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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 Base Fee CSL ,c-. 1) 0 . /71 Surcharge Plan Review dr� MCES SAC f�}/�/l;f!✓ftl p( . d ac). Cr-- 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