpy_Midwey 91dB• - Moom N.181
1827 l/nivergity AVa., St Peul, MN 55704
Phone 16121 297.2111
^ a'c' iwrv HEaUEST WILL NOi
eE ACCEPTEO 9Y TME STqTE BOAflD
UNLE55 PNOPEH INSPECTIpN FEE IS
ENCLOSED.
_5-(a-VREQUEST FOR ELECTRICAL INSPECTION EB-00001.04
/ See inshuebans ior complabng thus form on baek of '??
1215 ? Y'llo` `o'"
??ll" Below Work Covered by This Request
CU
AAa Rep. Tvoe ol Builaing Aoolmncea W,red-?-
ved
Range Duplex ce
Water Heater s
Home OWE
Apt. BmlAinc? Dryei
'Commercial Bld y. FurnaCe Industnal Bldn. e:,
..,,,nu , ,aN-ijon ree u
eiow-
- --i -
M Fee ServiceEnirenceSuxa p
Fea
eaders
s
0 to 200 Am s Cncurts
Ahove 200 ,
Ain? ?s
s 30 Am
Swimming Pool p
= o 100 qm ;
Transrormer5 lAn
qm s
p,
?
r,s M A
b
ve 100_Ampa
5??5
ctiOn .
r
ra6OtheF
Rgmqrks - ALFEE
floo9h-in (
( I, the'Ebctiicxl
Final InsDectoq heraby
/ j'I.In
y caridy Ihat the above
inspectipp hes been
??brequeslvolElBmonfhatrom ? ^?de.
Thie repuest void
] ironths fmm
° D 9 79 0 9 4 3
Raquest D:?te Fire No. RouBh.in Inspecl?on
??p?_^l Nepwretl> ?? ?Ready Now
?
Zotl6,7
iia -
II Nnuty InsPec-
' When Featly
n?L,censed ElecVical Contraetor I hereby request insoection ot ebove
wner electrical work installed at:
5[reet Atldress, eon or floute No.
/S? C!F-r'ISOnJ A? rVE CitY
?t
ecLOn o. Tpwnship Namo or No. flange No. Cnry
O
Or.cupa:a IP INTI Phnne Nn.
^rc
??I?' ?1'?+
Power Syppli
cIry
/?A
Atldress ?r
,vt?V On?
Eectr wl CoM,actor Company Namel
l
0?Mor7psanl ?r?,Qi? Cunvar.tm's L?ce.Se No
.
D
Mnilmg AdJress (COn[ractor or Owner MakinP Ingtailauon)
Author¢ed Siynatur Conlractor/ wner Makj fl Installatianl Phune Number
r?
1 9'i??9
MINNESOTA STATE BOAFO OF ELECTRICiTY
GriB9s-Midwev Blde - Room N•797
1821 UniversitY Ave., St. Paul, MN 55100
Phona (612) 297-2111
TMIS INSPECTION REQUEST WILL NOT
BE ACCEPTEO 6Y TME STATE BOAND
UNLESS PROPE0. INSPECTION FEE IS
ENCLOSEO.
?4 REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-cu
See inshuctions for comoleting this lorm on beck of yellow copy.
o n q L? ? n_ "X" Selow Work Covered by 7his Request ?O
kel AAd Nep. Type ot BuilcbnB APOliancee Wired Equipment Wved
Home Range Temporary Service
Ouplex Water Heater Lightiny Fixtures
Apt. Bmldmq Dryer Electric HeaUn
Commercial Bldg. Furnace
Silo Unloader
Industnal Bldg. Air Conditroner Bulk Milk Tanl<
Fdffil Othei Deufy ther Itipeufyl
[ eo Specify Other Othir
k Fee ServiceEntranceSiza H Fee Feetlers?Sublea0ers k- -Fee dremts
D to 200 qm s 0 to 30 Am 5 0 to 30 Am s
A6ove 200 Amis 31 to 100 qmps 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_Am s
7ranstormers Irrigation Booms Partial: Other Fee
Signs SUeciallnspection
S ^
Hamarks , /4
F£E ?-1
TOTAL??? U
r
Hough-in Dnte
I, the Elec ncxl
Inspector, hereby
Rnal r certdy that the nbave
O.ne -aspecbon has baen
'Q ? maaa.
TMa reQUest vo1C /8 montM from
This repues[ vmd
18 nwnihs Irom
C 12158 Nenuest Uate fire No. RouAh-vilnsuer.tion " ?/
r fl q red' ?Ready Nuw ??p W?II Nouly Inspeo-
?/ ? 1'es ?No ????? When Feady
Licensetl Elecincal Convactor I hereby request mspection ol nbove
OWIIP.! BIPCiri-l wnrL .n-llnA -
Street AdAress. Box ar RoWe No.
/S73 C?Xp,+/ ,dof'i04?-
ecuon o. TownshiP Name or No. RanyC No. CounlV
Occupant I?T)^/J -?n Phune No.
Power Sunoiier
gA: Address ?
Etectncal ConVactor I ompany Namel Contrar.tnr"s Licnnse No.
MadIne AAJress IC cractor or Owner Making Installationl
a ,?3VZ
Authorized Signature IContractor/Owner kinB tn tallation) Phone,Number-
::?.:?-?a2 i
minrvt50Tq STATE BOAND OF ELECTNICI7V
Gnges-Miawev glag. - qoom N-191
1821 UniversitY Ave., SI. Geul. MN 55709
Phona (812) 297-2111
TMIS INSPECTIDN NEUUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PPOPEP INSPECTION FEE IS
ENCLOSED,
REQUEST FOR ELECTRICAL INSPECTION EB•DU001-04
See mshucpons for comDieting this form on back oi
vellow coov.
,12158 "X" 8e/ow Wak Covered by lhrs Request
..f
NaO. Tyoe o18mlEine ApoILences WveE Equipment WveA
Home Fange Temporary Service
Duplez Water Heater LiGhting Fiatures
Apt. Bwidinq Dryei Electnc Heatm
CommerCial Bldy. Fumace Silo Unbade.r
Industnal Bldg. Air Condivoner Bulk Milk Tank
Farm Otnei pau y OthFr 15"r.,fy1
1 P.! SVCtI y 111C! O1hU1
omnute /nsnection FaP RPr/]W
p Fae ServicaEMrenceSae B Fee Faxtle,s/Subfee.ders N Fea Cvcwts
? ? to 200 qm s 0 to 30 qm s 0 to 30 An•
Above 200 Amps 31 to 100 Amps 31 to 100 q 5
Swimming Pool Above 100_Amps Ahove 100_Amps
Transiormers Irtigation Booms Pnrtial-'Other Fee
aigns Specfal Inspection $ CO TOTAL FEE
flertwrks
\)
?NOU9h-in Oate '
1. <na E\ lecViwl?
s- 4CL? Inspecbr, hereby
Fnal ? ??1e certitythattheabova
! ?insDeclio
?7 n has been
?? mBAe.
This reqvest vmC s-' a-?7l
18 rtqn[hs trom V"
Q 12157 ?
F?....?..??., ,.?v?u•?a? ..o??un?w? I hereby request mspacOan ot ebove
? Owner electrical work mstalled at.
Sveet Address, Bor or Route No. J?
/ lc'?_QN W Y City ?
ecLOn o. Township Name or No. Rnnye No. Co?unl?y
r/
Occu4am (P 1 T)
o
iz oN Phone No.
Power Suppli0r
Z
V
M
5
e2r
f Atldress
A
E _
1
16
i
D
Eleetti I t,aCio pa?? me • Co? ,3eto, •s Lii,en:e No.
Mailin Address ICOntractor or O ner Mabnp Instaila onl
...zo .t?G?j'1 %a in?
Authorizetl SiBnemre IContractnr/Owner Mabng InstallaLiinl Phone Numbe
r
r
?
MINNESOTA STATE BOAND OF ELECTRICITY
Grigps•M,dway Rldg. - Room N•191
1821 UniversitV Ave., St. Paul, MN 66104
Phone (6121 297-2'111
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BV THE STATE BOAflD
UNLESS PFOPEF INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION /ee-ouoot-oa
11' Sre insbuebons for comple<inill this form on beck oi vellow copv
(r 12157 "X"' Below Work Covered bv 7his Reauesl F
7dc1 Pao. Type of ewlamg Apohancea wrted Equiyment Wi.ed
Home Range Temporary Service
Duplex Water Heater Liyhtiny F„ctmes
Apt 8uiltlmc? Dryer Electnc Heatrn
Commercial Bldy. Furnace Silo Unloader.
Industnal BIAg. Air Condrtioner Bulk Milk Tank
Farm Other Sveu v OthF, ISnerifyl
? P U??.? v iher Olher
_nm mq a /nc na?r-., C,,,. o..i,....
?
N Fee ServiceEmmnce5ize x Fee Fexdars/SuGfeaders W Fee Cvewt
s
Uro200qm s
0[o30qm s
?
O,o30Am
s
Above 200 qm>5 31 [0 100 qinps 31 to 700 q
Swimming Pool Above 700_qmps Am s
Above 100
Transiormers Irrigation &oorc?s _
Partial,'Other Fee
Signs Speaal Inspettion
xema.ks S???O TOTA F?E?
'
HOVBII'lll ,? i --i
Di1LP.
UL? ? C' I, tpa Etactiical
r o Inspector, heraby
Final Dnte certdy that tha above
rh0 insoectlon has been
maea.
1B onthe Irom 7-l-
il?ra repueal voitl m
4?I9c:z-
43435 01; /7 ///
g
a'
? '
do
Request oan
1- q q Fre No Pough-in Inspection
Feqwretl?
? ReatlY Now JKWill Noldy Inspector
P
P
V1'es C N. When
eatly
I= licensed coniractor $owner hereby request inspection of above electrical work at*
Jao Atlaresn Stree, Box or Roule No )
4 Ciiy
G.sqt'o' P . /N
Secoon No Township Name or No qange No Counl
OccupanliPPINT)
D Phone No
d L •
PowerSup Atloress
El2tlnt31 CO,hactor Corppany Name) ConVacto!'S LIC2n52 No
Mading Adaress lCOn;rn
ctor or Owner Making Inslellalion)
/
G?S.t_? ?v
Au• SignaWee ICOnhacl 0/? t MaWn nsalle0on) PhOn¢ Number
?L - - . ??LLLY ?
1%
n
X
X
MINNESOTA 9fnTE BOAHD OF ELECTRIQTV THIS INSPEGTiOrv REOUEST WILL NOT
Griggs-MlCway BIEg - Hoom S473 8E AGCEPTED 8V THE STHTE BOAFD
1821 Umversity Ave. St PeW. MN 55106 UNLES$ PPOPEF INSPECTION FEE IS
Phone (612) 642-0900 ENGLOSEO
REpUEST FOR ELECTRICAL INSPECTION /? EB-OOOOb08
? See instrncoons br compisling ihis torm pn Dack or yellow copy s'?.?:A i `/io /
? ?} ? -nj "X" Below Work Covered bv This Rem,P?r 2"0 ,.1 4v? ?///
ew Atld Rep TypeoiBuAdmg AppliancesWired EquipmentWiretl
Home Range Temporary Service
Duplex _ Water Heater Elec[nc Heating
Apt euilding Dryer Other (Specdy)
I ? ? Comm/Industrial Fumace
Farm Au Contlihoner
C OtM1er (syeciry) Conlrectors Remarks
C?Wroeaoa -
13A3,Q"6TNT 471A1
Lr3'1-f
Compufe lnspection Fee Below
4 Other Fee
ISwimming Poal
#
Serv iceEntranceSize Fee # Crtcmis/Feeders Fee
0 to 200 Amps 0 to 100 Amps
Transbrmers Above 200 _ qmps Above 700 _ Amps
SiynS Inspecrors use Only TOTAL
Irngation eooms
??
?
3
Special Inspection •
•
AlarmiCommunication ?
IOther Fee THIS INSTALLATION MAV BE 0 D DISCONNECTED IF NOT
COMPLETED WITHIN 18 M
I, the Electrical Inspector. hereby Ro°9n-'° ooc
certify ihat the above inspection has
6een made. F??ai
OFFICE USE ONIV
LITms requp5l voitl 18 mOn1h51rom
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN _tL I S•
( :`-j U3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings. #( t '7 o
?
Date _/L_! ,2-r I '7"_
/?
? )
Site Street Address Sn/?/ Unit #
PropertyOwner??,?P,_N_ Telephone# (G?l}- 6?7-9v?69
Contractor Telephone # (9S31 - - '
City State229A) Zip
The Applicant is: _ Owner ? Contractor _Other
Altetations to existing dwelling $ 50.00
Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
?
_ Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
? Water Softener _ Water Heater $ 15.00
replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ .50
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approve .
l -
Applicanf's Pri^n eame plicanYs ' nat re
II i; NOV 0 9 200
4
:ey
COMMERCIAL
2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4675
Foundation Onl New Construction Interior Im rovement
• Structural Plans (2) sets • Architectural Pians (2) sets . Architecturai Plans (2) sets
• Civil Plans (2) . Strudu2l Plans (2) • Code Malysis (1) "
• Certificate of Survey (1) . Civll Plans (2) • Project Specs (t)
• Code Analysis (1) •' • Landsqping Plans (2) • Key Pian (i)
. Project Specs (1) . Code Analysis (1) " • Master Ezit Plan (1)
• Spec.lnsp.&TestingSchedWe" • Certificate of Survey (1) • EnergyCalculaUOns (1)notalways"
• Soils Report (1) . Spec. Insp. & Testlng Schedule (1) " • Elec. Power & Lighting Form (1) not always"`
• Meter size must 6e estabiished • Meler size must 6e established • Meter size must be esfablished - if applicable
• Project5pecs (1)
1 • EnergyCalcula6ons (1)
1 . Eledric Power & Lighting Form (1) " y
b • Master Exit Plan (1) !
1 . Emergency Response Site Plan (1)
1 • SoilsRepart (1) S
. MC/ES SAC determination letter . MGES SAC delercnination letter • MCIES SAC determination letter
call 651-602•1000 call 651-602-1 Q00 call 657-602-1000
Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for details.
Contact Building Inspections for sample.
**` Permit for new buildings or additions will not be processed without Emergency Response Site Plan. Ask 8uilding Inspections for requirements.
DATE: ?fz?'Z WORK TYPE: _ NEW REMODEL CONSTRUCTION COST: /,Sy c?`l J
SITE ADDRESS: ? S 7 I' I S 7 S ?' `d' L' !`?r+"t 5«? ??
TENANT NAME: 7_ cA? SUITE #:
FORMER TENANT NAME, IF APPLICABLE:
DESCRIPTION OF WORK
Name: / Zo"1 ?? l? S Phone #: ( ??3 > ZIZ,S 3?
PROPERTY Last First
OWNER
StreetAddress:
City: 19 State: Zip: Z 5?-
Company: 8 Phone #:
CONTRACTOR
StreetAddress: /71e-5 Ze?l
ARCHITECT/
ENGINEER
City: State: 1?? = Zip:
l `
??????`;,
Company: _
Name:
Street Address:
City:
State:
Licensed plumber installing new sewer/water servlce: Phone #:
Phone
Zip:
I hereby acknowledge that I have read this application, state that the information is cor ct, and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. ?b ?
Signature of Applicant: /? !?:3 ` ?/?j?
THOMAS LAKE HEIGHTS 2ND 75951
PERMIT
DATE &
TYPE LOT BL ADDRESS
12/83 4-PLEX 210 02 1542/ BAYLOR CT
220 02 1543/ CLEMSON DR
230 02 1543B
240 02 1546 BAYLOR CT
5/86 4-PLEX 250 02 1545/ CLEMSON DR
260 02 1547/
270 02 1547B/
280 02 1545B
4/86 4-PLEX 290 02 15551 CLEMSON DR
300 02 1557/
310 02 1557B/
320 02 1555B
4/86 4-PLEX 330 02 1565/ CLEMSON DR
340 02 1569/
350 02 1569B/
..,
15.65B-
--.__?--------
.
t
4/86 4-PLEX 370 02 1571/ CLEMSON DR
` 380 02 1573/
\ 390 02 1575/
400 02 1575B
5/86 4-PLEX 0 2 1577B/ CLEMSON DR
420 02 1577/
430 02 1579/
440 02 1579B
5/86 4-PLEX 450 02 1581B/ CLEMSON DR
460 02 1581/
470 02 1583/
480 02 1583B
APPROVED 3/85
PAGE 4 OF 5
34
:
BUILDING "p624
(936. 5)
/
.
?
7( 935.0 T.c. 1 " !G
? I/- (936.0) O 1? ? Alp.
` ? '
` ?y2 ?aol Z,
?' rab °??z?3f. ,9 ?
O o? ? ? 3
} 2: v?\° ?G
Paul A. Johnso
Land Survevor, Minn. Reg. No.10938
?nwnenro?a w ?wTCn'xsox.wwwuorA O tiooN?' QR
W CERTIFICATE OF SURVEY fiO?
COMBS-KNUTSON ASSOCIATES, INC. ?w ??p„?v.t ?S
COIIfUUI?i FNi1MI[Ilt N WO tURYp011i ? SRE FIAMMOi f-M71LV1 tl
y v
OolWo
? J 30
7C X 936.0 TC. X 9? 7
m°? CLEMSON
x 936 2 x q3?7
? ?Jo' ]
?,o
qQ. .
2
?^r
q°' ? ;?r Zy???o?
0? y2
. a? 5
?
9gba
?
??.
R O
y_J
iI,3p
'hy
C.
?v.
,
-atl ? ?V
a° J
q3by ?`}??h
??.
r
0 Denotes Iron Monument
° Denotes Wood Stake
XOOQ.O Denotes Existing Elevation Proposed Top of Foundation Elevation=
(000.0) Denotes Proposed Elevation Proposed Garage Fbor Elevation= 938.5
0-- Denotes Direction of Surface Drainage Proposed Lowest Floor Efevation= 939.0
I herehy ceRiry that this is a true and correct representation of a survey ot the boundaries ot
Lots 37, 38, 39 and 40, Block 2, THO?+AS LA1CE HEIf:HTS 2ND ADDITiON,
Dakota County, Minnesota
i
And of the location of all buildings, if any, thereon, and all visible encroachments, ii any, from or
on said land. It also shows the location of the stakes as set tor a proposed buiiding. As surveyed
by me or under my direct supervision this ZIId day of April 19 86
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-881-4875
NawConatructbn Reaulremenffi
• 3 registered sile surveys shaxing sq. (t. of lot, sq. ft. of house; and ?I ruofed areas
(20% maxlmum bt Coverege allowed)
• 2 copies of plan showing Deam 8 w(indax sizes; pouretl fourM design, atc.)
• lsetofEnergyCalculetbns
• 3 cOpies of Tr99 PreSBrvatbn Plen If bt pl2q6d atter 7/1/93
• Rim Joist Detail Options seleclion sheet (bltlgs with 3 or less un'?S)
DATE
SITE ADDRESS
NPE OF
APPLICANT A
STREET ADDRES5
SUIn
VALUATION
TELEPHONE # CELL PHONE #
IULTI-FAMILY BLDG ZY _ N
FIREPLACE(S) _ 0 ?1 _ 2
FAX #
W.-I ZIP 551 2Z
PROPERTYOWNER ?'lil? ?d JZ1ldr. TELEPHONE# -b
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNFSOTA RULES 7670 CA7'EGORY 1
(J submission fype) • Residential Ventliedon Category 1 Worksheet Submitted D?7c,
. Energy Envelope Calculations SuDmitted , Plumbing Conhactor: __
Plumbing system includes:
Mechanical Conhactor.
Mechanical system includes:
Sewer/Wafer Conhactor:
Air Conditioning
Heat Recovery System
Phone #
Phone #
Fee: $70.00
-------------------------------------°---------------------------------------------------------------------------°-°---
I hereby acknowledge that I have read this application, state ihat the information is correct and agree to comply
wlth all applicable State of Minnesota Statutes and City of Eagan 0,Xdpn? ??
Y\ Signaiureof
OFFICE USE ONLY
HemodeVNeoelr HeuuiremeMs
. 2 copies W plan
. 1 set ot Energy Calculatbns for heated addilbns
. 1 site survey for exterioraddnbns & decks
• Indlcate d home served by septic system for additbns
Phone #
_ Water Softener
_ Water Heater
_ No. of Baths
Lawn SprinklerL°
_ No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated M02
r
r. •
i
i . -. .: . - •
_
i '
., ? . .. '. ? { . ? ' ' i. :yi_s .>_ _ .<•1. '; .'i '' .;.
`% "_? - .' ;i' ' `? ..???•?._ _ ' e{r. ??? - '? . _ ??-'?: '
. _- ' 'y? - .? '.?'??'."i:.'y ??? ? ??r'?_' ' , . . - P° _
' . . ?. .?a ?• .? . . ? .. .. , . ,-?.
1985 BUILDZBG PEK?1I2 1,?PLICATI09 := CITY OF EACAI?,-
.?`,'Y' r -'w..s.;...?r._?:?.?.?'ri-'-iri_'s.:;?-::?: ' :.:'?1'.".;6,.i",``_`•'? 'y'a? 'S??`???"
NOTEi AI.L ;?HrkA.0 ?_ "Y. •y. ?:.iy`•`. ? " ', a' ..' .?y.Z."_'.-? ? . .. ?: d?. ' ``-`?',' j:.:
RS;lfUSi.B£ LICEitSED?SIITA.THE CITL;QF??ElIGAfi t?;
.: .= f .?". _ _ _ '? e G' t a _S.?,ri' ? %„ : .l -F?-? .. attY?._? ?- eTf` L.r. 'i+.?,?'.`..•? .
.?.a..+ _?
- ."::=..;af:?:?'?=•_ _' ?`:F,.-.,,.s.,,•?;: ::_{;;f._?. INCLUDE~2_SETSyOr'4PLARS'., •? ?_?.:;_
CFRTIFIC6TE5'OF.SUSYEY;
. ` .- . . /1?SF?' OF EP:ERGY CALCULATIONS'
' . - ` ,/? • - ' ?/ ? ?J . . ; p/
- To 5e Lsed For.. Calvation:
SiLe A
odress: OFFICE USE ONLY .
-
Lot d ?j? Block c'21_ Sect/Su Erect ` Occupancy. ':. •
Zoning
_ Farael t- _ ' • -.- - - .? - - 'nepair Yype of Coast -
_' ??? ` ?"" •` ?/? En} arge . C of_Stories
, U.rner _L.LCJ !"
/V??2t :*"G'/7E.e Length
Demolish Dzpth
- Address 0 ?L"- Grade • - . Sq Ft
- city/zip c'ade --------- ----------------------
' Fhone ?/,??O - ?d G ?3 y"? OAPPP.DVALS
Gontrzctor qssess-ents rermit p'f ? Ja
'aterl5=uer Surc'r.arge ?D
Address Police Plan P,evi=_u
- ' Fire ` SAC
Gity/Zip Code " - . - Engr k'ater Conn ,,ro0 e?
Planner Xzter N.eter ?i
Pno:,e • Council Rcad Unit. 79D `D
Bldg Off . Farks : .
krch./Engr. •_ L l. :?CL21? cv?-i? APC`. :- - ?'
?reaLrent P1•.:'?
= -
Yariance
Address . -. , . - .T02'AL ?3
CiLy/Zip Lode -
Fhone 0
. .
TOWNHOUSE - FOR SALE UNITCITY OF EAGAN N2 11790
3830 Pilot Knob Road, P.O. Box 21-198, Eagan, MN 55121
/?,7 2 ?
BUILDING PERMIT PHONE: 454-8100 Receipt k (C'
7o be used tor 1 OF 4 PLEX est. value $ 61 ,000 oate APRIL 14 19 $6
1571 CLEMSON DRIVE Erect gX Occupancy &3
Site Address ?_..-
Lot_ 37 siock 2 SeuSub. THOMAS LAKE
Parcel No HEIGHTS 2
.
W Name N .W HORTZON HOMES
; Address p n BOX 1367
0 Ciry1`1PLS- Phone4 20-3 9
, o Name SA MF.
?u
?
Address
Q
" Ciy Phone -
Ua
W W
F
U?
?w
a
Remodel ? Zoning DD
Repair ? Type of Const. 3iz
Addition ? No. Stories
Move ? Lengih dd
Demolish ? Depth--27-
Int Impr. ? Sq. Ft.
Install ?
Appravals Feee
Assessment _
Water & Sew.
Police -
Name D. GRISWpLg Fire
Address Eng.
Phone
Permit a1 F n0
Surcharge 30 _ SO
Plan Review 1 FA _ 00
snc s7s_no
waterconn. snn_nn
Water Meter 63. 50
Road Unit 290. 00
Tr.PI. 156_00
Planner
Council
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City oi Ea n Or inan/ce/,S APC.
Signature of Permittee -? Y'"? 2i1e? Var. [
Copies
Total ?9-.40
A Building Permit is issued tN ' on the express condition that
all work shall be done in accordance with all app Sta? f M ? inn o and CiTy ol Eagan Ordinances.
Buildin9 Oflicial 5
1
\S ,r .
? • • 4 _ / ` ??`??• .. • . `C ? ? a t • ` . ? 1 -% ?
- " • - . . - ._ ' . - rt . ?
- - ' -, 19B5 $UILDZNA PEfu1IT ATPLICATIQN.`- CI?7 OF EAG9B
'HOTE:--'?AId,.COH?R9CTORS;lI
. `?•? ? ? - y¢?~? ?
To Se Used For: ?fa2LG? .?u-?
? SiLe rddreas:
.
,
In: OF iUCiAN
3`
? • .?:T-r• ? a -CY: ??'f
? ?y?V• y?3:R - ? ? ? .? ? ,
UDE 2_9ETS OF PLAHS? .. •:?'... ' c
TZFICATES OF.SUHVEY;
E6ERGY CkLCULATIONS '
Date:__ ?- /7 - sG
OFFICE USE OHLY
?
( ? - •--- • . ` -
Lot: ?J d Block
?
Sect/Su'Erect Occupancy .
.'.eTodel
-1 Zoning
-
Farcel -
,
Eepair _ Type of Const
!, -' ,•
C
:ner " ,?/ C. arge .
'?C 0 of Stories
. l
e . Length -
• /? Denolish Depth
Grade Sq Ft
- City/zip Code Y?7¢O,/d-, ?/I 5.5 3( g---------- ----------------------
" Fhone ^1.77? -.?%d (j gPPP.OYALS
Gortractor 5ssessments fernit
rater/S°::er Surc'r.srce
4ddress Police Plan °evi=_v
. Fire ' SAC •
City/Zip Code ` - • ' Engr w'zter Conn
Planner t;aLer Y.=ter
Phone - Covncil Road Jnit
B1Eg Off Farks :
krch./Engr. ApC-. Treatrent Pl =.'
-. . - - i ' - - ?' Yariance
Address TOIAL ' .
City/Zip Code Phone 0
.•??? :K'_?! : _ . ?
/t?.
Ti\l?
` - _ - 3 cE
- ' - - `- - '^' 1 SET OF
Cal;uetion-
?-t--.?
CITY OF EAGAN
_ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N p-
PHONE: 454-8100
BUILDING PERMIT Receipt# ?
11792
721
To6eusedlor 1 OF 4 PLEX EstValue $61,000 Date APRTT. ld 19$1L
SiteAddress 1573 CLEMSON DRIVE Erect [}? Occupancy R3
Lot-38-1310ck Z Sec/Sub. THOMAS LAKE Remodel ? Zoning pn
Parcel No. HEI HT 2 Repair ? Type of Const V
Addition ? No. Stories
W Name NF.W HORT .ON HOM S Move ? Length 44
3 Demohsh ? Depth 9 7
Address p- n- BOX 1367
o Int Impc ? Sq. FL
City T7Pi.R Phone 420-3900 Inshall ?
= o Name SAME
oa Address
?
?
City
Phone
.
t=
Name
D GRISWOLD
? a Address
iw Ciry Phone 435-7594
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State o(
Mmnesota Statutes and Giryiof EeQanArdinances .
Signature of
A Building Permit is issued to.
all work shall be done in accord nce with all applicable State
Bullding Otlicial
Assessment
Water 8 Sew.
Police
Fire
Eng.
Planner
Council
BIdg.Off. 4 1?71 /?RF
APC
Var. Date
Permit 31 6 - nn
Surcharge 30_ SO
Plan Reviewl 58 _ 00
SAC 575_OO
Water Conn.g p p_gp
Water Meter 63 _ SO
Road Unit 29 fl _ f10
Tr. PI. l 56 _ h f1
I Total?
r
on the express condition that
an Ordinances.
r
:.
? . ' - ?, _ ?.L r , . . ,t _r ? _ ?-._ ?. ' '?? ? ? i ' ? - ? 1. `:V •
- " . : ? ?? , '?'y .- t . -?? ..' - - •'.? ?'?.,' -ti
- -_' . . '_ ? ?.n :: .'_ . .' . _ . '- . . _ . : ` G :' • . . -. c_ "?: • ' ?
•.° ' 7985 BUILDSNG PERMIT A?PLICATION.;- CIrl' OF EAGAII.,-.?'
- ? - ;;;r,-- :y_.t:_-? ?. ._ _ s ??.:-?-.K`4?? .Y?=••'. --
_ _ . '-}? _ _ -? . - _ ?r:•=?;i-: }r..E-?; : _ }f;f!'.,?,._:;--.'z`-`?a..'s%i?_:irPq z' `, .y">. _}:'?:-,t - E?
-_ = NOiE: ? A[1,,COY1iRACiORS; t4llS2. SE!LICENSED YITA,.INE;CITT;,OF_ EAGAB;,?; ;•F: ?. :_.?.'?.??<,
« . f: : i•.6 S? ? y._ - ;.
. . . L-. _ _ •?_'-. ?S:e:?;:. - '' S . . .. .
INCLUDE` 2,SETS OF' Pi.ARS'
• - - - - :+'? ` - -"? - ?ga__ ?'r-°- ':f?_.=?. - ?- -
CEBTIFICAT - -
ES OF.SU
3 SVEY: _
^1 SE? OF EF:ERGY CRLCULATIONS''
To 3e (!sed For: G?" Yalu'ation: Dote:
- Site ;,o3ress: ,,,O?,07Y,"??,./??$(,vri OFFICE USE ONLY .
Lotc?i Block'?- ,SectlSu?-,4/p?f _ Erect . Occupancy : -
?
-1 Fecojel Zoning
Farcel I
. _
? r".epair
Ty?e of Co^st
- /?'? ???
G
:ner
?L
J
?
' ,?/ En} arge .
?C
7t6
' 4 of S;.ories
.
=
c
- /7l_
u ?0 /
/
<k
sS,e _ Length -
?j u r?
bddress _? L/ Dzrolish Depth ,
, Gr2de Sq rt
City/Zip Cade MA --------- -----------------
' ft,one -3%OG APPP.OVALS ?
Cortrzctor !.ssess.ments rernit
"sterlS:uer S-ire'cErce
- bderess Folice Plan Fevi=x
Fire " SAC
City/Zip Code ` - Engr Wzter Conn
Planr.er l+ater Y.=ter
Pho-ie Council ncad Unit
hrch./Engr. ,i2114 ' Bldg Off
[(1v_&L, ApC = .- , ` Parks :
?reatmentPl ,.
- Yariance. ' " .
Address " TOTAL '. .
CiLy/Zip Code
Phone 0
CITY OF EAGAN p
,. ° 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 N- 117 9 3
BUILDING PERMIT PHONE:454-8100
Receiptn
7obeusedfor 1 OF 4 PLEX est.value $61,000 oate APR7i. 14 ?g 86
SiteAddress 1575 CLEMSON DRIVE Erect X$ Occupancy RI
Lot_39 Block 2 Sec/Sub. S LAKE Remodel ? Zoning PD
Parcel No. HE IGH ' ?- Repair ? Type of Const. 17
AddAion ? No. Stories
? Name NEW HORIZON HOMES Move ? Length 44
??
3 Address P. O. BXO 1367 Oemolish ? oeotn-2
° a MPLS phone 420-3900 Inllmpr. ? Sq.Ft.
ty mscau ?
a
o Name-
$ a Address
?W NameD• GRISWOLD
? n Address
aW Ciry Phane 435-7524
I hereby acknowledge that I have read this application and state that the
informahon is correct and agree to comply with all applicable State of
Mmnesota Statutes and City ot Eigan 9rdinanoes.
Signature of
A Building Permit is issued to: NF.W qnR T 7(
all work shall be done in accordance with all applicable
Building Ofricial
PhOne
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. Off. 1 5 fi_ D 0
Var.
Permit 316.00
Surcharge 30 _ 50
Plan Reviewl5$-90
SAC 575_00
Water Conn. 500 _ 00
Water Meter 63 _ SO
Road Unit 990 _ OQ
Tr.PI. lSFQ
I Total 2.089.00
- on the express condition that
Eagan Ordinances.
?
t . ?' . '? ? ' _ I ? '. . .r ,. y. !J ` .`•- ? •? • . , ? ? . _, - •` ??'•?''^
, ' . ' ? . s{ . ?`. ? • ? . - ? r .,f`R L
' - . .r 1 • . ' • , , - ??` ? J~
. . ? ? ? `• . _ ? ' ? . . ? . ' ? ? . • . l'+?
• ._. ..'. : .? ?.. _, . n . ' . . _ ?.?. y?Z^. ?-'
( ' ' ? . -.' ' . ? • ' . . . ' : ?yl . .:
1965 BUILDSHG PERMI? A?PLICATI09:-- CII'7 OF EAGAH?,
?-_'- `?? ' -= = ?` , r- ;i?:g .??t i:?,:,. - -vr?i]?y;?:,'-.i?. ,?i - •'s: ?t ??-:, _ -Y.:`+,.'-:`.+.?'S`=%t.
_ KOTE: ' ALL,COHTRACTORS??1SlfSF_?SE'tICE1tSED?SfITH CITL' ' :? `
_ THE- OE: EAC9M ;`?_ T;, ?. ? _ -`•;} :
_.. . , . . ..
' . . - ? ... _. .., .? ? _ .iY ''• "_ Sr: _,,ST'{'?`r_ .a..`}?[:,.?' " "' "- :.?.r .. _ "
, . . 2S???? ? Y'i?'?..' 0.•: { ?:-' f?'t'•'_' _ •j...-/-i - .•
2_SETSVOF PLANS:
. - . _ .' -- '- -r-` , - 'r-5,:.;_:`?i i?-'r:._ ':i_?.-s.....•, . -.? • _ , _
3 CER7IFICATES ?OF.SUHYEY; - ; -
SE2 OF ft:ERGY CRLCULATIOHS-' •
To Se Lsed For. Valuation: ' Date:
? Site Address: QFFICE USE ONLY ..
Lot: Block : Sect/Su Erect Occupancy, :
C2,°erodei Zoning . .
_ Fartel 0 `- - • fiepair Type of Const -
_ En?large . 0 of Stories ?
. C-aer *&'/?&??ve . Leagth . . .
`l/ ? Denolish Ikpth
_ Address /?lo Grade _ Sq Ft
• City/zip Code ----------------------------------
' Fhone y7??'3%Q(?j APPP.DYALS
ConLractor Assessments Permit
KaterlSewer Sirccarse
4ddress Police Plan °evi_w
c - ? Fire ` SAC.
Gity/Zip Code Engr ' WaLer Conn
Planr.er hater Y.eter
Phoae Council P.cad Unit.
krch./Engr, Bldg Off Farks .
c-C APC Treatrent P1
Yariance - . : _ . . . ,
Address TOTAL ` . ,
City/Zip Code
Fnone f _ `SE ? " 7Y?
BUILDING PERMIT
Receipt #
N° 11791
e?/-2 -2 (f
To be used for 1 OF 4 PLEX Est value $ 61 000 Date-APg=y jd lgg(-
SiteAddress-1575B CLEMSON DRIVE
Lot_40_elock 2 Sec/Sub. TAOMAS LAKE
Paroel No.
$ Name NEW HORTZON HOMF
o Address P. n. BOX 1367
Ciry M_phone 420-3 00
Erect )U Occupancy
Remodel ? Zoning PE)
Repair ? TypeotConst. V
Addition ? No. Stories
Move ? Lengih 44
Demolish ? Depth?']
Int. Impr. ? Sq. Ft.
Insfall 0
o Name SAMR Approvals Fees
co a Address ASS0SSrt7Bnt Permit 316 _ 00
? City Phone Water & Sew. Surcharge 30 _ SO
? a Police Plan Review 1 SR _ ?p
_i Name D. GRTSWnT.n Fire SAC $75_?0
s j3 Address
¢z
En9'
WaterConn.500,90
a W Ciry Phone 415-7524 Planner Water Meter 63 _ 50
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe CoUnCil RoadUnit 290_00
information is conect and agree to comply wlth all applicable State of Bldg. Off. 4 7LI49 T. PI. 1 5 6. 0 0
Mmnesota Statutes and Ciry of?ga Ordina ces. APC Parks
Signature ol Permittee?y"? ?? Var. Date Copies
Total? ?vp
A Building Peimit is issued to: NEW HORI ZON HOMF$
all work shall be done in accordance with all appticable State of Mi sota Statutes nd i on
} Ea an the express condifion that
Ordinances.
Bullding Oflicial ? ? ?
Y
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55121
PHONE: 454-8100
ow* 1992 BUILDING PERMIT APPUCATION ' CITY OF EACiAN REQUIREME(dTS:
01 n?
SINGLE FAMILY 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET ENERGY CALCS.
MULTIPLE DWELLINGS 2 SETS OF PLANS, 3 REGISTERED SITE SURVEYS, 1 SET OF ENERGY CALCS.
# OF UNITS RENTAL FOR SALE
COMMERCIAL 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SEf OF
SPECIFICATIONS, 1 SET OF ENERGY CALCS.
PENALTY APPLIES WHEN TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING
DAY OF MONTH IN WHICH REQUEST IS MADE Q$ LOT CHANGE IS REQUESTED ONCE PERMIT IS
ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH
ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
f/N;S/ 4serGR
To Be Used For: ttv,t 2-OkNIleI66 Valuation:
Site Address
Date: / --? y- 9.2-
Lot ? Biock I FEE
_ Occupancy Bldg Permit 35, ?
Parcel/Sub 4444 Lr",b 1,,,,( Zoning Surcharge •sw
l
• O Actual Const
All
bl Plan Review
License Fee
wner a owa
e
47, # of stories SAC, City
? Address Length SAC, MWCC
Depth Water Conn.
- City/Zip ? i- S.F. Totai Water Meter
Footprint S.F. Acct. Deposit
. Phone 2- S/W Permit
On-site sewage • S/W Surcharge
Contractor On-site well Treatment PI.
MWCC System Road Unit
Address City water Park Ded.
PRV Trail Ded.
CryjZip 8uWLei PuriN ^vopies
SUBTOTAL
Phone License APPROVALS Penaity
Planner Lot Change
Council TOTAL 35,5
Arch./Engr. Bldg. Off. Ds / s 0-92
Variance
Address
City/Zip Code
Phone #
Sewer/Water Licensed Contr. . Processing time
for sewer/water permits is two ays once area as en approve .
407-p _ agrees that all work shall be done in accordance with
ignat re o ermiitee
all appiicable State of Minnesota Statutes and City of Eagan Ordinances.
CITY OF EAGAN p?p 0 0 7 5
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
/? OI7I/1
BUILDING PERMIT PHONE:661•4675 Receipt # ??
Tobeusedfor BASEMENT FINISH EscValue Date_-_: FEB 3 ,1 992
Site Address 1571 CLEMSON DR
Lot 37 81ock 2 Sec/Sub.THOMAS LAKE HTS
Parcel No. 2ND
Name DOUGLAS B LARSON
Z AddreSS 1571 CLEMSON DR
? Cj(y EAGAN MN Z]P 55122
Phone 683-9462
x Name SAME
0 U Address
? CitY Zp
Phone
$
License #
I hereby acknowlege that I have reatl this application and state Ihat the
iniormation is correct and agree to comply with II applicable State of
Minnesota StaNtes and ol Eagan, rdi .
i
Si9naNre ol Permitee - -p'??
A Building Permit is issued to: DOUGLAS B LARSON
on the express condition that all work shall be done in accordance with all
applicable State of Mmnesota Stawtes and Ciry1of Eagan Ordinances.
Bwldmg Official ty il.? ! ?.27
Occupancy
Zoninq
(ACtuaq Const
(Alloweble)
# ot$tones
Lenglh
Depth
5 F Tolal
S F. Footprinis
On Stle Sewage
On Stle Well
MWCC Syslem
City Water
PRV Required
Booster Pump
APPROVALS
Planner
Councd
Bldg. Off.
Varience
OFFICE USE ONLY
ewg. Penna
Surchaige
Plan Review
Liceree
SAQ City
SAC,MCWCC
Water COnn
Waler Meter
Acct. Deposn
SNJ Permil
SNJ Surcharge
Treatmant PI
Road Unit
Park Ded.
Copies
TOTAL
FEES
35.00
.50
aS Sn
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-75951-370-02
DESCRIPTION:
PERMIT ?
PERMIT TYPE:
Permit Number:
Date Issued:
1571 CLEMSON OR
LOT: 37 BLOCK: 2
THOMAS LAKE HEI6HTS 2N0
REBUILD
Bu ild'Sn2?,wPermit Type
?uilding [Jqrk Type
r'Census_ CocLe ?
,-,
f? -5
..?
DECK
DECK
ALTERATION
434 ALT. RESIDENTIAL
x y-?
'aitSMt{ ?v
?-.`.t"( l ?4`sq•i: ?'?4m? ?$ryLl
BUILDING
030374
07J17/97
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Total Fee
$50.00
$50.50
CONTRACTOR: - Appricant - OWNER:
NELSON, KEI7H 14206550 BLUMHOEFER MICHAEL
185;L1 86TH PL N 1571 CLEMSON DR
MAPLE GROVE MN 55311 EAGAN MN
(612) 420-6550
.
? - i
I hereby acknowledge that I,have r,ead this appl}cation and state that the
infarmation =ie cQrreot ariftf ag.?•ee to opmplyz?wi:thl ?aik'=.aPp'jicakle Stdte-7Qt [Rn,
3tatuC'es and City of Eagan Ordinaaces. `
r
A IC /P RMITEE SI NATURE I ED BY SIG ATURE
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
? CITY OF EAGAN
8830 PILOT KNOB RD - 65122
681-4675
New Construction Reauirements RemodeVReoair Reouirements
? 3 registered site surveys
? 2 copies of plans pndutle beam 8 window sizes; poured fid. design; etcJ
? 1 energy calculatlone
? 3 copies M Vee preservation plen H bl plaCed after 7/7/93
reQulred: _Yes _ No
DATE:
? 2 copies of plan
? 2 aite surveys (exterior etltlttiona & decks)
• 1 energy celwlations }or heated additions
Ca"
76
CONSTRUCTION COST: X 2,fz' cz
DESCRIPTION OF WORK: [3_e Q U I lA 1 U IC 1? DF-Z-K
STREET ADDRESS: ?S7 I C' IL-'Yl SCS/l.) p/c
OL T Aq BLOCK SUBD./P.I.D.#: PROPERTY
OWNER
CONTRACTOR
Name: APit mt?,nPjnn , 7Yl uknrl. Phone #:
?.
Street Address:
City:
State: Zip:
Company: K C l T bf ?S Q,shcU Phone #: L'1 '2-0 L?d
Street Address: 8"G n PC License #:
Ciry:03 iw/? 6 A&VLS State: Zip: S3-3 //
ARCHITECTI Company:
ENGINEER
Phone #:
Name: Registration #:
Street Address:
City: State: Zip:
Sewer 8 water licer•ned plumber (new construction only): . Penalty applies when address change
and lot change am ?equested once pertnit is issued.
I hereby acknowledge that I have read this appliqtion and state that the information i rrect and a e to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
GeRificates of Survey Received
_ Yes
_ No
* s-a . s()
Tree Preservation Plan Received - Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex a 11 Apt./Lodging ?
? 02 SF Dweiling ? 07 4-plex o 12 Multi RepaidRem. ?
n 03 SF Addition ? 08 8-plex n 13 Garage/Acoessory o
0 04 SF Porch o 09 12-plex ? 14 Fireplace n
0 05 SF Misc. ? 10 = plex ?95 Deck
WORK TYPE
0 31 New o 36 Move
0 32 Addition
Repair o 37 Demolition
GENERAL INFORMATION / 9d` y- ! ?y f ,o
e!*
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. Tt. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq, ft, Census Code. ?
Depth Footprint sq. ft. SAC Code OL
Census Bldg ?
2 Census Unit o
APPROVALS /
X
Planning Building
Permit Fee i
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Treils Oed.
Other
Copies
Total:
Engineering
Variance
Valuation: $
% SAC
SAC Units
„
?
X 935.0 T.c.
?
?
Q.
?
y
?
W
Ci ? 3 °
BU I L D/N6 ap° 2¢
7 I C msau p R
1?o X t 0 (j t?-go «p
(936. 5) ? (0) ff?
? ? ws
(9sb.0) 0 b N
•' e\? Q , ,LI ?'C.' J R J
10??T, po _
` 30
ab °' ?°? o''?'?
0
! ? v+
9
'? ,0
A` /
9•J'PF9 - •a? `o' e `\ \? cb
? oow p bp ?52 y? a?'S
.?o a a.yb- O +
1 }
°? X 936. D TC. X 9?'?
nTC L'L EM 5 0
x q3??
0 Denotes Iron Monument
° Denotes Wood Stake
X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation=
(000.0) Denotes Proposed Elevation Proposed Garage Fbor Elevation= 938.5
0- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 939.0
t hereby certify that this is a true and correct representation of a survey of Me boundaries ot
Lots 37, 38, 39 and 40, Block 2, THO?IAS LAKE HEI(;HTS 2DID ADDITZON,
Dakota County, Minnesota
And of the location of all buildings, it any, thereon, and all visible encroachments, ii 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 ZDd day of April 19 86
J/!iii? GG. 1?I'1
. McCOMBS-KNUTSON ASSOCIATES, INC.
/*? ??? CCMf,ItIMG 4GIYfINS S 111f0 SYIIV[10R I Slf! IU?YYUf
/l?'.?, wMM[/JOIY W MuTCN?MSON.Y??a[[OTw
Paul A. Johnsod?
Land Surveyor, Minn. Reg. No.10938
"CERTIFICE OF SURVEY
fior
NEW HO#?[ZON HOMES
July, 1997
City of Eagan
Eagan, Minnesota
To Whom It May Concem:
Re: 1 S7 1 C 1 Em S6P 1) 2
The holder of this letter is hereby authorized to build a deck up to a total area measuring 1Ox20
on the property owned by Aorizon 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-Lazge
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 PERMITTYPE: suzLoiNs
Eagan, Minnesota 55122-1897 PermitNumber: (1330299
(612) 681-4675 Date Issued: 0 6/ 2 5/ 9 I
SITE ADDRESS:
157' CLEMSON Dt2
L07: 38 fiLOCK: ?
TI-iOMAS LAKE HETGHTS 2PaD
P.I.N.: 10-75951-3II0--02
DESCRIPTION:
ReBu7Lo
BluildSricj*-_j'ermit ?ype
Buzld.incj: 1?4r,k Type
/ Census €t}de
?_-•
rv ?..,. ;, . . ' . . . .%:
f
\ ,r
oECi:
DcCK
ALi'ERAI'TON
434 ALT. RcSIDcNTIAL
t
REMARKS:
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
COfVTRACTOR: - Fl p r 1 i t; a rit- OWNER:
NELSON, KEITH 14206550 PLAl1TZ KAY
18511 86TH PL N 1573 CLEh7SON DR
tIAPLE GRQVE "IN 55311 EFGAN Mh
(612) 920-6559
S here6y acknszwletlge Chat.1 have ?rea-d Ghi.s,
infarmation is carrect and agr^ee L'o comply
StatUt??s and Clty' af, Eagaas OrC13ttaAcos. a
L
PPLICANTlPE I SIGNATURE
aPp1i??t,it3a and ztAte that tfle
with al1 appl_cabte State of Mn.
-ISSUED`? W. ST?fiNaA U ? E ?
c.crv i?r- FnrAr!
r'46iirrr.z _ 'n:RMl.n!nl.. No. 57
1A"iE::; ;:)ri,/i:'.`..,/'i)'t 1't:Mh'.,: 1.4a..'.°.';:?9
I%
NAPfI";: 4_E'iTl-I D
'i'c':Io 9l.7(I' 150S t'LCMSfIf? )II'+ 5Q„00
'r.?'.;'.if', 9001. :!.'li3 Ct_'r.'M;;(iN Dh? 0,S(.1
?;? I tl 9001. 1.1575 r;P 1150.00
2155 300i. :I575 C;LE:Mf>rN Uf: U..:5O
r
Ioi;:.71 }ip:_h)1.pI: PamiPJni;c LIl'I.,.f70
Cf;flr",5`?W
USI:Ft .[ri;; NANCV
?
3 b-Z?C) 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681?675
New Conatruction Reauiremerds RemodeUReoeir Reauiremenfs t L
? 3 regiatered si[e surveys ? 2 mpies of plan
• 2 copies of plans (lulude beam & window saes; pourod fid. deaign; eta) ? 2 site surveys (exterior addttfons 8 tledca)
? 1 energy wlculations ? 1 eneigy calwletlons for heated addWans
? 3 eoPiea o} tree praeervation pWn 'rf bl platted after 711/93
required: _Yes _ No
DATE: ^' S"Q 7- CONSTRUCTION COST:
DESCRIPTION OF WORK: (? r? ? ?L+2 I a x W LLLE,
SIREET ADDRESS: ? I S 73 ?)Lt7"So-J U?
? 'p
LOT ? BLOCK SUBD./P.I.D.#: ???' (??-?h)Ld,
PROPERTY
OWNER
CONTRACTOR
Name: All,Phone #:
Street Address:
City: State: Zip•
Company: ?? t`f'f-I- N?Sd7l-/ Phone #: yzo W-?V
Street Address: Arll License #:
City:,6l-VV46-e- State: z??Xi Zip: Sf 3??
ARCHITECT/ Company:
ENGINEER
Name:
Phone #:
Registration #:
5treet Address:
City: State:
Sewer & water licensed plumber (new conswction onry):
and lot change are requested once permit is issued.
Zip:
Penalty applies when address change
I hereby acknowledge that I have read this applicadon and state that the information is cortect and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
Signature of Applipnt
_ Yes _ No
_ Yes _ No
REZ-
iuiq D
NotRequired $ ;
PERMIT
A,bTl OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: a u z Lo z NG
Eagan, Minnesota 55122-1897 Permit Number: m 3 G, 2 0 8
(612) 681-4675 Date Issued: 0 6 j 2 5/ 9 7
SITE ADDRESS:
1.575 CLEh1SON CR
LO'1': 39 BLOCK: 2
TMOMAS LF1KE HEIGMTS 2140
P.I.N.: 10-75951-390--02
DESCRIPTION:
-,,.. REsurLo
3i1dind?,f ermi.t Type
ay?,il.d?nq l4?4;k Typs
"?Ca'r.eeus Ctrda
?' -
.?
. . .. ., ?, r3
< "? y
a "%:? "_,b-?-•
oECh
DfCK
AI.TERFlTION
434 Al.'1'. RESIDEN7IHL
REMARKS:
FEE SUMAAARY:
Fiase Fee $50.00
Surcharge g.50
Total Fee $50.50
CONTRACTOR: - Applicanr -- OWNER:
NEL50N, i<EITH 14206550 SWAN"f1N LFlURA
1&511 86TH PL N 1575 CLEM^a0W Dft
MAPLE GROVE PiN 55311 EAGAN MN
(612) 420--5550
e
i hereby aalInowJ,edqe thet I haue rerad th€s applkea'Clara 4,nd 6tate thaC the
inParrriati+arr`'is aoreect ' 'rid a'?r?a `txs-cui-o•piy s??t:K a11 4t1p13tab.ta ,?`atate af h1n.
StatuCes and Gity afi Eagan Ordinances.
o'?: R o, r? ,IEm,?
I APP NT/9 FP G IUUF1? ?
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4675
?
New Canstructfon ReauiremeiAS RamodaVReoeir Reauircments
? 3 regiatered site survoys ? 2 copros of Plan
? 2 copies of plans (Indude beam 8 window saes; poured fid. deafgn; etc.) ? 2 site suneys (exterior addffllona 8 decks)
? t eneigy ealalatlona ? 1 errergy plwletlons tor heated additions
? 3 eopies af tree preaervetlon plan ff IM plalted after 7/1/93
requlred: _Yes No '
DATE: lo' S!7 CONSTRUCTION COST:
DESCRIPTION OF WORK: .& 110 LPD 'toX Id QL7-IC
STREETADDRESS: J
LOT M BLOCK
! 5-7 S? 0- WmSDrt/ // k
I SUBD./P.I.D. #:
PROPERTY
01NNER
CONTRACTOR
Name: 1I WmLfm . hu.tm Phone #:
?..
?
Street Address:
City: State:
Company: ? L't-H 64>29>t--?
Zip:
Phone #: ti 2,0 (° 53V
Street Address: C-? 7``r4- /V License
City:A21/f- 6i?-j state: OYX?- zip:
ARCHRECT! Company:
ENGINEER
Name:
Phone #:
Registration #:
Street Address:
City:
Sewer & water licensed plumber (new construction only):
and lot change are requested once permit is issued.
PenaKy applies when address change
I hereby acknowledge that I have read this application and shate that the information is correct and agree to comply with all appiicable
State of Minnesota Statutes and City of Eagan Ordinances.
OFFICE USE ONLY
CerSficates of Survey Received
Tree Preservation Plan Received
Signature of Applicant
_ Yes _ No
_ Yes _ No
- Not Reqwretl
State: Zip:
--?-CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE
P.I.N.: 10-75951-390-02
DESCRIPTION:
PERMIT
PERMITTYPE: euzLoins
Permit Number: 031194
Date Issued: 12 / 01 J 9 7
1575 CLEMSON DR
LOT: 39 BLOCK: 2
THOMAS LAKE WEI6HTS 2ND
(GAS INSERT)
6"611ding , M,Permit Type FIREPLACE
Bwilding,W6,rk Type NEW
??`Census Code 434 ALT. RESIDENTIAL
?A
?
t._w
_ dR
'? . " _ .'p...
>.w ? • ' '~pv??
??..fY'4ij?G??Y .{????°R'j....&?•.a
V?y T?, di i .w,
F-t ,
c=?
REMARKS:
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CONTRACTOR: - Applicant - OWNER:
GAS LINE PLUS INC 12266220 SWANSON LAURA
4806 RU7LEDGE ST 1575 CLEMSON DR
PRIOR LAKE MN 55372 EAGAN MN
(612) 226-6220
L
I here6y acknow2edge Ctiati Z F7'?ve rJead CfS1s6#ipl38a?16-n a-nd.`state tha't' the ..'
information is correct and agree tn comply with allapplicable State vt Mn.
$Gatutes and City of Eagan Ekrtlinarrees. T
/? _ . ... ...... .. . _. :.,
J -l(
APPLICANT/PERMIT?TU(iE IS ED : S T F ?
CITY OF EAGAN
' 3830 PILOT KNOB RD - 55122
1997 FIREPLACE PERMIT APPLICATION
'5 jq4 681-4675
DATE:
DESCRIPTION OF WORK:
STREET ADDRESS: -?-,
LOT ? BLOCK
_ CONSTRUCT N W FIREPLACE
? INSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OTHER:
75
i SUBD./P.I.D. #:
APPLICANT. (circle one only) OWNER CONTRAC
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.
PROPERTY
OWNER
FIREPLACE
INSTALLER
GAS LINE
INSTALLER
Name: ?`)c_ Pyvyz r\ L (:?,r F\ Phone #: 41?
?
Signature: -
Street Address:
City:
?J U.ff 'o
PERMIT FEE: $50.50
ALTERATIONS TO EXISTING
R.
State:
Zip:
Company: L\,\E-_ Phone #: ,a n
Signature:
Street Addzess: Pj(, -, '? A tL,d 9 ?} License #:
X S-537z
City: State: Zip: 4-;G91
Company: V,'t 4?7- Phone #:
Name:
Signature: _
Street Address:
City:
State:
Zip:
PERMIT ?
CI'1'Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
1575 CIEMSON DR UNIT 8
LOT: 40 BLOCK: 2
THOMAS LAKE HEIGH7S 2ND
P.I.N.: 10-75951-400-02
DESCRIPTION:
REBUILD
Bti3ldin'ig.?Permit 7ype
$uilding. Wqrk Type
?Census C`6de
r- _
,
..!? -z ? ; i "`• %
..6
{
Base Fee $50.00
Surcharge $.50
Total Fee $58.50
?
??l?it)L, l3
.. .. v°0.?f''??¢i. ? .......
REMARKS:
FEE SUMMARY:
CONTRACTOR:
NELSON, KEITH
18511 86TH PL N
MAPLE GROVE MN
(612) 420-6556
I
?
- Applicant -
14206550
55311
PERMITTYPE: BuzLozNG
Permit Number: 0 3 0 3 7 5
Date Issued: 0 7/ 17 / 9 7
DECK
DECK
AI.TERATION
434 RLT. RESIDENTIAL
OWNER:
FOX
1575
EA6AN
THOMAS
CLEMSON DR B
MM
Z he-reby acicneswledge that -1-,have rse,if tFr`is' 'apPilicattLDr abd state that'tthe.
informat3on is correet and agree to comply,with all applicable State ot Mn.
Statutes arjd C3Cy o$ Eagan"'brdYnahaei.'
?
PLICAW / R SIGNAT E ISSUED BY. IGNATU E
1997 BUfLDING PERMIT APPLICATiON (RESIDENTIAL) # S-Q , .?
l CITY OF EAGAN
8830 PILOT KNOB RD - 55122
b
681-4675 717
New Canstruction ReauiremeMS ggmadellRaoair Reauircments ? 9 registered aite surveyc ? 2 copiss of plan
• 2 copies of plans (inUutle beam & window sizes; pouretl fid. design; etc.) ? 2 site surveys (exRerior atlditions & dedcs)
? t energy calalatlons ? 1 energy celculetiona for heakd additions
? 3 coples of tree presarvation pian'rf lot plariad after 7)1 f93
required: _ Yes _ No '
DATE: 7-- I-c'1 ? CONSTRUCTION COST: l!?6v -??
DESCRIPT{ON OF WORK:
.STREET ADDRESS:
LOT -JO- BLOCK
PROPERTY
OWNER
CONTRACTOR
Name: {t mfa1 Phone #:
u.,
mv
Street Address:
City;
State: Zip:
Company: l'f e I-f'If Al/?ZSts?V Phone #:
Street Address: l ,Vr// Ai t` 00G License #:
City: /YI/IA/e State: /19,4? ZipSTj
ARCHITECT! Company:
ENGINEER
Phone #:
Name: Registration #:
Street Address:
City: State: Zip:
Sewer & water licer•sed plumber (new construction onty): . Penalty applies when address change
and lot change are iequested once permit is issued.
I hereby acknowledge that 1 have read this application and sfate that the information i5,9 rrect and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
_ Yes
_ No
Tree Preservation Plan Received - Yes - No - Not Required
Y _ SUBD./P.t.D. #: .J lh mnn,L
OFFICE USE ONLY
?
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
0 02 SF Dwelling ? 07 4-plex
0 03 SF Addition ? 08 8-plex
? 04 SF Porch a 09 12-plex
? 05 SF Misc. ? 10 = plex
0 11 Apt./Lodging ?
? 12 Multi Repair/Rem. o
n 13 Garage/Accessory o
? 14 Fireplace n
,z::;? 15 Deck
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
WORK TYPE
0 31 New 0 36 Move
? 32 Addition epair o 37 Demolition /
GENERAL INFORMATION ? ??? ? ? f ",
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main levei sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. 9"
Depth Footprirtt sq. ft. SAC Code
Census Bldg ?
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee ?
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Oed.
Other
Copies
Total:
Valuation: $
°k SAC
SAC Units
X 935.0 T.C.
`V
`
Q?.
0
?
v I
? 30
%2`, r•'
\l r :.:
JO ?
? l
.: .(1 . o
qq 0
? ?
?
rc x 936.0 rc. x N
°CL EM 5 0
x q36,?
BU! L DiJVG 'A 2¢
n !y? :?-.
a. Q I
).57113 C Ivmsav Df,
??Jlox)a
R E &o rc,o &?Asr
s
9 ?J
OO =
Dcb vl
I , ? y2' 30-011 ?O ?
LQe\?
o° 5z JL` ?y
A?. ? ?` +q.ybh O }q
O Denotes Iron Monument
° Denotes Wood Stake
X000.0 Denotes Existing Eievation Proposed Top of Foundation Elevation=
(000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 938. 5
f- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 939.0
1 hereby certity that Mis is a true and correct representafion of a survey of the boundaries oY.
Lots 37, 38, 39 and 40, Block 2, THO?IAS LARE HEIGHTS 2rID ADDITION,
Dakota County, Minnesota
?30
hh
D.
AL'
V i
And of the location of all buildings, if any, thereon, and all visible encroachments, i( any, from or
on said land. It also shows the location of the stakes as set tor a proposed building. As surveyed
by me or under my direct supervision this Znd day oi Anril ?g A6
Paul A. Johnso
??.`.p. MYTCXINSOM.YlwJFiOTA ?-,
Land Surveyor, Minn. Reg. No.10939
RFJLE?NEW CERTIFICATE OF SURVEY
fior
McCOMBS-KNUTSON ASSOCIATES, INC.
????? CORfUlflNi lIIOI1IGi ? IAIIC ILIIIYGS f7VS1 u??? I,,,?MES
:•?,
(936. 5)
/
/_.• (936.0) e `\ 'OAb.
, ; ' a52 ?aol 2~
?' _? z3 I
J C
July, 1997
City of Eagan
Eagan, lvfinnesota
To Whom It May Concern:
Re: I S73 .Q C I E1Y1SaA) C) R
The holder of this letter is hereby authorized to build a deck up to a total area measuring 10x20
on the property owned by Horizon Hills Home Owners Association. The holder of this letter
understands that because the deck is built on Association property, it becomes the property of the
Association, with the unit associated with the deck continuing to exercise their private use
exclusions.
The Association will ensure the deck is constructed and the cement footing is poured to meet the
City of Eagan building requirements and will order the final inspection of such when work is
completed.
Please feel free to contact me with any questions or concerns.
Sincerely,
Horizon Hills Home Owners Association
Bazbara Koob, CMCA
Property Manager, Member-At-Large
cc: File
P.O. BOX 21423, EAGAN, MN 55121
(612)688-0695
HORIZON HILLS HOME OWNERS ASSOCIATION
i 37, eL ? oL CITY OF EAGAN CITY USE ONLY
`?.7S ?p /?, ?? PLUMBING PERMIT
SUBD. (612) 681-4675 RECEIPT #'d
DATE °?
RESIDBNTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE THE FOLLOWING:
g? ??.? N0. FIXTURES EA. TOTAL
NEW CONST I? REPAIR/ADD ON (?
ADD ON _ kf SHOWER 3.00
REPAIR _ ? WATER CIASET 3.00
SATH TUB 3.00
v IAVATORY 3.00
OWNER NAME: /`i ????OW _ KITCHEN SINK 3.00
IAUNDRY TRAY
HOT TUB
SPA 3.00
00
3
SITE ADDRESS: / .
WATER HEATER 3.00
? FLAOR DRAIN 3.00
?
J GAS PIPING OUT.
'it ,?•
iy.pS??
INSTALLER: ? _ (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
ADDRES S: /?J ?I c?LG/vt S o ti D4 OTHER
WATER SOFTENER 5.00
CITY:'?k ZIP: PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE W. TURNAROUND 15.00
/.S . o0
?
? STATE SURCHARGE .50
lS.,5-0
SIGNATURE OF PERMITTEE TOTAL: S
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS: _
TENANT NAME: _
SUITE 0:
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
CITY OF EAGAN
CONTRACT PRICE:
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
$
(SIGNATURE)
CITY OF EAGAN
C APPLICATION FOR PERMIT
? SEWER AND/OR WATER CONNECTION
*IOT173: PAYMF?7P OF FEE AT TIM pF :
r,rrLIcr.TTON ooFS Nom wrsTTwm
APPROVAL OF PEE2MIIT.
itvsnECriorr oF sEwat Arro/ox WA-Tat '
TALG'1'AT.7ATTOjQ$ Wn,L ND'1.' $E $SCHID- -
ULID UNTII, PmNffT fAS BM ?
APPROVID. '
?
1) PROPERTY ADDRESS: '1i'ACimwIV br•
LEGAL DESCRIPTION: j?_?'p • Z- ?rbr)WIQ5 LL?k-e_ 4L Z
Lot Block Subdivlsion or Tax Parcel ID )
IF E}QSTING STRCCiL'RE, DATE OF OR2GINAL Bi.?ILDING pERMIT ISSL'ANCE: '
?
PRESIIW ZONING/PROPOSID C'SE: (Nbn Year
(D M%MF2CIAL/RE!'AIL/OFFICE
Q IIIDC'STRIAL
? INSTI'IL'TIONAL/GOVII2NNIEN'p
F] R-1 SINGLE FAMILY
r-I R-2 DCPLEX (Tr,o L?nits)
R-3 TOWNFIOIISE (Three + Units) ( 4 Onits)
Q R-4 APARTMEN'P/CODIDOMINIUNl ( Units)
2)
i
AC
CITY. STA:E
3)
u r ?•
NAM•
:
ADDR£SS:
CIT"L, STATE, ZIP:
PHONE:
Plumbers License:
Active
FScpired
Not recorded
Staitial
4) C!??u9:4?J• ip•
NAME:
ADDRFSS:
CITY, STATE, 2IP:
PHONE:
iL
5) ?? r ? a?• : o • sa • o-?
? CUNNECTION 'IO CITY SEWER 14 CONNECTION 'IO CITY WATER OTuR '. .
5} ? Y• Y' • i• n PLEASE HOLD APPROVID PEE2MIT E'OR PICK-UP BY ONE OF ABOVE ----' -
r?r PLEn,SE MAIL ApPROVf9 PERMIT ZU 1, 2, 3, 4, ABOVE
, (Circl one)
» 4•q-?
ra?
FOR CITY USE ONLY
PERMIT # ISSL'ED
3s -? - y.?3 4
Pd w/Bldg. Permit FEES:
$ $ ?G ' S G SEWER PERMIT ( INCLL'DE SL'RCHARGE )
$ $ ?O5 a WATER PERMIT (INCLC'DE SL'RCHARGE)
$ $ WATER METER/COPPERHORN/O[:TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ /S V U ACCODNT DEPOSIT - WATER
$ $ ? wAc
$ $ SAC
$ $ TRONK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRL'NK SEWER
$ S LATERAL BENEFIT/TRL'NK WATER
$ WATER TREATMENT PLANT SL'RCHARGE
$ S OTHER:
S / .;z Gl V:SSo TOTAL
6 i 7 7 J-'
RECEIPT
RECEIPT
DOES OTILITY CONNEC TION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMZT FOR WORK WITHIN PLBLIC
Q
NO ROADWAY" MUST BE ISSUED BY THE ENGINEERING
DIVISION
. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY:
TITLE:
DATE:
?
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*R7Pw,: PAYMF:NP OF k'EE AT TSME OF
APPLicmioN mES NOr CONSTITUTE
APPROVAL OF PERbffT.
ir7sencriox oF sF.wM ArID/ox MUM '
TAl4i`Ai7.ATTONS WIL1. NOi' BE $CHED• '
UI.ID UNFII, PEE2MIT HAS BEFSI ;
APPRaVFD. ;
?S Please Print
"1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF EXISTING STRCCiiR2E, DATE OF ORIGINAL BC'ILDING pERMIT ISSL'ANC.E: '
? (MOn Year)
PRFSENr 7ANING/PROPOSID C!SE:
0 COIVP-IEE2CIAL/REi'AII,/OFFICE
r7 IbIDCSTRIAL
f7 ZNSTI'IL'TIONAL/GOVII2Nh?,T]T
R-1 SINGLE FAMILY
R-2 D[;PLEX (1WO Dnits)
? R-3 TOWNH?SE (Three + Units) (?Onits)
? R-4 APARTMENT/CONIDOMIDIIUM ( Units )
2)
AC
CITY, STATE
3) • u ?: ?• For City [.?se
?"?: _?J?YI ??a171?''1Q - Plim?bers License:
??5: 1?nr minn ;nnlz ??d • ?t??
? F?cpired
i CITY. STATE, 2IP:.Mi]nne*)n?? ?? --j Not recorded
PHONE: A?• ZSZ I MASTER LICENSE# I7(t?jM t?' ?ytial
4)
••. • • , i?+•
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5) ? r
? ,•? r• a• : a as
CONNECfION TO CITSC SEWII2 ?.
qd CONNECrION TO CITY WATER 0 OTf1ER
6) '' M' - r i• ? P7,EASE HOLD APPROVED PII2MIT EC)R PICK
BY ONE OF ABOVE -' -` --
(? PI.EASE MAIL APPROVID PIIiMIT ? 1, 2,- ? 4. FIBOVE
7 7 (Circle one) A
7) m.S,C-?w /1_cI_ o/?
IL
4.
PERMIT # ISSL'ED
7 S-v 1502-
Pd w/Bldg. Permit
$
$
?.? .. 5?
$
$
$
FOR CITY USE ONLY
FEES:
$ Id - S6 SEWER PERMIT (INCLUDE SCRCHARGE)
$ 165-0 WATER PERMIT (INCLUDE SL'RCHARGE)
$ WATER METER/COPPERHORN/OL'TSIDE READER
$ WATER TAP (INCLUDE CORPORATIO[V STOP)
$ SEWER TAP
$ $ 15-,D O ACCOUNT DEPOSIT - SEWER
$ S ?S D- Z' ACCOL'NT DEPOSIT - WATER
$ S G G• v n $ wAc
$ _ .S 7S $ SAC
$ $ TRLNK WATER ASSESSMENT
$ TRONK SEWFR ASSF.SSMENT
$ $ LATERAL BENEFIT/TRONK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ - ?S l• ? U $ WATER TREATMENT PLANT SDRCHARGE
$ $ OTHER:
a $ TOTAL
? /77
RECEIPT RECEIPT
DOES UTILITY CONNE CTION REQUIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A" PERMIT FOR WORK WITI-IIN PDBLIC
Q
NO ROADWAY" MUST BE
DIVISION ISSUED BY THE ENGINEERING
. LIST AS A CONDITIO[V.
SD BJECT TO THE FOL LOWING (?b[VDITIONS:
APPROVED BY:
TITLE:
DATE :
CITYOF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*__&_1 SINGLE FAMILY
Q R-2 DL'PLEX (1t„o L?nits)
1?7f R-3 7Ch4NiOLSE (Three + Units) (A-Units)
y`?c
? R-4 APARTN4IVT/CONIDOMINILfi1 ( Uni.ts )
Please Print) ^^^^
^
1) PROPERTY ADDRESS: I?}?^CAeJr]C??y%.j DY•
LEGAL DESCRIPTION: 'L . Iby?s Wj?p 4+L. Z
/,1.0 Lot Block Subdivision or Tax Parce ID )
If' EXISTING STRCCiL'RE, DATE OF ORIGINAL BLILDING PERMZT ISSL'ANCE: ." '-
? Year )
PRFSE[1P 7ANING/PROPOSID L'SE: (I•bn
CA+VEI2CIAL/RETAiL/OFFICE
Q IDIDL'STRZAL
rl INSTIT[,'TIONAL/GOVERNMENT
2) NAP9E:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
. 3) NAME:'rho6mn Pijn hIA'?
ADDPZSS:122o i -mi nnPhn n Hw,
? CITY. STATE, ZIP:inneAbak-& LdN_.st_y
rxorE: . 2?21 MASTERLI(EN5E#
4) ??. • •
NADE:
ADDRFSS:
CI11', STATE, ZIP:
PHONE:
iL
NOT?': PAYMFTLC OF FM AT TIM pF
APPLICATION mES NOT ODNSMTUM
APPROVAL OF PERNIIT.
itvsenClzota oF sEWEt nrm/ox Mant
INSTALT+1'IONS WII,L NOT BE SC1gD-
ULFD [1NPII. PII2MIT HAS BEIN
APPROVID.
rlwtweis L1Cei152:
Active
? F?cpired
Not recorded
1
5) ? v ? r• •?• : o • o? - a?
? CONNECPION 1C) CITY SEWEft ? CONNEXTION TD CITY WATFR OTHER .
6) '? ..•?. ? PIEASE HOLD APPROVID PERMIT F'OR PICK-CTP BY ONE OF ABOVE
PLEASE MAIL APPROVID PERMIT SD 1. 2. 3Q 4, ,ABJVE .
?
(Circle one)
7) r. r. •. utIA f?Qj`iiY iYf_4u-?..+! Q-Q •
FOR CITY USE ONLY
PERMIT # ISSC'ED
735- s- y/Z
Pd w/Bldg. Permit FEES:
$ $ 5--G SEWER PERMIT (INCLDDE SURCHARGE)
$ $ /U • S? WATER PERMIT (INCLUDE SL'RCHARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOLNT DEPOSIT - SEWER
$ $ /S l- -6 ACCOONT DEPOSIT - WATER
$ SG U • u-0 $ WAC
s 5'? -o o $ sAc
$ $ TRDNK WATER ASSESSMENT
$ S TRONK SEWFR ASSESSMENT
$ $ ' LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ I.S7^OO $ WATER TREATMENT PLANT SORCHARGE
$ $ OTHER:
$ /-2 % V. S O $ S / e?6 TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN P[JBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISIO[V. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING (tONDITIONS:
APPROVED BY: A?
TITLE:
/??
DATE: 73
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
MASTER LICET]SE#
.
***************.x.**?*??***.#*,
. 1573
P ease Print
1) PROPERTY ADDRESS: '
?Y•
clumox/
LEGAL DESCRIPTION:3F -
Lot Block Subdivision or Tax Parcel ID )
IF EXISTING STRL'CIURE, DATE OF pRIGZNAL BiJILDING PERMIT ISSL'ANCE: '
?
PRESENP 2ANING/pROPOSID C'SE: (hbn Year1
C] MN1MERCIAL/REl'AIL/0FFICE 0 R-1 SINGLE FAMILY
r7 IDIDCTSTRIAL r-I R-2 DL'PLEX (2wo C?nits)
f-I INSTIZL'TIONAL/GOVERNME6Tr ? R-3 ZUWDII-IODSE (Three + Units) (_A_Onits)
. ? R-4 APAR7TNENT/CODIDOMINItM ( Units)
2) .•• y;?
Nl1NIE:
ADDRE3S:
CITY, STATE, ZIP:
PHONE:
3) u r ?•
NAME:
ADDRESS:
? CITY, STATE, ZIP:
PHONE:
4) ??« • • i?-
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
2?-
***t****#******t****t*f**#***#**t**x
y*. *iOTS: PAYMENT' OF FF,E AT TIIM pF
y APPLICATION DOFS NOT cmS1Twm
* APPROVAL OF PERNR'P.
?
* IxsrnClzort oF sEWEx ArID/at MOa
*f Tracmnr.ramrONS WIId. NOT BE 5C3ED-
? ULID UN1ZL PII2NIIT HAS BM
s APPROVID.
t1Ul11UC1S L1C:CII5L-':
? Active
? FScPired
Not recorded
Sta?tial
5) ? v i a• •w : o
ONNE(,Z'ION TO CITY SEWII2 4?g CpNNECTION Ro CITY WATER ? p=_'
°?.
6) '? ."•?. Q PI,EASE HOLD APPROVED PIItMIT FOR PICK- ? BY ONE OF AH:7VE -' --' --
? PLF.ASE MAIL APPR(7VID PERMIT TO 1, 2 3, 4, ABOVE .
(Circ one) ?(
7) 1/??A !1 (II Rl?n
FOR CITY USE ONLY
PERMIT # ISSL'ED
73,5-3 311z 3W
Pd w/Bldg. Permit FEES:
$ $ /T/S G SEWER PERMIT (INCLUDE SURCHARGE)
$ $__ WATER PERMIT (INCLUDE SC'RCHARGE) ..
$ $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ?S G (J ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ wac
$ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ S LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ /•? ?7 ?I S C' $ ? ?
r v
? TOTAL
RECEIPT RECEIPT
DOES LTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MUST BE
DIVISION ISSUED BY THE ENGINEERING
. LIST AS A CONDITZON.
SUBJECT TO THE FOLLOWING CO[VDITIONS:
APPROVED By;
TITLE:
DATE :
oF
3830 PILOT KNOB ROAD, P.O. BOX 21199 BEA BLOM9UiSi
EAGAN, MINNESOTA 55121 M°y«
PHONE: (612) 454-8100 DATE : AUgUSt 22, 1985 THOMAS eGaN
JAMES A SMITH
JERRV iHOMAS
ADDRESS : THEODORE WACHTER
Counctl Members
LEGAL DESCRIPTION: Lot 37 - Block 2 rHOMnsHeocEs
City Atlmmistrator
EUGENE VAN OVERBEKE
Thomas Lake Hts. 2nd Addc,+va81k
Dear Eagan Resident :
RE: RIGHT-OF-WAY/BOULEVARDS - CITY PROPERTY
It has been brought to the attention of the Public Works Department
that you have placed a structure or obstruction on the City right-
of-way in violation of the City Ordinance referenced below.
CITY ORDZNANCE
SEC. 10.32. OBSTRUCTIONS ON PUBLIC PROPERTY
Subd. 1. Obstructions. It is unlawful for any person to place,
deposit, display or offer for sale, any fence, goods or other
obstructions upon, over, across or under any public property
without first having obtained a written permit from the Council,
and then only in compliance in all respects with the terms
and conditions of such permit, and taking precautiona-v
measures for the protection of the public. An electrical co=?
or device of any kind is hereby included, but not by way of
limitation, within the definition of an obstruction.
Subd. 6. Continuing Voilation. Each day that any person con-
tinues in violation of tnis section shall be a separate offense
and punishable as such.
SEC. 11.1. GENERAL PROVISIONS
Subd. 9. Structures in Public Right-of-Way. No buildings,
structures or uses may be located in or on any public lands
or Right-of-Way without approval by the Council.
The public right-of-way or boulevard is that area from the curb
to your property line (approximately 13 feet) and is intended solely
for utilities and snow storage. The structure must be removed from
this boulevard area to provide for required storage and also to
protect our snow removal equipment from damage. We apologize for
THE LONE OAK TREE. .. THE SYMBOL OF STRENGTH' AND GROWTH IN OUR COMMUNIN
RZGHT-OF-WAY/BOOLEVARDS - CITY PROPERTY
PAGE 2.
the inconvenience this relocation may create, but it is necessary
to prevent damage to your structure and also to our snow removal
equipment. The only exception to the ordinances are mail boxes
if they are installed according to Federal specifications as
furnished by the post office. A copy of this letter notifying you
of this violation will be placed in your parcel file with a copy
to the appropriate enforcement division.
THEREFORE, YOU ARE HEREBY NOTIFIED TO HAVE THE VIOLATION CORRECTED
AND THE OBSTRUCTION REMOVED WITHIN 60DAYS OF THE DATE OF THIS LETTER.
After that time, you will be subject to the fines as stipulated
in this ordinance.
The City of Eagan cannot accept any responsibility for damage that
may occur to those obstructions that are in violation of the City
Ordinance.
If you have any auestions, please feel free to call me at 454-5220.
Yours truly,
William H. Branch, Superintendent
Public Works Department
WHB:jbd
Large Rock on boulevard
RESIDENTIAL PLUMBING
Permit Application
City OfEagan
f 3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Please complete for: Single Family Dwellings
Townhomes and Condos when pernuts aze required for each unit
-M IS.t?
Date -IL / / p?
Site Address ?? `? Y? ??? Unit #
Property Owner C Telephone # ( )
Contractor
-
=
Address
:
C<<Y
?: -
Zip
S S
State
0 Telephone #
.
-en___ _
0
Z----Oth
t
t
li
i
O
C
er
wner _
on
rac
or
The App
cant
s _
Septic System New L-----f2efufbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant faes may apply.
Altera[ions to existing dwelling $ 50.00
Add fixtures to lower levels or room additions, excluding water softe ner and water heater
_ Abandonment of septic system
_ Water tumaround (+ 5/8" meter'rf needed -$121.00)
Other:
_ RPZ _ new _ repair _ rebuild $ 30.00
_ Lawn irrigation system
? Water softener _ Water heater $ 15.00
acement additional
repl E7,33
$ .50
State Surcharge
Total
$
I hereby apply for a Residential Plumbing Permit and aclmowledge that the information is compiete anti accurace; mat ?ne worx wuI
be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a
permit, but only an applica 'on for a permit, and work is not to start without a pemv ? that the work will be in accordance with the
approvedpY3n in tlyaTase pwork,ysl?ch requires a review and approval of plans. /? ?Z/?'
Applicant's Printed Name Q ? Appl?icant's Signature
.?-
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
c?,, o`
Please clnplete fo ridifications to existing residential dwellings. //1 I?
\
Date,/?3 / !
Site Street Address ?lY.? Unit #
Property Owner /f)V .G Telephone #
121-
Contractor
ti
Telephone#
- _gNz
Address , e'> City 1 . _ State ?_ Zipt??
The Applicant is: _ Owner _ ntractor Other
Alterations to existing dwelling $ 50.00
_Add fxtures to rooms, excluding water soften an ater heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter s r uired)
Other:
? Water Softener ter Heater $ 15.00
replacement _ ad tional
Lawn Irrigation System /RPZ- new _ repair rebuild $ 30.00
State Surcharge $ 50
T
I hereby apply for a esidential Plumbing Permit and acknowledge th t the information is complete
and accurate; that t e work will be in conformance with the ordinanc s and codes of the City of
Eagan and the plum ' g c9des; that I understand this is not a permit, ut only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
?afzdy?e vP.P -
Applicant's ir n et d Name Ap icanYs Si a ure
?j I UCT 2 6'L3?4 ;
L .
_ i
, Li
7
( 0 V[ U 2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
,? 371;(,7;
New Construction ReauiremenLs RemodeVReoair Reauiremenls O(fice Use OnN
3 registered stte survays showing sq. (1. of lot, sq. ft. oi Iwuse; and all roofad areas 2 coples of plen Ceh of Survey Recd _ Y_ N
(20%maximum lot coverage allaxed) 1 set of Energy Calwlalions (or heated additions T2e Pres Plan Recd _ Y_ N,
2 copies of plan showing beam & window s¢es; poured found design, etc. t sRe survey for additions & decks Tree Pres Required _ Y_ N
1 set of Energy Calculations AddiNon - indkate Aonsite septk sysfem On-sile Septic System _ Y_ N
3 copies of Tree Preservafion Plan'rf lot plaHed aRer 711193
Rim Joisi DetalOpCrons selecdon sheet (buddings wHh 3 or less unils)
/?
Date -/ l la
l ? S °? ?3 oD
Cninstniction Cos
Site Addre Unit/Ste #
?3 3/ - / -15 35
Description of Work Sjd/lv?
, WOP iAgm -' G?/n/pOW 7-? N1
Multi-Family Bldg '
? Y _ N Fireplace(s) _ 0_ 1 _ 2
6esidari?
6
/ B
?
J
Property Owner Telephone #(
?Bi
mn.
S -04 ?
Contractor v'1< 4id/'S
Address CJOl / G •! oNGO?o?-N" City -5;, 5? AJL
State n/rtl¢5o;1- Zip ?S? Telephane # (G? ) aS-6 -I06 ?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissionlype) 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 plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an a lication for a permit, and work is not to start without a
permit; that the work will be in accordance with the pprove an in the case of work which requires a review and
approval of plans.
?./(1hh? ?Utl?lc?/s
ApplicanYs Printed Name licant s Si ature
Clty Of ??kan
3830 Piiot Knob Road
Eagan MN 55122
Phone:(651) 675-5675
Fax: (651) 675•5694
- - - - - - - - - - - - - - - -
? Fo(O(dce'Us??
? Pertnit #:
? Pertnit Fee: ?
I I
I Date Received?
I
?-lII I??n =r? 1`??i ?I?
I Sta :
? - ----???x
2008 MECHANICAL PERMIT APPLICATI* I OCT 16 2008
Date: ?C?3jDv Site Address:
Tenant:
Name: Phooe:
RESIDENT/OWNER
r
Address / City ! Zip'
CONTRACTOR Name: i ns J
Address:
r ??
\ State: ? Zip:
Ciry:
_ cI
Contact Pereon: "WO
Phone:
Additional _ Alteration _ Demolition
New ? Replacement
TYPE OF WORK _
-
Description of work:
NOTE: Both roof mounted and grourtd mounted mechanlcal'equlpment ls requlred to
be screened by C!ty Code. Please contact 1he Mechanlcal lnspector or one'of the
Planneis for lnformatlon on ermltted screen/n methods.
RESIDENTlAL COMMEAClAL
PERMIT TYPE New Construaion Interior Improvement •
-
? Fumace
Install Piping _ ProceSSed,
' Air Condi[ioner _
Exterior HVAC UnR "
Gas
-
9
-
Air Exchan er
• HVAC unlts must be screened
_ Heat Pump Under / Above ground Tank [_ Install /_ Remove) .
Othar ^ W hen Installinglremoving tank(s), call lor inspecUOn by Fre
- Marshal and Plumbin Ins ector
AESIDENTlAL FEES:
$50.50 Mlnimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 FIfB fepaif (replace humeA out appliances, ductwork, etc.) (indudes $.50 Sta[e SurCharge)
$ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installatioNremoval OR Contract Value $ XI
$50.50 Mlnimum (includes State Surcharge)
_ $ Permit Fee
- If Permit Feg is leaa than $7,000, surcharge is $.50.
- State Surcharge
=$ ?
_
- It Pertnit FM is> 57,0017, surcharge increases by $.50 for each
$1,000 Pertnit Fee (i.e. a$1.ODt•82,000 Pertnit Fee requires a$1.00 surcharge).
$ TOTAL FEE
I hereby acknawled9a ihat this intormatron m complete antl accurale; [nat the work vnll Ee m conformance weh the oramances arM cotles of the Ciry ol Eagan; that
I underst3nd this a not a pBfmll, but ony an applicauon lor a permrt, antl walk is not to start vnth ut a perm2; that the.vNrk will be in aCCOfGance vnthi e approved
pl in ihe case of work whic re wres a revo aytl app " al of pWns.
` -Q ?
X
x
no esnt'e Printed Name ApplicanYs Signature
FOR OFFlCE USE Revfewed By: Date:
Required Inspectfons• Under Ground Rough In Air Test Gas Service Test _In-floor Heat _Fnal
PERMIT
Permit Type: Mechanical
City of Eagan
Permit Number: EA105200
Date Issued: 07/02/2012
Permit Category: ePermit
Site Address: 1571 Clemson Dr
Lot: 37 Block: 02 Addition: Thomas Lake Heights 2nd
PID: 10-75951-02-370
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Furnace & Air Conditioner
Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
Comments:
445-2840
ME - Permit Fee (Replacements) $55.00 0801.4088
Fee Summary:
Surcharge-Fixed $5.00 9001.2195
Total:
$60.00
Contractor: Owner:
- Applicant -
Owens Companies Liz Rainey
930 E 80th St 1571 Clemson Dr
Bloomington MN 55420 Eagan MN 55122
(952) 854-3800
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.
Applicant/Permitee: Signature Issued By: Signature
i C . ,L5fes4' ' ci..., 5 0 fj
1
i. c
1
L
i
Use BLUE or BLACK Ink
i For Office Use
j Permit ~I ILD p
i a l i
My of Eapo 4 5~ • a
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 ~ Date Received:
Eagan ~4 Al
Phone: (851) 675-5675
I I
Fax: (651) 675-5694 1 Staff..
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 - site Address: is 1 ! 19, 131
Name: Yz- 4zn_~s____ Phone: (V-2- 72, - S a~
Resident/
"Owner Address / City / Zip:
Applicant is: _ Owner Contractor
Description of work:
Remo F n -
T Kleof Work
Construction Cor, `'?.l_& C5 Multi-Family Building: (Yes No
Company: C PJI'3 VC Contact: 2~f en
%_.1 1LJ
ContractOr Address: City: ~ ~IaRA~Jfc~.s
State: ML Zip: Phone: mac? ZS -
License SC - 210 6 2- Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
-Yes --No if yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer $ Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public informatVon. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the Clty to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hairs
before you intend to dig to receive locates of underground utilities. www.uoohen3tate2ne0ll.or_Q
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
xfr_ rn_a en x
Applicant's Printed Name Applica s Signature 49
Page 1 of 3
• Use BLUE or BLACK Ink
For Office Use
41/.` Af
Permit It: ICity of EaQali Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122ermit
Received: 7-167-1
Phone:(651)675-5675
Fax:(651)675-5694Staff:
JUL 142017
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7A3///17 Site Address: 14-7 1 C ' '0 Unit#:
Name: /DAC.PN J-L4v /G „,„!� / ' d Phone:
Res_ 'dent/€darner Address I City/Zip:
Applicant is: Owner / Contractor
t
Description of work:L"X/� c 4.L i'i , erre 1 -1
Two ° '��61-
Construction
�
Construction Cost:_ 3 Multi-Family Building:(Yes X /No )
Company: ,44yr -Ais-vraT2c' / Contact: r41/441.- /1-7 IT
Contractor 4 Address: /7lx frjt City: f/Ll tortrivtey
State: !✓ Zip: 55/r -V_ Phone:4674-51- PI Email:/24/41-10/+'vY 0 M"' °®
License#: Lead Certificate#: iv/1-t' — F// O '1- /
If the project is exempt from lead certification, please explain why:
/104442 , IE't 1 4 /glee.
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE: lan a d. m z r e sK ., fi u" a! s 's'
Wilaf they
, e ,4 M Y ... .
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.gooherstateonecali.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota -)- e Building Code st be completed within 180
days of permit issuance.
x ?Att.- I: ficAfr x /" /.w L
Applicant's Printed Name Ap ricant's Signature
Page 1 of 3
I S 1 I UW1'607\
DO NOT WRITE BELOW THIS LINE . 1Ltgali3
SUB TYPES
Foundation — Fireplace Porch(3-Season) Exterior Alteration(Single Family)
Single Family _ Garage Porch(4-Season) — Exterior Alteration(Multi)
Multi /0 Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration Fire Repair Windows _ Demolish Foundation
Replace _ Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation 0 aj .— Occupancy C -3 MCES System
Plan Review Code Edition 07/I 2c.(5- SAC Units
(25%_ 100%,3 ) Zoning ?.P City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length /ef Fire Suppression Required
Type of Construction U 13 Width /v
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) >O Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: / 4),/i "K 2k )144" , Building Inspector
RESIDENTIAL FEES c
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Surcharge
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City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA144979
Date Issued:08/17/2017
Permit Category:ePermit
Site Address: 1571 Clemson Dr
Lot:37 Block: 02 Addition: Thomas Lake Heights 2nd
PID:10-75951-02-370
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: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Steven W Diaz
1571 Clemson Dr
Eagan MN 55122
(406) 861-0996
Home Depot Usa Dba The Home Depot
2455 Paces Ferry Rd
Atlanta GA 30339
(952) 345-6057
Applicant/Permitee: Signature Issued By: Signature