1581 Clemson Dr
Use BLUE or BLACK Ink
For Office Use
j Permit
City of Eajan
1 Permit Fee:
3830 Pilot Knob Road RECDIVFD j
Eagan MN 55122 1 Date Received: 1
I
Phone: (651) 675-5675
MAR 10
Fax: (651) 2011 1 Staff:
2011 MECHANICAL PERMIT APPLICATION
Date: Site Address:
Tenant: Suite
RESIDENT / OWNER Name: ~7S hone: aISZ. - C~8 7. 3 `JZ
Address /City /Zip:
G L~ J ~--CONTRACTOR Name:
Address: Home Energy Center
- 2415 Annapolis Lane N #170
Plymouth MN 55441
State: 763-476-1990 fax 763-476-1143
Contact: Email:
TYPE OF WORK New Replacement Additional teration Demolition
Description of work:
NOTE: Roof mounted and ground ounted mechanical equi ent is required to be screened by City
Code. Please contact the Mechanical inspector for information on permitted screening methods.
PRESIDENTIAL COMMERCIAL
PERMIT TYPE Fumace New Construction _ Interior Improvement
Air Conditioner _ Install Piping _ Processed
_ Air Exchanger Gas _ Exterior HVAC Unit
_ Heat Pump _ Under / Above ground Tank Install / _ Remove)
Other When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) 5,-
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orcr
I hereby ackno ledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Ea an; that I u Id and this is not a permit, but only an application for a permit, and work is not to st rt without a permit; that the work will be in accordance
with he appro d plan in the case of work which requires a review and approval of ans.
X_ ) CA"
Applicant's Printed Name ppl kadr-s-349 nature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground Rough In -Air Test -Gas Service Test In-floor Heat -Final
Exterior HVAC Screening Inspection
; FOR SALk: TOWNHCJ;.,CITY OF EAGAN
.-" 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
•- ' ' ,? PHONE• 454-8100
r?"' r
f BUILDING PERMIT Receipt# -
To be used tor 1OF 4 PLLX Est Va1ue $61,000 Date ;4 ?ly $
SiteAddress 1583 CLF.cliSGy DR Erect ? Occupancy `23
Loc 47 aiock 2 Sec/Sub. THOt•;RS LAKE Remodel ? zoniny Ri
Parcel No. HEI{CHTS 2A1iJ Repair ? Type of Const. !Vn
Addition ? Na. Stories
= Name NEW HOR I ZON HOtr'iES ??ove O Length d?1
; Address P.O. BOX 1367 Demolish ? Depth ?'?
o Int Impr. ? Sq. Fr
City Mpj•$hone 420-3900 Instau ?
o Name SA146 Approvals
=
0
(j ¢
Address
Assessment
~ City Phone Water & Sew.
t ¢ D. GR I SViQLD Police '
W Name Fir
? e
Address
En
g.
<W City Phone 435-7524 Planner
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe Council
Bldg.Off. 5l1/$6
information is correct and agree to comply with all applicable State of
Minnesota Statutes and Ciry of Eagan Ordinances. APC
--
-
Var. Date
,
Signature of Permittee
-
A Building Permit is is:
all work shall be done
Building Official
Permit ? 316• 00 ?
Surcharge 30.54
Plan Review 158.00
sac 575,00
Water Conn.-Soo:00
Water Meter 63 • 50
Road Unit 290 . 00
'
Tr. Pi. l -1.1c+ .;i o i
Copies
Total 42, Ctiy.00
on the express condition that
and Ciry of Eagan Ordinances.
I - I w.mae no. I P.rmwe Haa.. I Dsh I TN.pnons # I
DaN
Occ.
Fty.
Frmp.
Disp.
,S s PERMIT # /? ?
MECHANICAL PERMIT RECEIPT # w
CITY OF EACAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ?,? `?
CONTRACT PRICE: PHONE: 454-8100
Site Address •-?'=?? •?r ??' gLpG, npE WORK DESCRIPTION
Lot Block Sec/Sub•
,. i 77 ?.-- ?
Res. New
14
? Name
m =?1 I. . I Mult Add-on
? Address 1C;;?1 X , ' Comm. R?air
;?
c City i,POL?'??dne L•?'4ici
Other
541(D
c
3
O
Name _
Address
City -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlet,s #
Other
M BTU
M BTU
M BTU
M BTU
CFM
/
FEE
S/C:
TOTAL•
4S.$. ?1
If
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PEFiMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
?
f,.C// .6•?' '<... I?
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
' PLUMBING PERMIT
' CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
Site Address ?
Lot ) ) Block
? Name
?s Addre:
?
c Ciry _
? Name
c Addre
p City ?
FEES
COMM/IND FEE - 1°r6 OF CONTRACT FEE
MINIMJM - 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)
OF
FOR CITY OF EAGAN
PERMIT # O S
RECEIPT # C? 7
DATE:
BLDG.TYPE
Res. ?
Mult
Comm.
Other
WORK DESCRIPTION
New
Add-on -
Repair
NQ. FIXTURES
Water Closet - $3
00 TOTAL
?
?
.
' Bath Tubs - $3.00 .
? Lavatory - $3.00 --
? Shower - $3.00 ?
' Kitchen Sink - $3.00 '
Urinal/Bidet - $3.00
Laundry Tray - $3.00
' Floor Drains - $1.50 .'
? Water Heater - $1.50
Whirlpool - $3.00
?-
Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50 ?
FEE
STATE S/C: L)
GRAND TOTAL• ? ? ?'?
CITY OF EAGAN
3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT
To be used for Est Value $1 , 600
SiteAddress 15k, 3H
Lot Block 2 Sec/Sub. ;'lit'#:AS Li: il TS 2N1
Parcel No.
s Name ,f'E?dCr.t.
W
z Address - •
° City Phone t? E 1-?? 5I y
¢ Name l;i.??T-i,-+_•i,?I f:.'?CYY.:i1.I'J
o
2i- 335L
o u Address
4u? Ciry ' ' . 'LLE Phone 890'-6367
Address
City Phone
I hereby acknowledge that I have read this application and state
that the information is correct and agree to comply with ali applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
SENTi:t•!8bk 14
O FFICE USE ONLY
On Site Sewage _ Occupancy
MWCC System _ Zoning
On Site Well _ Type of Const
City Water _ (Actuaq
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
V
Assessments _
Water/Sewer _
Police _
Fire _
Engr. _
Planner _
Council _
BIdg.Off. _
APC _
Variance _
HF:,1T-:d-Lt..) F i ; i'Le1CL• S
A Building Permit is issued to:
all work shall be done in accordance with atl applicable State of Minr
Building Official
Receipt
FEES
Permit
Surcharge
Plan Review
SAC, Ciry
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment Pt
Parks
Copies
TOTAL
I A 16 7
,19 .
I
443u.;v
T. i10
on the express condition that
i Statutes and City ot Eagan Ordinances.
?
Permit No. Parmit Holdar Date Telsphone #
Plumbing
H.V.A.C.
Electric
Softener
Inspection oate Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
CITY OF EAGAN
FO32 SAbE 'tOboNtwjj?6 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 :
BIIILDING PERMIT Receipt w
SiteAddress 1$83B CLF;t-ISO
Lot 4 8 Block 2 Sec/Sub. _
Parcel No.
` W Name NE'`J IIORIZOid
3 Addres5 P.O. BOX 136
° ciry I,12LS Phone 42
= o Name SAi•iE
I ? Q Address
j ~ City Phone
? F W Name
x n Address
W City Phone -4.
I hereby acknowledge that I have read this
information is correct and agree to compl
Minnesota Statutes and City of Eagan Orc
I Signature o( Permittee " -'- ?
( A Building Permit is issued to: NE1? H
?I all work shall be done in accordance with all
i Building Official
' -- ----------- - --? _ __
0 0 0 nAtp
Erect 17' Occupancy H3
Remodel ? Zoning R1
Repair ? Type of Const SIii
Addition ? No. Stories
Move ? Length 4 -1
Demolish ? Depth
Int. Impr. ? Sq. Ft
Instalt ?
applicable State of
P.Ih
i 4._ 11 `•? 7! 7
Permit 5 313900
Surcharge 30. UO ,
Plan Review-156,.50
SAC 575.00
Water Conn. rion= 00
Water Meter 63 _ 50
RoadUnit 240-Q0
Tr.PI. 156_UO
Var. Date Copies
Total $2, 084 . 00
on the express condition that
Statutes and City of Eagan Ordinances.
Assessment
Water 8 Sew.
Police
Fire
Eng.
Planner
Council
BIdg.Off. 511186
APC
I I - Psrm11 No. Prrndt Holdk. Dab TaNphon? k
PlumWn4
IMMA.C. a -7 ?-?o -
JEW-W
?
o _
50filemn..
Impection Dab Inap. CommAnb
I FooNn{p I
Footinps II
Foundafbn
Framiny
Rooflny
Rouph PIb9. g
Rough Hty. ?
Inwl.
Finplsce
Flnal Htq.
FInM Plby.
.•
Bld,. FM.l
c?.e. oa.
9AA-f?.
D.kF
?
/ NV ?e"
k
? S?t 3S ?
. ` ?
Site Address ' -
Lot ` ? L Block
- Name _
m Address
c City -
Name _
c Address
O CitY -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping OuUets #
Other
PERMIT #
1 MECHANICAL PERMR RECEIPT #
.. -" CITY OF EAGAN
r 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
YiL? M BTU
M BTU
T_ M BTU
M BTU
CFM
/
FEE
S/C:
TOTAL:
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU , - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE .
FOR: CITY OF EAGAN
. PERMIT #
CONTRACT PRICE
Site Address
Lot j ? Block
m Name
? Address
c Ciri
? Name ?
3 Address
O CitY
PLUMBING PERMIT RECEI
ClTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
FEES
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMiJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1.000.00)
FOR CITY OF EAGAN
BIDG. TYPE WORK DESCRIPTION
Res. X New '
M ult Add-on
Comm. Repair
Other
NO. FlXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
'
Laundry Tray - $3.00
' Floor Drains - $1.50
Water Heater - $1.50 -
Whirlpool - $3.00
Gas Piping Outlets - $1.50
?
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE: - - `?
STATE S/C:
GRAND TOTAL• - -2
?
CITY OF EAGAN
3830 Pilot Knob Road
I Eagan, Minnesota 55123
(612) 681-4675
I SITE ADDRESS: i „ , .
; I t t MN UF?
o-ir irilit'., zNn
PERMIT SUBTYPE:
I ,., i S NI ,
?
oN
PERMIT TYPE: `'' f'
Permit Number:
Date Issued:
46 K i() i; V . APPLICANT:
FiAV [ (i
TYPE OF WORK:
f IPiAi
Permk No. Permit Holder Date Telephone #
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspectlon Date Insp. Comments
Footings I
Foundaiion
Framing
Roofing
Rough Plbg.
Rough Ntg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg_ Plbg. Inspec4a- Ndi(y Plumber
Conrt. Meter
EngrJPlan
Bidg. Fnal
Deck Ftg.
Deck Fnal 72 7 f3 ? s
Well
Pr. Disp.
IN
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
I + t 1 h!'.IIN Uh
PERMIT SUBTYPE:
, ,. , . 101,41
ON RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
,. ,. I
1 4lt.Nl.
TYPE OF WORK:
? . i . . .
II11'.1 !k
INSPECTION .. . ..
F I" ? nf„f ?
Sft'AFtAIt Ntf+P'Itl'? l+kl I1F41111111) FOR AIiY I'll)MI-I tN1y 1W FIII 1111I Al 11i+1"1
I ? i-, ?
PermR No. Permit Holder Date Telephone M
SJW
PLUMBING
HVAC
ELECTRI
ELECTRIC 900?? 9
tnapectbn Data Insp. Comments
Footings I ?-W
lq"t {,e
Foundation
f,,?; C SQ?O[
biain
f
Framing ?/?' 9? ? ,
?,?,f t w•s h!NO k e,? f
Roofing h. i'? [r i?+ ?? t Z Ih ea
Rough Plbg. ? -
Rough Htg.
ISUI. n
N,
F?replace
FinHl Htg.
Orsat Test
Final Pibg. Ping. Inspector - NotHy Plumber
Const. Meter
Engr./Plan
Bldg. Finai
Deck Ftg.
Deck Finei
Well
Pr. Disp.
1
4?w_ k ? ? L L
?
r?ta
FOR SAi.E CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
• " PHONE: 454-8100
? i `?
11S?J
BUILDING PERMIT Receipt # f
To be used lor 1 UF 4PLi:X Est. Value ?61,000 Date ?'AY 8 , 19 ? 6
Site Address - 1581 CLEi,iSUt1 JR Erect LIK occupancy
Lot 4 b B1ock 2 Sec/Sub. `Fi{0M'1S LAF{£ IiTSRemodel O zoning
211D ADDI`l'IOy Repair
Parcel No ? Type of Const. yii
. Addition ? No. Stories
,v}:::i•I HQR I ZflN H4.?+?',ES
Name
Move
?
Length 44
`
_ ??
n. ?nY 1367 Demolish ? Depth -r,
o .
Address Int Impr. ? Sq. F!
City =Phone 420-3900 Install ?
Z o Name SA14E
0 ? Address
~ City Phone
u¢
W W
? W
UZ
¢ W
<
Water R Sew.
Police _
Name D. GRISWOLD Fire
Address
Phone
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.
Signature of
Eng.
Planner
Council
Bidg. Off. 5/ 1/t3 6
APC
Var. Date
Permit y .S1b.UU
Surcharge 30 _ 50
Plan Review--I-S&-00
SAC 575 _ 00
Water Conn-5.tl.a-(T0
Water Meter 63 _ 50
Road Unit .2 qr) - 0 Cf
Tr.PI. 1`16 _00
Parks
Copies
Tot31 $2. 069. UU
A Building Permit is issued ta ivs.rr nvnirjvc+ nvr:jra 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
. wmn No. aermn Naa.? on• ra.pnm. r
Mumtiinp 3
IHMAC.
?
?'' ' _ ?y •
- /G _
eleebic
?
I
--? -
sonener
- -
Inap?ctlo? Dab Imp. Comtnonb
FooUnysl ?
Footinqs 11
FoundaHon
Framinq
Rooling
Rouph Plbq.
I Rouyh Mlp.
Insul.
Flreplace ?
Final Htq.
Final Plby.
&dy. FInN
Cart. Occ. ?
Dsck Fly.
Deek Frmy.
Well . r
Pr. D1sp.
PtUMBING PERMIT
' CITIr OF EAGAN
3630 PILOT KNOB ROAD, EAGAN, MN 55121
ili1TRA(_T POlf_F• ounuc. eee_24M
Slt@ AddfB9S :..L.:iL
Lot Block
m Name
Address i.-dL
y Ciry
?
? Name
3 Add{ess
p C?, fti?'i? ?
FEES
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)
r
FOR CITY OF EAGAN
PERMIT #
RECEIPT a
DATE: ?I
BLDG. TYPE WORK DESCRIPTIDN
Res. X New K
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
L Water Closet - $3.00 4 -
' Bath Tubs - $3.00
' Lavatory - $3.00 -
=hower - $3-00
? Kitchen Sink - $3.00
Urinal/Bidet - $3.00
' Laundry Tray - $3.00 -
f Floor Drains - $1.50
' Water Heater - $1.50
Whirlpool - $3.00
'
Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
- Rough Openings - $1.50 ?
FEE Lk.V
STATE S/C: ?_;O
GRAHD TOTAL• ? ? `DL)
L Y
CONTRACT P
Site Address _
Lot `J (C
NarW '
? H
? Address
c City _
? IVame _
? Address
O ?ity -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
Phone
L.- M BTU
M BTU
M BTU
M BTU
CFM
i
FEE
S/C:
TOTAL•
. ' . . . ' ' . ... , " " . ,, - .- .. . , '" . . . ? ? ' . /
? , : • PERMIT #
. VECHANICAL PERMIT RECEIPT #
+ • ? CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
F• : 7? l ounuF• dae_ainn
TYPE WORK DESCRIPTION
Res. -' New ?
Mult Add-on
Comm. Repair
Other
FEES
RES. H1/AC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU
GAS OUTLETS
COMM/IND FEE - 1a/o OF CONTRAGT FEE - 6.00
- 1.50 EA.
MINIMUM - RESIDENTIAL FEE - 10.00
MflVIMtJM - COMM/!ND 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 EACAN
PERMIT #
MECHANICAL PERMIT RECEIPT #
? CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAH, MN 55121 DATE: _
Site Address 1 +
Lot i-' Block
BLDG.TYPE
.. • '?-__._
Res. X
M ult
Comm.
Other
WORK DESCRIPTION
? Name _
? Address
c City _
NemB • u i a?, ci n
c Address a n c
p City Phone
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Neater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping.0utlerts #
Other ?` r. i. ? I? r o
FEE
S/C:
TOTAL•
New X
Add-on _
Repair _
FEES
RES. HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
ADO-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1%OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SO II SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
?
BUILDINC3 PERMIT
T? L? .......? {... YLCK
Site Address
Lot 43 Block
Parcel No.
W Name ?
o Address ?
City
o Name ?
OV
„Q
Address _
? clty
Ucc
WW
Name
?? Address -
<W CIty
I herehv acknowAeqe t
A Building Permit
on the express cc
applicable State c
Building Official _
Phone _
I have read this applic
agree to comply with
ssota Statutes and Ci
G
that the
State ot
90
OFFICE USE ONLY
Occupancy - FEES
Zoning - ?s.?
(Actual) Const - Bldg. Permit
(Alloweble) - Surcharge .30
# ot siories
i
R
Pl
Length ev
an
aw
Depih SAC, City
S.F. Total - SAC, MCWCC
S.F. Footprints _
On Site Sewage _ Water Conn
On Sile Welf - yVater Me1er
MWCC System -
Acct. Deposit
Ciry Water -
PRV Required - S/W Permit
Boosier Pump - gNV Surcharge
Treatment W
APPROVAIS Road Unit
Planner
il - Park Ded.
CounC
BIdg.OH. --
_
Copies -
?
s
Variance - TOTAI
? r _ ,- y.. . . ?_..,4.. - . .-,, - w- - ••,r.•?.-,? . q .m w:, . . , . ,
CITY OF EAGAN ??R1
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt #
Fct Valna $' ,000 flata JULY 2 _
C
Phone
18J89
Permk No. Permit Holder Data Telephone k
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Date Intp. Comments
Footings I
Foundation
Framing
Rooling
Rough Plbg.
Rough Hig;
Isul:
Freplace
Final Htg.
Fnal Pibg.
ConsL Meter Plbg. Inspector - Nolify Plumber
Engr./Pian
Bklg. Finai
Deck Ft9_ t a.
Deck Final rJ-Z 3'?b bI ., v[ 4l
Well
Pr. Disp.
Y'V2t §AI.L
. .,,
,
4
Mri i_ CITY OF EAGAN
P30 Pllof Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
Assessment
Water & Sew.
Police
Fire
To be used for Z OF 4 PLEX Est. Value $61,000 Date +Y a .19 a(
Site Address 1581B CI+E!'1SON UR Erect Lx Occupancy R3
lot_ 45 Block 2_Sec/Sub. THOMAS LAKE Remodel ? Zoning
HFIGHTS
Parcel No 2N Repair ? Type of Const
. Addition ? No. Stories
W Mame Nf;W 1-10i2IZUN HOMES Move ? Length
A
P•p• »O'{ 1367 Oemolish ? Depth
27
;
? ddress
Ciry 1'iPLS phone 420-3900 Int.Impr.
Install ?
? Sq.Ft.
? Name S??
_
? -c Address
City Phone
F W Name D. Gii 1 ?
_z
Address
i W City Phone
I hereby acknowledge that I have read this application and statethat the
information is correct and agree to comply with all applicable State o1
Minnesota Statutes and City of Eagan prdinances.
Signature ofPermittee `
A Building Permit is issued to: N£GI HOR 1 ZUN HOMI:S
all work shall be done in accordance with all applicable State of Minnesota
Building Official ? .4 ?_-
Planner
Council
Bldg. Off. 5/ 1/$ 6
Var. Date
? e --
li3'4
?' . . _ ,
Permit $ 316.00
Surcharge 34.50
Plan Review 158 . 00
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit 290.00
Tr.PI. 156.U0
Copies
Total $2. U z3 y. C p
on the express condition that
and City of Eagan Qrdinances.
I I PwmN Na I Permk HMder I oae. I T.i.pno" # I
Dab
Mty.
Plbq.
Dlsp.
' PLUMBING PERMfT
' CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
IIJTRA['T PAI[_F• nunuF• tce-Atnn
Site Address = )
Lot ! ! Block
m Name
? Addre
c City
_ Name
c Addre
o CitY L
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 GOES
BEYOND $1,000.00)
SIGNATURE OF
FOR: CITY OF EAGAN
PERMIT #
RECEIPT #
DATE: LIL
BLDG. TYPE WORK DESCRIPTION
Res. v New
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
_Water Closet - $3.00 s
` Bath Tubs - $3.00
?Lavatory - $3.00 - `- ?-
Shower - $3.00 ?-
=itchen Sink - $3.00 `- L Urinal/Bidet - $3.00
' Laundry Tray - $3.00 "- -?'
-Floor Drains - $1.50
' Water Heater - $1.50 -
Whiripool - $3.00
i Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
-_Private Disp. - $10.00
Rough Openings - $1.50
FEE -- ??J
sraTE s/c:
GRAND TOTAL• 27 SD
• .
CONTRACT PRICE:
Site Address
Lot ` - Block ?
Name "po. ?
m
Address-??
c City
Name ? W
?
c Address
O CitY
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping OuUets #
Otfier
PERMIT #
_ 1lAECHANICAL PERMIT RECEIPT #
+ CITY OF EAGAN 0
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE _
Phone
M BTU
M BTU
M BTU
M BTU
? CFM
FEE k J ??
S/C:
TOTAL•
BLDG. TYPE WORK DESCRIPTION
Res. ? New
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
; ??`, ,,; ; i ? •• 1 f ...
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
GEO. SEDGWICK HTG. & AIR COND. CO.
HOUSE HEATING TEST RECORD
ADDRESS CITY
OCCUPANT OWNER _
HEAT LOSS -'-" DATE HTG. IMST.
SOLD BY INSTALLED BY ic-K
Electrical Work By ` --) Gas Line By S?__T _ : (I_
TYPE OF HEAT GA_ FA -IL HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE ???R?f c;;•??" MAKE OF BURNER '^--?
Model _?)`? L4??, G?4-4- CC; Model
Serial a.;--5 B 4 L/ R Max, BTU Rating -"
INPUT `aG, oe? MAKE OF FURNACE
CONTRaLS
THERMOSTAT:L` Heat Plug
Valve _ -:,x J?-1 5 l\.' SG ,-- 1.
Limit Sre? c- C
Limit 5etting Z5 o F
Fan Setting
Pilot Type f f 1 L
Pilot 11Aake S PA t?!< /<? ?.1 ?Tc>i2
Pilot Model w SG ?
Pilat Timing `r-
L.W. Cut Off --
Pressure 3 - 5 ?J Percent CO c
2
Input CFH -7
Percent Oz
Stack Temp. Percent CO o??--
Vent Size ?
KIND OF LINER
Draft Hood ir-,l a Lk 0
Filters Size
StZE NOCNF_
Regulator
Number
Chimney Location Inside ~` Outside
Chimney Construction C-L?SS 0
5moke Bomb "` -- Wiring n ?
Draft - Test Tag c- a
Door Pressure --`? Lighting Inst, <<
Date Tested
Company Testing <- K
Name of Tester
??
C 6 rJ rZ JN
GEO. SEQGWICK HTG. & AIR COND. CO. rCf-??f
HOUSE HEATING TEST RECORD _ ???3????? ?? ?
ADDRESS CITY ?C?
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST
SOLD BY
Electrical Work By
TYPE OF HEAT
MAKE ?l`r
Model 3q!v
Serial a .1- ?t; 9 5 r-t
INPUT St3 , c o 0
CONTROLS
'
'
THERMOSTAT 83
`
Heat Plug -`-?-
Valve X 3L4 5 N 50 ?- --
Limit S-rctti C.C>
Limit Setting _ D -5 C ° ;G
Fan Setting 1 c' d c ?
Pilot Type (7--LEC T« n rv 1 L
Pilot Make
Pilot Model
PilotTiming - /NSTJ-kr! ;
L.W. Cut Off
Pressure j • `? ?? (,J•- c - Percent CO
Z
Input CFH Percent O
2
t 4"7?
Stack Temp. J- Percent CO _bJ C>f%J ?
INSTALLED BY
r-t `1, Gas Line By. _ ?? r; , Nf -!C
GA_ FA ? HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE OF BURNER
Max. BTU Rating -
MAKE OF FURNACE
Vent Size -,.>
KIND OF LINER `-'-- SIZE NONE
Draft Hood ' , " '? L{ Regulator
,
Filters Size Number
Chimney Location lnside X Outside
Chimney Construction C-(.-+': S 's f1
Smoke Bomb
Draft
Door Pressure
Date Tested _
Wiring n+'?
Test Tag
Lighting Inst. c. K
_ '7 - Q, "7
Company Testing S e- -n'c,
Name of Tester _ C-o ?j iz ?=1 ??
GEO. SEDGWICK HTG. & AIR COND. CO.?-
w _ HOUSE HEATING TEST RECORD ???? ?? ,`?? . a?f?
ADDRESS j ? ?` ? ?-?-''' ? ?G +V ? F? i'?? CITY
OCCUPAIVT OWNER
HEAT LOSS DATE HTG. INST. ?--
SOLD BY -'-- INSTALLED BY ?Q??,
Electrical Work By ? 3C-N Gas Line By - `-?-=X e-,
TYPE OF HEAT GA _ FA HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE - ???'Z\I A
Model :-? Ci `-I !;? tA,r"i
Serial --?' _;L a <- Ll ?.9
INPUT -` ?
CONTROLS
THERMOSTAT Heat Plug
Valve S?! 3?-1 S^/SC ll- ?-
Limit S i?ii/ c c
LimitSetting ° F_
Fan Setting ? D C ° r
Pilot Type C L EC_7/?C, .A_// L
Pilot Make S PFl 1?-K lcitti! ?'T? ?
Pilot Model :?> C r
Pilot Timing i r-i 5 7'/-tn/ 7-
L.W. Cut Off ?-"
Pressure tj•C- , percent CO 3°?l
2
Input CFH Percent O 61`71
Stack Temp. ?w'`5 C, F Percent C02 L) 6 /\/ %r--
MAKE OF BURNER
Max. BTU Rating -
MAKE OF FURNACE
Vent Size -.?
KIND OF LINER SIZE NONE
Draft Hood r;-, I-, LL c?i:, Regulator ti' t S
l !
Filters Size Number
Chimney Location Inside >-' Outside
Chimney Construction C-?f-\ S S Smoke Bomb Wiring d K
Draft Test Tag
Door Pressure Lighting Inst. ? k
Date Tested L-1 - ?,, f
Company Testing ? ? ? ? , "i ` C «
Name of Tester C-o ti t;?-, i-LC--,
GE0.5EDGWICK HTG. & AIR COND. CO.
HOUSE HEATING TEST RECORD
ADDRESS g-1 `J LLCAN1Lc" f-I L?. R VV ?
CITY A (.? L9 rV
OCCUPANT OWNER N' t?,4-4 µc 01 tzc N
HEAT LOSS DATE HTG. INST. "'--?
SOLD BY •----?- INSTALLED BY S?- ??c,s•l r c l-
Electrical Work By B? P:) Gas Line By
TYPE OF HEAT GA_ FA? HW_ STEAM SPACE HTR. UNIT HTR
GAS DESIGN
MAKE ??1?.??"r MAKE OF BURNER
Model Model
Serial ??9 (- Ja (oB 43C'Max. BTU Rating - -
INPUT SG. a o o MAKE OF FURNACE
CONTROLS
THERMOSTATW'P-_Heat Plug -?-
Valve ?)k 3L15..,A 5r_ x - i
Limit S? E- rA L o
Limit Setting ?-S o ° F
Fan Setting ? oo' ?-
Pilot Type ? t E t??Z C?1 I C
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off
Pressure LJ - c- • Percent C02
Input CFH 4-7 Percent OZ
Stack Temp. -?-7 y` F Percent CO C--
Vent Size `f
KIND OF LINER -- SIZE NONE
Draft Hood iN a« c E'-?, Regulator
Filters Size Number
Chimney Location Inside I'' Outside
Chimney Construction C L tl : S L?,
Smoke Bomb `-"- Wiring r?k
Draft ` r Test Tag
Door Pressure Lighting Inst. r K
Date Tested
Company Testing
Name of Tester ?-??? « ??
OTHER_
CONVERSION
CITY OF EAGAN Remarks -- -
Addition Lot Blk = Percel #10
Owner strBBt 1581 Clemson Drive stete Eagan, Mn 55122
Improvement Date Amount Annual Years Payment Receipt Oate
STREET SURF. ? 1981 279.71 55.94 $ 1u.8 A0121 2 --8
STREET RESTOR.
GRADING
SAN SEW TRUNK
*SEWER LATERAL
1981
-37.61
7.5,2
1.0
A0121 P
5-5-83
WATERMAIN
*WATER LATERAL 9
WATER AREA 1981 136.51 27.30 5 4,61 A0121 2 --8
STORM 5EW TRK 1981 .91 A0?172 -5-83
*STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CiTY OF EAGAN o Remarks -
Addition Lot ft 4E Blk ' P^ Percel #10
Owner s?,,,t 1581 B Clemson Drive st8te Eagan, Mn 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 111.$ A012172 5-5-83
STREET RESTOR.
GRADING
SAN SEW TRUNK ?
*SEWER LATeRAL - 152 15•0 6012172 5-5- 3
_
WATERMAIN
*WATER LATERAL
1991 i
WATER AREA
R H rj . 1 A0?172 5-?j-8
3
STORM SEW TRK 2?}g, 9l Aoi2i72 5-?j 3
*STORM 5EW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
13UILOING PER.
5AC
PARK
CITY OF EAGAN ? Remarks - Addition '?yp1Ea$ j,8ke Ei[?i ?? ddition Lot ;?? Rlk ?
owner street 1583 Clemson I7rive
Improvement Date
unt
Am
,
Annual
Years
Payment
Reteipt
Dete
STREET SUR F. 111.89 2 S
STREET RESTOR.
GRADING
;
5AN SEW TRUNK
SEWER LATE
RAL .
61
7, S2
1.0
A0121 2
5-5-83
I WATERMAIN
,tWATER LATERAL
WATER AREA 4.61 0121Z 5-5-83
STORM SEW TRIC 249•_g;_ A0121 2 --8
*STORM SEW LAT
I
CURB & GUTTER
SIDEWALK
STREET LIGHT
? WATER CONN.
BUILDING PER.
SAC
PARK ?
I CITY OF EAGAN y? Remarks -
Adtlition Thomas. Lake Hei ht?'Additio LDt ik ; ?-Paresl #lq m'q59""9'"
? o„++ne. Street 1583 B Clemson Drive State Eagan, NIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
S7REETSURF. ?
STREET RESTOR.
GRApING
SAPI SEW TRUNK / 7_o
*SEWER LATERAL ga 1981 • 5 .. 5 15.05 2 - -8
WRTERMAIN
*WATER LATERAL 19$1
WATER AREA 4.61 A0121 2 - -8
STORM SEW TRK
P 245. 41. A0121 2 --8
*STORM SEW LAT 191
CURB & GUTTER
SIDEWALK
STREET LtGtiT
WATER CQNN.
BUILOING PER.
sae
PARK
ITY OF EAGAN WpTO URVICE PERM
0 Pilot Knob Rosd ?,/?
. O. Box 21199 3? r-7? PERMIT NO.:
agan, MN 55121 DATE:
I
nD=
?c: ori.:?on omes No. of Units:
r;
iAddross:
/lddress• I.V_, _emson ur--;,i:
?lumb?r ` ?'o'r.F. san um.; n.•
, . N,.: 37a i Charo,:
Size: •, ??:
Reoder No.: OS?t/ sqc ?7if;.?
? ?vrM !o o?vb ? . ??e?r_ • - p'?-
o?.?a... llDen ?. 00pdTr
By
COnneCtiofl Qlprye:
Acsoimt Depoair: _
Permit Fee:
Su?chorpe:
Misc. Chorgs; -
Totol:
Dote Paid:
SEWER SERVICE PERlWT
PERMIT NO.:
?
DATE: ? i -
No. of Unita: _
Owner. :ei,? RoTiEOtI! FlCme:: -
Address:
Slts 1lddress: .l.e;?!?r,n •. ., - - ?r: .i; -
i
Pluriber. ^
, }?-
I OYm h asMA wNb !w CIlf of 4N,
Oea"?.
By
Date of Insp.:
'lvd: j?1AE o-).DuPa mezer
Pnid:
of Insp.: IIfo Inrp.:
I
' OF EAGAN WATER SERVICE PERMIT
Pilot Koob Road
Box 27199 PERMIT NO.: "
n, MN 55121 D/?TE:
g: : . ? No. of Units: - - -' e'?
,. k7L'iZOL7 riU.. 3S
No.:
to aa=olq vrllh 11M Ckp of Ee"w
of Insp.:
TY OF EAGAN
30 Pilot Knob Road
0. Box 21199
gan, MK 55121
conn.cfion thor0,:
llawunt Depodt: _
Permtt Fes:
Surcharos:
Misc. Chorpy; _
Totol:
Doft Paid:
1
47
?
ITY OF EAGAN yyAjM fERVICE PERMIT ?
0 ?Pitot Knob Rwd
P,, 0. BOx 21199 PERMIT NO.:
'E+9an. Mf: 55121 ? DI1TE:
Zanirg:
No. of Units:
OwnOr: ":•' O2' T.o1 ??OfifS
AddrlS5:
Si» /lddross: ` I enson I?rive 4 _aomas ;ts II ?
ti?r, um '
Plurnber. P
1 ?Mw 1a som* +?Mh iV
OW1106*e011? A
CITY OF EAGAN WATER SERVICE PERMR
,3830 Pilot Knqb Rosd
P. O. Box 21189 _ PERMIT NO.: '
Eagdn, MN 55121 DATE:
Zonlny:
NO.Of VnitS. :e
:OW'fllr.
IAdelross: c?
Sft AddIlSx ; i?
?Plwribsr:
i
MNor No.: Conroction Charge:
Siu: AooouM Depoatt:
Roodx No.:
? Parmit Fae:
i 1 q/IN 10 sonsply Mkb !o Qhr of `?M Surcharge:
I oa,?..«.. . . `
llAlic. Gnrp?s; _ - i
Total:
DoM Poid:
CITY OF EAGAN SEWER SERVICE pERMn
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagdn, MN 55121 DATE;
2orgng' No. of tJn1h: _
Owner: • _ • + ; ? ; /1dd?rss:
Site Address:
P1umbllr: _ 21n=nnnA
?. ? ? ? ef yp,
?.a
8y
Date of lnsp.,
' `.f; ? , ;l+?•,?,
Connection Charge: -. j `-
/1ooour+t Oepait; '
Pont* FN:
Surchor+pe;
Misc. Choroac
Toto1;
Dote Paid:
CITY OF EAGAN WATER SERVICE PERMIT
3830 PifiM Knob Rosd
P.D. 6dx 21199 ?(??,/?")?? PERMIT NO.:
Eagan, MN 55121 `?? ?"r? ? DATE: -
; - „ _ c--.
Z4ninp: "w No. of Units:
'OY 1'Oll . Oi'.?c'?
Owner;
/1dd?ess:
SJtr ?lddress: '- --emson ?!r ve omas ts '_,- Y
' OF EAGAN
Pilot lCnob Road
3ox 21199
i. MN 55121
No..
te eo.pyr rrMb !r. Cihr oF L.'.w
wArER sERvicE PERM
PERMIT NO.:
DATE:
. Na of Units:
Connection Charys:
/1ooount Deposit: _
Permit Fee:
5urcharpe:
Misc. CMrqes: _
Totol:
Oote Paid:
' OF EAGAN Sam smtvm PEmff
Pilot Knob Road
8ox 21159 PERMIT NO.:
i, MN 55121 p,ATE.
No. of Units:
ss: -
: Slte Acldmsa: ._ 3 Clemson Dr ive I.4
; PI1N116Qf: _ ? f: • a ?• ? • ?r { . -j .? -
i
!1 Mrw ta eemply wil6 eiM Ciyr of fa"¦ Con?NCtion Chorpa; _
"Or?iM?oM. llccount Deposit:
PenMt F+s:
Surclwqw:
BY Misc. Chorpes:
? Dote of Irup.: Totd:
f i"?" aoft vb+a:
eader No.:,O_TN Y S
Nme to emapig wiN? !IN
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, M NESOTA 55122 ?
_ IA 19
AMOUNT
Thank You
N_ 62172 ?
- - - - UVhite-Payen CoPY
Yellow-Poating Copy
Pink-File Copy
CITY Of EAGAN wATU SF"ICE PERMR
3830 pilot K ni+ Road _
P. O. Box 21199 PERMIT NO.:
Esgian, MN 55121 pATE: .
Zonirg: No. of Units:
pN,ror. zw iiurizon Homes
Address:
Sih Addross: ;3P Cleaiso ;% ioon?a- 1;,ts 2
plunnber. oMpsoa PliiI
Me.r No.: 072 k&I ,tV1 : 00. ??Opa
otivvv-
size: •? 'Te?
De 15. 00Pa
Reod?r :o.:
j 1C; . tlc)pd
h wm !M Cqk W.ye; . SOpd
I.oa. ao.*
0.a..¦ar. rulor rti- 156 . OOnd TP
CITY OF EAGAN
3830 Pilot Knob Road WATER SERVICE PERMIT
P. O. 6.ix 21199 ' PERMIT NO.:
Eagan, MN 55121 DATE:
Zonirg: No. of Units:
Owner:
Mdmas:
Slte /lddreas:
Plumber.
Mebr No.: Connsetion Chorfle: ` -
Size: Acco
t D
i
t:
un
epos
Reoder No.: Pemtit Fee: '
1 Nne to eewPhr wh6 tlw Gh of dM¦ Surd?arpr
0dh""'ne. Misc. Cho l 55. Cat?nri n'?>
?
3830 Pilot Koob Road
P. O. Box 21199
Eagan, MN 55121
Zonirg; ?_
Total:
Dote Poid:
.??...??
SEWER SetVK;E pERMff
PERMIT Np.:
DATE:
Own.r: Nea lorizan Ro;?es No. of Units: _3: ?+? ?.::
Address:
Sita Address: 15E3B rYe;r8art
PIuf11b1lf: _ ,. fLOB±Tifinn ?D 1 ?....9, . ?, . - - S .
N? haftn*h wilh tw Cw eI ??ew
of IrKp.:
of Irap.:
100.04pd ?
CanrNCrlon Cho,p.; _ 475. (?c3Pd
Accoint Depostt:
Permit Fes:
5urcho?go;
Misc. Chonpy;
Tota1:
Dote Pald:
Il(? REQUEST FOR ELECTRICAL INSPECTION ee-oonoi.oa
If See insVUCtions for complebnq this larm on beck ol vellow cooV.
ll /_
12342 "'X" Below Work Covered by Ihis Request ?l y& 33
Hdtl flep Type ol Bwltlin0 Apphancea WveE Equiumenl Wved
I
Home
Fange
Temporary Service
.C'cipiex Water Heater L?ghtiny Fixtures
Apt Bmldinq Drye, Electnc Heatm
Commercial Bldy. Fumace Silo Unloader
InAustrial eldg. Air CondiLOner Buik Milk Tank
farm Ocne1 vec.? v Oihe, ISnoniyl
? -r uc"AV Oiher r'I ?-y Oin(:r
Comoute lnsoectron tee Nelow'
p Fee ServiceEntrenee5¢e tt Fee Fexdees/5u1teeders a Fe,e Circuits
? 0 to 200 qm s 0 io 30 Am s i 0 tn 30 Am
v Above 200 Amps 31 to 100 Amps 31 to 100 A
Swfnuning Pool Above 100_Amps Above 700_Am{»
Transiormers Irrigation Boortis PdrtOther Fee
$igns Speciallnspection
$
TOTAL
)
pemr?rks ? Ado
Roug?-in Di1e
7i ,Ihe Elect•i
spac , ereby
ey thet Ihe hove
Final
a 1 ?6J1
/ J 4 V insoaction nes eeen
maae.
thurecuasirolElBmontlufmm ?•? ? -
Thiz reques[ void
/ C[/ _:? ?s
16 monlhs trom 9 / ?G' _ // (??
Q 12 3 4 2 r yf //-/;-) ..? Y? ? , -
Renuest??ate
{ Y
? ? Fve No. floaph-in InsuecUOn
Aepurted7
?Ready Now-?'Will Nob?y Inspec-
J
r
vr 7
r-. . ves ? N tor When R tly
"`""-' 1 hereby reqoest inapaction ot above
?,• Owner elactncal work in5talied atStreet dress, Bot or Rou?NO. CiTy
? G ??, ?
l '?-?Y%-
?/J??
eC ion o. 7ownship
Name or No. Renye No. County V
Or.cupant (PRINT) Phone Nn.
/"? 1G1 ?-'
Power Sapplier Atldress
E?IyP,cv[/r?ical ?C^YonvacTtor ICO/TlDany Namel
/r--r?: /` i?
'
'
? Comractor'e License No.
? ?
d
?J
> ?_
?-?2 fl '(? G?
Mailing AdJress (Contractor or Own r Making Instaflauonl
G
AuMor¢ed S,gn ur onvactor/ ner M i g Ins? 1S+aUo?.n')• ph"
nincauiq SIATE eOAND OF ELECTRICITV I "l5 INSVECTIDN REUUEST WILL NOT
Griggs-MidwaY Blde. - floom N-191 gE ACCEPTED BY THE STATE BOARO
1821 University Ave., St. Peul, MN 55106 UNLESS PNOPER INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
Thisrequestwid 12,/?_??
1e wnths Irom lQ 7 (G'
C 12 3 41
Request Date Fre No` RouPh-in In' er.bon v
'
??"
C R?eq{wretl>
' DReatly Now?Q-Will Notrtv
'
/
?/?
Y ???y u1
es ?NU [orWhenFeady
0 Licensea Mecvical Conlractor I hereby request msoecbon of ebove
? Owner ....." ...e.e l- ....
t Address Bo or Route No.
? E Ci y?
?
i owns?ip Name or o, qanye No. County?j
Z?-
OcpcupantlPRINTI J Phone No.
Power Supplier' AdOress
El ytncal Contractor (COmpany Name) Conhar.tor's Lmense No.
?-
MaJmp AdJress (COnvactor o4 Owner Making In/sJtallatmN
'
? ? •
?
/
r
J
J/ // / h-1il ?
/
AuNonzed Siena/u. (Cnnhactor Oyrner Ma e Inst av nl Phone Number
,?,i,•,' . 933-2? 21
MINNESOTA STATE BOAND OF ELECTRICITV f° THIS INSPECTION XEQl1E5T WILL NOT
Griygs-M.dwey Bldy. - poom N•197 BE ACCEPTED eV THE STqTE 60AND
1821 University Ava., St Peul, MN 55109 UNLESS PHOPER INSPECTION iEE IS
Phone 16121297.2111 ENCLOSED.
K REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi_oa
, Sae inslrucbons for compietirp Ihis lorm on beck of yellow coOn y' ' //
J 4 i '"N" Below Work Covered by Ihos Request ?C%y `n .33
c.na nao. Tvoa oi e?.".?e AGCliancea wilae eauiun,ant wi.aa
7L -Home• Range Temporary Service
Duplez Water Heater Lighnny Fixtures
APt. Bwldme? Dryer Electnc HeaUn
COmmercial Bldg. fumace Silo Unloader
Industnal Bldg. qir Conditioner Bulk Milk ienk
T F
arm
Omrr pem v
Oihe? ISnenryi
_
n.
...?..r
e 1..? t cr Sucu Y
,.......,._?__ n_i_..
. pthL,r
>
Rough-in - v /
Dnte
? I, ihe Elec
`?/1 Inspector, hereby
Fnal ?
' certity that the above
' ?
[+te ingpecUOn has bean
..?.._....ee..,,.?..o ___.?..'_ P Y -ee.
??6?4 6 J 9 ?" ? ? / 9s??
,
Aii
•
?
ReQU95t Oete • Frce o Rough-ln InOSettron Repw etl
R
/
r (YOU m t call mspeclor when ready) Inspeqion Olher Than oug?-In
0
?
/
,
t( 7 qeady Now
WAI NobN Inspector
Ves ? No Date Read
10 licensed contractor gpwner hereby request inspection of above electrical work aC
Job AdEress (Sireet Box o Rou?e Na I
' city
$ & / ern Soo br,
Sectmn No Township Name or No qenge No County
cupanllPRINT1 Phone No
? vid ?tr z
Power Suppiier Aatlress
Elaclncal G nVaoror (Compeny Name? GoMraoor§ Lwense No
D.x.Cvwr! e??
Mading A4tl;'Bj ICOnVactOr Or Ownef MdkmG I n51alldti0nj
(-]ODJ?
AwM1Onietl SrgnaWre lCOmracmnOwner Manng Instanalion, Phone Number
MINNESOIA STATE BOAflD OP aCTPICITV r THI$ MSPECTION REOUEST WILL NOT
Griggs-Midway BIEg. - poom 5473 BE ACCEPTED BY THE STATE BOARD
1821 llnivarolty pve. St. Vaul. MN 55100 UNLE55 PROPER INSPECTION FEE IS
Glwne (612) 642?0800 ENCLOSEo
9114Q/y' REQUEST FOR ELECTRICAL INSPECTION ?'f=""''?a EB-0p000+ /oe
Seeinslmctions tor comDleting ihis brm on Oack of? Ilow oopy
• ?
??
?
M64699
"X" Bcdow Work Covered b This Re uest ?
Yew Add Rep TypeolBmltling ADPliancesWUed EqwpmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Bmldmg Dryer Load Management
Comm./Industrial Fumace Other (SpeCity)
Farm Air Condinoner
Otner (suecrty) Conlreclor's Remarks
Compute Inspectron Fee Belows rn' •
n Other Fee # ServiceEntrance5ae Fee 8 Cirwtls/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transtormers Above 200 _ Amps Above 100 _ AmDs
SI JOS InsOeclar5 Use Only ? TOTAt.
Irrigation Boome D
Speciallnspection
AlarmlCommunication THIS INSTALLATION MAY BE ORDEREO DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTH .
I, the Electrical Inspector, hereby AOOqn"°
cerufy that the above inspecllon has
been made. F,,,ai oe? 'P
OFFICE USE ONIY
Thns raquesl witl 18 monlhs Irom
Fe.219 '70 ,s9
A 7 0 2 4/,4 aa f?,, ?? -:?o '*0
Repuesl Da?e - Fne No Rough-In Inpsection Reqwretl
(VOU must call ins or en reetly) s cLOn Other T?an Rough-In
Reatly Now Wil Notily IngpMOr
1e
`p Q ? Yes N. Da ReaOy
Ilicensed contractor J owner hereby request mspectwn of above electncal work at
Job Address ISVeet 9ox or Roule Na I
Or s
I 5%3 Cl Cny
Lt
enir, h ar.
Section No Townsnip Name or No qan9e No Counq ?
?V\
Occupam (PqINT) Phona No
Power Supplier Adtlress
Elec, vector (COmveny Nama)
?
t? or5 Lioense No
Connatt
?,.
- ?)?, (
MBiling qd0ress iConlractor or Owner Making In alla0on)
?b oaa rnv0
Autnorrzetl Sis? e
? ICOnVaCOr.Ow :er M.a4mq Insla??alio ? Phone Number
LIV,.,.. ? a. 47?,-9S 5,5
MINNESOTA STqTE BOAflD OF ELECTRICITY ?THIS INSPECTION FEQUEST WILL NOT
Gnggs-MiCway Bltlg - Room 5-173 C/ 8E ACCEPTED BY THE STATE BOAPD
1821 Unrversity Ave. 51 paul MN 5511)4 UNLESS PROPER INSPEGTION FEE IS
Ppone (61I) 603-0800 ENCLOSEO
??EB-OOOOt-08
REQUEST FOR ELECTRICAL INSPECTION fyM?
W70524 ? Sae insvucuons lor compleLng this form on back oi yellow cupy - "X" Below Work Covered by This Request ?446y?'ew?,4ddIRepI TypeofBudmng ApphancesWiretl EquipmentWired
Home Range Temporary Service
Water Heater Electric H98ting
Dryer L oad Management
W
l Fumace Other (SpeCify)
ir Conditioner
Conlreator's qemfiarks
(sperdy)
Compute InspecLan Fee Below
k Other Fee k ServiceEnlranceSize # Circwis/Feeders Fee
Swimming Pool 0 to 200 Amps
f 0 to 100 Amps
Transtormers Above 200 - Amps
7 Above 700 _ Amps
SIgt1S lnspeclars Use Only TO `
Irnqahon 8ooms ? (ov
nx" (}O. J(_,7
Special Inspec6on
Alarm/Communication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspector, hereby Rou9°"° oe?a
certrfy that the above inspection has
been made Finai
OiFICE USE ONLY '
This request voitl 18 monlhs iram
Tms reQUest voiC
16 munths 6om /
C 12328
Ranur3t"Date Fire No. RouAh-? InsDerfon
/?q? ?? Reqwretl? ?ROatly Nuw?Will Nnirty Inspec-
?J i} / • / O ? ??es ?NO ? ?o. When Feotly
0 Licensetl 0c06c I ConVactor I hereby reQuest msoecpon o( above
? On'^er elactrical work installed at
S[reet Address, 9oa or Route No. City
ecvon o. hiv Name or No.
it Ranqe No. Coonty
4D ,
OccuGaot (PRINT) Phone No,
/( J 7--7z
Power Sup0lier Address
. I.G
Elec[ncal Convactor ICOmpanv Name)
77-'.1
.r Contracmr's Liccnse No.
L
MaiM1nq AAJress (Contrac
m
r
r
o
'Owner Makinp Ins[ail2tioN
?
,-
'
-
7
?? ?-C?i ? ??!/?.?'?G ? ?? I?/L/??_!L S
AuMorizetl SiBna Convactor/Owne r Maki Instal io I Phone Number
933-25^1
MINNESOTA STATE BOAflO OF ELECTRICITY THIS INSPECTION NEQUEST WIIL NOT
Gripgs-Mitlway Bldg. - Room N•191 BE qCCEPTED BY THE STqTE 60APD
7821 Umverefly Ave., St. Paul. MN 66104 UNLESS PPOPEH INSPECTIDN FEE IS
Phone (612) 297-2111 ENCLOSEO.
7REQUEST FOR ELECTRICAL WSPECTION EB-001101.04
4- L, I p See instrvctions for complenng this torm on back ol vallow copy. C9 /?// 33
((' ?P?`? q "1(" Below Work Covered by This Request ???
w#A A
dd eD. TVPe oi BuilEinB ApplcanCes WveA Equiyment Wved
Home Range Temporary Service
Gtiplex Water Heater i , Liyhtiny Fixtures
Apt. BuilAmg Dryer Electnc HeaUn
T Cominercial Bldy. Furnace Silo Unloeder.
Industnal BIAg. Av Conditroner 8ulk Milk Tank
Farm omr? aec? v n?ne? isu??c??v?
t a,r Suocily thor Oihdr
p Fae ServiceEnbenceSize n Pee Feeders/Sabteeders Crrcwts
o to 200 qm 5 0 to 30 qm S to 30 Am>
Above 200 Amps 31 to 100 Amps 1 ta 700 Amp,
Swimming Pool Above 100_Am s j bove 100-Amps
Transtormers Irngation &)oms artial.'Other Fee
Signs SpeciallnspecLOn
Hemarks o
flou9h.in
the Elech 1
?(? ereby
certdy thet the above
F?nal ?/!?-? mspecban has baen
. L(/ I ?ea.
(Iiis rBCUestvoi018 montM from
Tlms request vaitl
18 momhs 1rom
C 1234Q L-uc-, /46 -Z
Rpqv^St Uate Fre No. PouPhLn InsVecUOn
ReqwreA,
?FeaAV Now ?9Ndl Nouty Inspec-
/) y
?(n.%''',F q / CJ "6 ?Yes ?NO lor When fleedY
? Licensed'Electncal Con[rector 1 hereby request insoecLOn ol above
? Owner electncal work installed ar.
Streei Atldress, Box or Route No. Cii?
ectmn o. Township Name or No. Range No. owety
C
j
panl (PqINT)
Occu Phone No.
J
/? /
Pawer SupDlier Address
?? Q??"'?G
Elec[ncal Contrar,tor lCOmpanv Nxme) C{o?M'rnJctor'/s 9License No.
? ?i? / Ar? / ?) 6.?
MaJing dJress Contraolor or wner MakinB Instaflationl
Authorired Sig (Convactor/Owne, M?ng Ins la n)
/ / )- Pyqqq?Npm,Jpp?
yAO ?
C/ .
17
MINNESOTA STqTE eOAFD OF ELECTRICITY d THIS INSPECTION FlEQUEST WILL NOT
Griggs-MidwaV 8109. - Noom N-191 BE ACCEPTED BY THE STqTE BOARD
1827 Universitv Ave., St. Paul, MN 55104 UNLESS PNOPER INSPECTION FEE IS
Phone 18721 297.2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-ouooi-oa
?? `?-1 See insvuctiens br complxtinp Ihis lorm on beck of yellow copy.
Il 12340 "X" 8elow Work Covered by lhis Request ????•% j
AAd Rep Type o1 BuJemg ADPlienCee WveA Equipmem Wved
Home Range Temporary Service
Ouplex Water Heater Liyhtiny Fixtures
Apt. BwlAing Dryer Electne Heaiin
Commercial Bidy. Fumace Silo Unloader
Intlustnal Bldg. Air ConAitioner Bulk Milk Tenk
Farm +ne, oN,:rv einf?lsnc??fy)
? er SVecirv 01her . ? o, n..,
l,0//IpUiB fIl50CC[lOO hPP HPIOW "
p Fee ServiceEntranceSixe k Fea Fexders/5ubfeeders k Fee Circwts
i ,c-/ o 200 qm s 0 to 30 qm s %c 0 m 30 Am
l/ bove
20D qm?s 31 to 100 Arnps 31 to 100 Am
i
nvnmg Pool Above 100-F?mps
nsiormers Boorcis
ns Speaal Inspecuon S
Bemerks ?^?
TOTAL F
% L.»_Roueh-in Dale
(`f the E c<n
Inspector, ereby
Final
?1e certdy that the above
insDection has baen
mia reoueat voitl 18 montlv Irom
RESIDENTIAL BUILDING -70
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWction Reauiremenls RemodeVReoair ReauiremenGS Office Use OnN
3 registered site surveys shaxirg sq. ft. of lot, sq. ft. of house; and all rooted areas 2 copies of plan Cert of Survey Recd _ Y _ N
(200h meximum bl covercge allowed) 7 set of Energy Calculations for heated addi6ons Tree Pres Plan Recd _Y _N
2 copies o( plan showing beam & window sizes; poured Tound design, etc. 7 sile survey for additions & decks Tree Pres Reqd Y _ N
lsetofEnergyCatrwlatlons Add'dion-indicateifar-sHesepficsystem On-siteSeplicSystem _ Y _N
3 oopies of Tree Preservation Plan rf lot platted after Il1l93
Rim Joist Defail Options selection sheet (bidgs wBh 3 or less unAs
o
Date ? / ? / 200 ? Construction Cost ?4,0oo?
SiteAddress 1533 CLEMSoV pk 1vE UniUSte #
Description of Work K,-PL&E 10X Z U DE C k
Multi-Family Bldg ? Y _ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner -Tiii?Dmt'} S- Lo2en z, Telephone # (?16) Y7iS- ? ??O
Contractor kh5i1-E EX7LR1okS
Address t-k%? W. (?OlH S't. City mINMLMPWS
State (hN Zip ?Wci Telephone#(C';I )-D2-4969 6?l lc?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate orv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
submission type) Submitted Submitted
. Energy Envelope Calculations 5ubmitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies. ,??
Licensed Plumber A ` LS' Telephone #(
Mechanical Contractor 00/ 11 Telephone # (
9y 3.002 D i
Sewer/Water Contractor ? Telephone #(
N If so, 25% plan review
I hereby apply for a Residential Building Peand acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
m I Ke 2vn*-) --1-1-4 z?-
Applicant's Printed Name Applicant's Signahue
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex g 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New
? 32 Addition
? 33 Alteration
x 34 Replacement
Valuation Zv ov -°
Census Code
SAC Units
Nbr, of Units
Nbr. of Bldgs
Type of Const
Footings (new bldg)
? Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Au Test _ Final
Insulation
W idth
REQUIRED INSPECTIONS
Final/C.O.
?t FinaUNo C.O.
_ Piumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/ieplacement)
_ Retaining Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Tota I
? 30 Accessory Bldg
? 31 Ex[. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
`Uemolition (Entire Bldg) - Give PCA handout to appl Icant
Occupancy P.'3 MC/ESSystem
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
"as-
S?d
NDS-?? (9325)
)J
en4acr7 sVVokL
0
0
X 000.0
(D00.0)
-4-
Derqtes Iron Monument
Denotes Wood Steke
Denotes Existing Elevation
Denotes Proposed Elevation
Denotes Direction of Surtace Drainage
.
olr • ?VfEW ED
?93bi:°s` ` ?/y1
I • ,?•? '?l3???
.
' Proposed Top of Foundation Elevationa
Proposed Garage Floor Elevatione 938.0
Proposed Lowest Floor Elevation= 938.5
I hereby ceAify fhat this is a true and correct represeMffiion of a survey of the boundaries oE
Lots 45, 46, 47, an 4d? Block 2, TFIOMAS LAKE HEIGHTS 2ND ADDITION,
Dakota County, Minnesota.
And of the location of all buildings, ii any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 23rd day of Avril , 19 86 ,
l i CGGC?" (??Gr's?
Paul A. .Tohnson
Land Surveyor, Minn. Reg. No.109 38
i° ?40? fior
MMMEWLY ' CERTIFICATE OF SURVEY
?
f CCOMBS-KNUTSON ASSOCIATES, INC. ,?A, ??? ?S
touuttuc eneinuu a wo tuRrFrou a sir[ run[u ma ro. IrG 111'
w0 MUTCXt16W/.WIN({pjA
7430
/ / (? RESIDENTIAL BUILDING 70 ?
CO ! (? / O Permit Application
City Of Eagan /3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConSWctlon ReuwremenLS RemodeVReoair Reoui2ments Office Use Onlv
3 registered sile surveys showing sq. ft. of bt, sq ft o( house; and all rooted areas 2 copies of plan Ceri of Survey Reoi _ Y_ N
(20%maximum lot coverege allowed) 1 setof Energy Calculations tor heated addNOns Tree Pres Plan Recd Y_ N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 sile survey for additions & decks Tree Pres Reqd _Y _ N
isetofEnergyCalculations Addition - indicafeHonsdesapHcsystem On-siteSeplicSystem _Y _N
3 copies of Tree Preservation Plan rf lot platted after 711193
Rim Joist Detail Options setectbn sheet (bldgs wAh 3 or less uniLs
Date?_/
3 / ZGe?j
ConstructionCost ?'`Z J aG
OOO ,
SiteAddress CLEM$GN D1Z Unit/Ste #
Description of Work Ft?LI\Cf )Ox t0 D<<d'
Multi-Family Bldg x Y_ N Fireplace(s) _ 0_ 1 _ 2
)
Property Owner R (t h6 ?--- __ Telephone #(7/Q,3
I
Contractor ? R$llE LX'1?K tOlff '
Address 40S W4:Sr CG'H ST _ City PiUN0112d)i
state MN ziP Telephone#((:15l )322-4`76`1 ex, 03
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residantial Ventilation Category 1 Worksheet • New Energy Code Woftcsheet
(4 submission type) Su6mitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _
fee applies.
(?---? ?
Licensed Plumber Telephone #(
Mechanical Contractor ll°Cr o 3 20W Telephone #(
Sewer/WaterContractor Telephone #(
N If so, 25% plan review
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval ofplans.
Mtkt CDr /?/
a% " '
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt - SF
? 04 02-plex ? 10 OS-plex PO 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex O 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types f;( Si +-i Y 7 F? eT -, A 6-
0 31 New ? 35 Int Improvement ? 38 Demalish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
1)110 34 ReplaCement •Demolitlon (Entire Bidg) - Give PCA handout to applicant
Valuation Z ? Occupancy R'3 MC/ES System
Census Code `J 3 y Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const U?? Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Founda6on
Drain Tile
Roof Ice & Wa[er Final
_ Framing
_ Fireplace _ R.I. _ Air Test Final
Insulation
REQUIRED INSPECTIONS
FinaUC.O.
?Q FinaVNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
U"IVI
N
C.
P d
.D p
v
(93)5)
.
?. -?.
,.o. . . [..• ? ?
j •
? ?ol
w'
I
r- a
ryti ?
yl e°.
\
? ? ? \
?ioo y?? .
? N68• `9!O
O
? /S yY
\L.e3VO\ 1
?
,IP
??asP?crsONS SY?
i
0 Denotes Iron Monument ?
° Denotes Wood Stake
Xp00.0 Denotes Existing EtevaNon ' Proposed Top oi Foundation Eleva6ona
(000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 938.0
-*.- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevatione 93H5
I hereby certify that this is a hue and correct represeMation of a survey of the boundaries ot
Lots 45, 46, 47, andQ Block 2, THOMAS LAKE HEIGHTS 2ND ADDZTION,
Dakota County, Minnesota.
And of the Iocation of all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 23rd day of Anrii , 19 86 ,
(?,-?Q
Paul A. Johnson 6-11"
_ Land Surveyor, Minn. Reg. No.10938
?= qo? CERTIFICATE OF SURVEY
for
r CMC(OMBS-KNUTSON ASSOCIATES, INC. ,?A, ??M' ?c
coNiouwa e?cnt[u ? wn tuRvIrou N mre runar cu .o. ?YG 11 ? VI ?/ ?7
WMxENOI?i w IartCM?MfOM,wre1WCTw
r . 743?
_ • t1` \ C ? S
3?00
O 00 ?
.a J '+ (9 Q
1 (?? Q
p? N +?\ ? ??? ?? \4
\ ery ` M1? pj ?
p \\.e
?' O40 9b6?
o ,•\oC: , " a?0? ?q ,
\ e, ? (
?? ? pO \?q\\ h?'O ::? '-
41
?937.5) 3? >e
b'? \ ryw
, ' er \Q?\\? °'?? p ?
a ry
'Y`?/, p ?9 CJ
1
d N6g? .00 ?
'?•r " b ol ^h
q3
/s_
.
0? o ?
?4 .
i ?
.?
? L-i
? (93B 0)
.
G?L E SO ?
?
0 Derates Iron Monument \
° Denotes Wood Stake
X000.0 Denotes Existing Elevafion ' Proposed Top of Foundation Elevatione
(000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 938_0
?- Denotes Direction ot Surface Drainage Proposed Lowest Ftoor Elevation= 93fl5
I hereby certify that this is a true and correct represeMation of a survey of Me boundaries of.
Lots 45, 46, 47, and 48 Block 2, THOMAS LAKE HEIGHTS 2ND ADDITION,
Dakota County, Minnesota.
And of the location of all buildings, if any, thereon, and ali visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 23rd day of Avril , 19 86 _
Paul A. Johnson
Land Surveyor, Minn. Reg. No.10938
i°-` 40' CERTIFICATE OF SURVEY
? ?-? for
McCOMBS-KNUTSON ASSOCIATES, INC. ?W ??? ??
eeNiovui uuo suertrou B srtt ruu[n ???F ?
? ?
?HI?,,."M?.,, 7430
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when pemuts are required for each unit
fi/S--.Sd
Date 5 / s / 03
- - -
-
?
I AWARI, SRINIVAS
Site Address
Uuit #
1581 CLEMSON DRIVE
EAGAN, MN 55122
(651)994-1426
Property Owner I Telephone # ( )
? i
Contractor NORBLOM PU1M131NO CO,
(612) 827-4033
Address City
•
State
ip Telephone # ( )
The Applicant is _ Owner ? Contractor _ Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
IncWdes County fae. Additlonal consultant fees may appy.
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.00)
_ Other.
Q1 2'" ''? = 1??1?
_ RPZ _ new installation _ repair _ rebuild
L1L
i s 30.00
_ Lawu irrigatian system
? ?
By_ - I
_ Water softener Water heater $ 15.00
x replacement _ additional
$ 50
State Surcharge
Tatal $ I hereby apply for a Residenhal Plumbing Permit and acknowledge that the infoimation is complete and accurate; that the work will
be in conformance with the ordinanres and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a
permit, but only an application for a pernut, and work is not to start without a pernvt; that the work will be in accordance with the
approved pian in the case of work which requires a review and approval of plans.
Jle_-C? NoCU"„-\
ApplicanYs Printed Name anYs Signature
.. .. . 41'1
Jv
COMMERCIAL
2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4675
a 73 a?
Foundation Onl New Construction Interior Im rovement
• S6vctural Plans (2) seb • Architectural Plans (2) sets • Architectural Plans (2) sets
• Civil Plans (2) • SVUCWraI Plans (2) • Code Malysis (1) "
• CertlBpte of Survey (1) . Civil Plans (2) • Project Specs (1)
• CodeAnalysis (1)" . LandscapingPlans (2) • KeyPlan (1)
. ProjectSpecs (1) . CodeMalysis (1)" • MasterExitPlan (1)
• Spec. Insp. & TesUng Schedule " • CeNflcate of Survey (1) • Energy Caiculations (1) not aN+ays"
• Soils RepoA (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always"
• Meter size must be estahlished • Meter size must be esfablished • Meter size must be esfablished - if applirable
• ProjedSpecs (1)
1 • EnergyCalculations (1) " d
d • Eleclric Power 8 LighUng Form (1) " t
1 • Master Ecit Plan (1) 1
1 • Emergency Response Slte Plan (1)
1 • Soils Report (1) l
• MGES SAC determination letter • MGES SAC detertninallon leller • MC/ES SAC determination letter
call 651-602-1000 call 651-602-7000 call 651-602-1000
Food 8 beverage or lodging facilities - submit plan to MN Department of Health. CaII 651-2750700 for tletalls.
Contact Building Inspections for sample.
Permit for new buildings or additfons will not be processed without Emergency Response Site Plan. Ask Building Inspections for requirements.
DATE: WORK TYPE: _ NEW ?,G REMODEL CONSTRUCTION COST: 1.5,, D!?e.L_
SITEADDRESS:
TENANT NAME: 7- m-7 SUITE #:
?
FORMER TENANT NAME, IF APPLICABLE:
DESCRIPTION OF WORK / U K-/?
Name: Z&-"I ?/?S Phone #:
PROPERTY Last First
OWNER ? 2 ???5 ?
Street Address: o
City: State: Zip:
Company: Phone#: /,
CONTRACTOR
Street Address:
CiTy: /?//'/5 State: Zip:
ARCHITECT/
ENGINEER Company:
Name:
S4eet Address:
City:
Phone #: (
Registrarion #: _
State: Zip:
Licensed plumber instalBng new sewer/water service: Phone #:
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. ?j ? ?
Signature of Applicant:_T?
. . .
THOMAS LAKE HEIGHTS 2ND 75951
PERMIT
DATE &
TYPE LOT BL ADDRESS
12/83 4-PLEX 210 02
220 02
230 02
240 02
5/86 4-PLEX 250 02
260 02
270 02
280 02
4/86 4-PLEX 290 02
300 02
310 02
320 02
4/86 4-PLEX 330 02
340 02
350 02
360 02
4/86 4-PLEX 370 02
380 02
390 02
400 02
5/86 4-PLEX 410 02
420 02
430 02
440 02
5186 4-PLEX 450 02
460 02
\ 470 02
480 02
1542/ BAYLOR CT
1543/ CLEMSON DR
1543B
1546 BAYLOR CT
1545/ CLEMSON DR
1547/
1547B/
1545B
1555/ CLEM30N DR
1557/
1557B/
1555B
1565/ CLEMSON DR
1569/
1569B/
1565B
1571/ CLEMSON DR
1573/
1575/
1575B
1577B/ CLEMSON DR
1577/
1579/
1579B
--
__--
1581B/ CLEMSON DR
1581/
1583/
1583B ?-
34
APPROVED 3/85
PAGE 4 OF 5
PERMIT # L_ S _a- RECEIPT DATE:
SOOE RESIDENT1AL PLUM$IRfl PERMIT APP11CATION
crrY og EAsm
S$SO fQ.OT KFOB iW
f.A6AP, MN 551EY
631-6$1-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITE ADDRESS: IS&J B l t-em,rjPSYI Qr,
wt,
OWNER NAME: : L???Aor{}' [y, , J(,L(4-Ci TELEPHONE #: Io5 -45 2- `'-cxS 4-5
(AREA CODE)
INSTALLER NAME: -ry . P. Pi OfiYl/(99r LS TELEPHONE #: LstI3+0
t?? (AREA CODE)
STREETADDRESS: ?Io-In AO?? lC.?.)
CITY: STATE: A47V1 ZIP:
J
_ SEPTIC SYSTEM, newlrefurbished (requires rivo sets of plans and MPC license) $ 100.00
includes $40.00 Counry fee
Note: Additional consuitant fees may apply
• MODIFICATIONIALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, exciuding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repairlrebuild $ 30.00
_ lawn irrigation system
Replacement/additional: _ water softener 1 water heater $ 15.00
StateSurcharge ???? 2 6 2??2 $ .50
f5 .sz)
Total
I hereby acknowledge thal I have read lhis applicahon, sWte that the information is correct, and agree to comply with all applicable Ciryof Eagan ordinances. It
is tha applicanCS responsibiliry to nolify Ne property owner that Ihe City of Eagan assumes o liabiliry for a da f es raused by the City during ifs normal
operational and maintenance activities to the fadlitles constructed under this permit w' hi iry properry/ ii of s n.
SI TURE OF PERMITTEE 1/02
- 7986 son.ntsc peerui arecacarioa - crci oF EscAa .
HO?6s ALI. COHiRACfOBS 1lOST BE LICFNM YISB ?HE C1T! OF EAGAII
3IBGi.B FAlM DfiE[dLIB('$ "-'_ : ?:?''_^ ?- =:.;. ' '? . . . • "
. v',.l[ `'2I.t:
'--.,INCLQDE 2 SEiS OF PI.AA3; 3 CERYZFZC9Tffi, OF SOE9Eit= 7 SE! :OF EN6RGY CALCOLATI083 .: :--_
. . . . •i ?' / _
/
,
?LTIPLE ?. .T.INGg - , REsIDENTIn Y ` B '?rAL Ull.?i •' ' FOB SaT QNITs V ' •
. r
. i"_ . . .. • . .. .
• INCLODE 2 SETS OF PLABSp CEH?IFICAT6 OR SIIHVE! -CHECK KITH BLDC.,DHPl.9
1 SET OF ENERGY CALCUL9TION5 . .
(O24MEBCIAG -• : - , . . : ,
INCLQDE 2 SETS OF ARCHITECTOR9L & STROCTORAL PLANS,
1 SET OF SPECIFICATZONS ABD 1 SET OF .
ENERGY CALCOLATION3, ' • $2,000 tnrmscAes sorro
To Be Dsed Fors RESiDENCE Valuation: nate:
Site Address 15-
O /
Lot Z16 Block J,
Parcel/Sub THOMAS LAKE HEIGHTS .?_
Ormar NEW HORIZON HOMES. INC.
Address P. 0. BO% 1367
C1ty/Zip Code MPLS. MINN. 55440
Phone 420-3900
Coatractor SAME '
Address
City/21p Code
Phone
' Arch,/Engr, D. GRISWOLD
9ddress '
City/Zip Code
Phone # 435-7524
Fsect Oceupancy 3
Aemodel Zoning
Repair _ Type of Const
Addition
Move # of Stories
LengtL ?
Demolish _ Depth
Int.Impr. _ Sq Ft
Install
APPHOVALS FEF.S
Assessments Permit 3/l0
Water/Sever Surcharge
Police Elan Reviev
Fire SAC
Engr Nater Conn d
Planner Aater Meter i
Couneil Road Onit
Bldg OPf S- - Treatment P1
APC Parks .
Variance Copies
TOiAI.
y)'IDd-cj, - C? 9 -
HOTE: ADDHESSES FOB CORHEE LOrS - CON2HAC?06/HOMEOWHEH AIISS DESIGHAYE WHICH 6DDEESS
IS DFSIEED. NO CHANGES AII.L HE ALLOitED ONCE BIIILDING PEHISI! IS ISSIIID.
FOR SALE TOWNHOUSE CITYOF EAGAN
Police
Fire _
BUILDING PERMIT Receiptp
fo be used for 1 OF 4 PLEX Est Value $ 61 ,000 Date
MAY $
? 6
SiteAddress
' 1581 CLEMSON DR Erect
L?
occupancy R3
46
Lot Block 2 THOMAS LAKE HTS
Sec/Sub. Aemodel ? 2oning Rl
Parcel No. 2ND ADDITION Repair ? Type of Const. Vsl
Addition ? No. Stories
w Name NEW HORIZON HOMES Move ? Length 44
z
3 Address
Demolish ?
P.O. BOX 1367
Depth
27
° MPLS 420-3900 Int.lmpr. ?
Ciry Phone
? Sq.Ft
Insfall
o Name SAME Approvals Fees
=
?? Address ASS@SSfllent Pefmit 316.00
? Ciry Phone Water&Sew. Surcharge 30.50
uW Name D. GRISWOLD
Q i Address
aw Citv Phone 435-7524
I hereby acknowledge that I have read this application and state that the
information is correct antl aqree to comply with all applicable State of
Minnesota Statutes and City of Epgan9rdinanye;
Signature of
A Buildmg Permit is issued to: Lvzw nur
all work shall be done in accordance with all appl
Building Official ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE• 454-6100
HOMES
e af KOfin7
Planner
Council
Bldg. Off. 5/1/86
Var. Date
N° 11925 I?
Plan Review 158.00
SAC 575.00
Water Conn. 500. 00
Water Meter 63.50
RoadUnit 290.00
Tr. PI._ ??56,00
Parks
Copies
Total $2. 089.00
on the express condition Mat
and Ciry of Eagan Ordinances.
M
. ?
?. ; 7986 B[iILDIBG PE@Q! iPPLICATIOa - CITS OF EsGAH ,
HOtSs ALL CO8TBAClOBS !lQST BE LICE85ED YITH TS6 CIiZ OF EAG6S
SIHCd.S FdKrLY IISiE[.I?1('$? ` ' 'Y' ? • . "-?• . - . .
.. ._..,r- ? `":.:? r_z'???.,;:'; "'.,? ?•, ; ? . ,::_: .--. K .. ,. . . _
=.: ?:lt? - ..» "KV????.'F: i..e'r, '..pj- •- -.: tr. :.u...•.`.? . ::.. .:.: • .. i _'y 2'.: ;
=.INCIADE 2wSET3,OF PL9NS; 3 CERTIFICA?ES OF SQE9ESS-• i SE?,OFENEAGY CALCULATIO?'7Q '= • -•
_ . _ .t.:._: i`?.: _i?,..-. :? ' ?"-f ,_ . - -., s,-- • "4 "? .'- _ ... " / ?
_+?M[JI.SIPLB DYELI.IHCa4 ? •HESIDSBTIEL gFIW'rAL IINI1S FO$ SAIX DNR3 V
?• _ . . ' . , -. . , , .
- INCLODE 2 SEiS OF PLANS, CEBSIFICASB OF SOBVBT - CHEB WITH BLDC. DSPr.9, .-
1 SET OF.ENERGY CALCOLATIONS
cm4mCIAL . , . . . . . -
INCLQDE 2 SETS OF AACHITECTORAL &.STEOCTQRAL PL9NSt .•.
1 SE2 OF SPECIFICATIONS AND 1 SE? OF
ENERGY C9LCOL9TIONS, ' $2,000 LANASC9PB BOND
Yo Be Used Fors RESIDENCE oaluation: A zi Z-) Date:
Site Addresa ?f s / `Q
Lot ? Bloek .1- , -
Parcel/Sub THOMAS LAKE HEIGHTS _2/
Ovner NE47 HORIZON HOMES. INC.
9ddress P. 0. BO% 1367
City/Zip Code MPLS. MINN. 55440
Phone 420-3900 -
Coatractor SAME
Bddress
City/Zip Code
Yhone '
greb,/Engr, D. GRISWOLD
Address '
City/Zip Code
fhone # 435-7524
Ereet ZL Occupancy 'AL5-
Remodel Zoning -
Repair _ Type of Const S
Addition # of Stories
Hove ' Length 7V(7-
Demolish Depth e,7
_
Int.Impr. _ Sq Ft
Install
APPEOVALT FEFS
Assessments Permit 3/?0
Water/Sever Surcharge
Police Rlan Reviev
Fire S9C
Engr Nater Conn
Planner Aater Heter
Couneil Road Onit 29p
Bldg Off Treatment Pl
APC Parks
Variance Copies
TO'LAI.
HOTE: ADDHESSES F08 CORNEE LOSS - CONTRAC?OSlHOHEOSi9ES lfOSS DESIGN9TS NHICH ADDRESS
IS DESISID. NO CH9NGES YILL BE ALLOWED ONCE BQILDING PERMIT IS ISSUID.
FOR SALE TOWNHOUSE CITY OF EAGAN
•. < 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121
PHONE: 454-9100
BUILDING PERMIT
N° T11924
Receipt # 4? a 7 ?,
7o be used for 1 OF 4 PLEX Est. value $61, 0 00 Date MAY $ 19 8 6
SiteAddress 1581B CLEMSON DR Erect ? Occupancy R3
Lot 45 elock Z Sec/Sub. THOMAS LAKE Remodel ? Zoning R1
Parcel No. HEIGHTS 2ND Repair ? Type of Const. l7}3
. Addition ? No. Stories
w Name NEW HORIZON HOMES Move O Length 4r
P.O. BOX 1367 Demolish ? Depth ??
3
° Address
MPLS
420-3900 Int. mpr
. O
Sq. Ft
Ciry phone Insta
o Name SAME Approvala Fees
$a Address Assessment Permit $ 316.00
'- ciry phone water & Sew. Surcharge 30 . 50
u= D. GRISWOLD Police Plan Review 158.00
Name 575
00
Fire SAC .
= Address 500
00
a Eng. WaterConn. .
<W ciry pnone 435-7524 planner waterMeter 63.50
I hereby acknowledge that I have read this application and state that the
iMOrmation is correct and aqree to comply with all applicable State of
Minnesota Statutes and Ciry of E gan Ordinances.
Signature of Permittee ?t?i[
A Building Permit is issued to: NEW HORI ZON HOMES
all work shall be done in accordance with all
of
Council
BIdg.Off. 5/1/86
Var.
Road Unit 290.00
7r. pi. 156.00
Copies
7otal $2.089.00
on the express condition that
and Ciry of Eagan Ordinances.
Building
" - 1986 BUII.DIHG PEm! APPLICATIO]! - QiS OF EAGAH , .
? HOTEs ALL COHTRACTOffi lSQS! BE LICEHSED filiH THE CIrS OF EAGAa
SIHCd.S FAlIIIS DRiELLIB(i4r '-- L" ? ''•' >' , : :',', - - -=- r : i ' - . _:
y F-.y Y"4_?.?':'-'?%E.,:ZY?'.?. ; , _ G-.'?:' ?_?'' __ , r,.'" ' "•
•?`rtt.s;+t'F-"i_??:.?"a°v=?Va.:?,.-'c :?:5"a.t"_?u? _ ."t'- •si.-"??'r4-'?.S.R .. Fi?._i- 0.•ay:
_INCLQDE 2 SETS OF Pi.ANS; 3 CEEtTIFICATES. `OF SOHVSL* • 1 SE[ OF EN6BGY CAI.COLATZOHS
MIJI.TIP[.8 DSiE[.LIHG4 -.HwIDfiBiIAL?.'HF71PfAL iTHIiS • FOSSAI.B ONIi3 ? •
INCLQDE 2 SETS OF PLANSt CEHiIFICATB OF SOBYSI -CKM YITH BL17G• DEPi-•
1 SE! OF ENERGIf CALCOL9TIONS
CoFmCI9L . - . - . "
INCLDDE 2 SETS OF ARCHITECTQR9L 8 STROCTORAL PL9NS,
7 SE2 OF SPECIFICATIONS AND 1 SET OF
ENERGY C9LCOLATIONSt ' ' -
#2,000 LANASC9PE BOND -,
To Be Osed For: RESIDENCE Valuation: DaLe:
Site Address
Lot 4?7 Block c?-
Pareel/Sub THOMAS LAKE HEIGHTS )-
Owner NEW HORIZON HOMES. INC.
Address P. 0. BOR 1367
City/Zip Code MPLS. MINN. 55440
Phone 420-3900 .
Contractor SAME
9ddress
Citp/Zip Code
Phone
Arch./Engr. D. GRISWOLD
kddress '
City/Zip Code
Phone # 435-7524
Erect ? Oceupaney 3
Remodel Zoning
Repair _ Type of Const
Additioa
Move # oP Storiea
Length ?
Demolish _ Depth 2Z
Int.Impr. _ Sq Ft
Install
9PPHOVAIS FEFS
Assessments Permit /o
Water/Sever Surcharge
Police Tlan Review
Fire SAC
Engr Aater Conn
Planner Fater Meter i
Couneil Aoad Qnit
Bldg Off f-? 1Y'eatment Pl
APC Parks
Variance Copies
iOiAL
HOTE: ADDHESSES FOE CORNEB LOiS - CONiEAC?OR/HOFIEOHHEB l105S DESIGNASS WHICH ADDEESS
IS DESIHID. NO CHANGFS KILL HE ALLOSiED ONCE BOILDING PEFQTIT IS ISSQED.
FOR SALE TOWNHOUSE CITY OF EAGAN
3830 Pllot Knob Road, P.O. Box 27-199, Eagan, MN 55721
PHONE: 454-8100
BUILDING PERMIT
Na 11926
Receiptp
To be used for 1 OF 4 FLEX Est. Value $ 61 ,000 Date MAY R 186_
SiteAddress 1583 CLEMSON 'DR Erect ? Occupancy R3
Lot 47 Bloc k Z Sec/Sub. THOMAS LAKE Remodel ? 2oning Rl
Parcel No. HEIGHTS 2ND Repair ? Type of Cons4 A7*+
Addition ? No. Stories
W Name NEW HORIZON HOMES Move ? Length 44
z
3
Address P.O. B?X 1367 Demolish ? Depth 27
o
Ciry
MPLSphone 420-3900 Int Impr.
I
ll ?
? Sq. Ft
nsta
o Name SAME Approvals
z
y a Address ASSESSfilEnt
1- Ciry Phone Water 8 Sew.
M Name D . GRISWOLD
AddreSs
Ciry phone 435-7524
, I hereby acknowledge that I have read this applwation and state that the
information is correct and agree to comply with all applicable Sfate of
Minnesota Statutes and Ciry o( Eagan Or nances.
vC
Signature of Permittee
Nt-W HORIZ N HOMES
A Building Peimit is issued to:
all work shall be done in accordance with all aoohcable Sffife of Minnesa
Police
Fire _
Planner
Council
Bldg. Off. 5/ 1/ 8 6
Var. Date
Permit $ 316.00
Surcharge 30.50
Plan Review 158. 00
SAC 575.00
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.00
Tr. PI. 156.00
Parks
Copies
-TT'-6$T.-00
on the express condition that
City of Eagan Ordinances.
8uilding Official l Yj? ? O o 1.?..PiZ?
?
?
" 1986 son.nING rBmui ap?.ICanos - Crci oF ssceA , ..
.
HOi6t AI1. WHTRACfOBS !lQST SE LICFNSED YIiH THE CIn OF EAGAa
? '' • . .
3IBCd.B FAlIII.T
.., ?, .:? : =' . . •;s',: ?=- ' .. , . . ' , .' , '- . '. •,
? ' ?3:., ,?^.r[;?- _i. F`,x:`'? s ti.saS...',`Li: >-Y: i: CL"''?_ '??', .- ''.a,. w!1, y^!- 1v_i` `t• .. t ::.? . ;
_••*ZNCLODE 2 SEY'S OF PL6N5? 3 CERTIFICATFS,OF SUHVET?-- 1?SET OF E6TERGY CAI.COLATIONS -•-
•
" MULLE DWQ.?.?? - H?m ??., ??i ?$, .5A? ?I?
' R .
'• INCLUDE 2 SETS OF PLANS, CEHTIFICATB OF SIIEYEI -CHECK WI?H HLDG.DfiP=•,
1 SET OF ENERGY CALCOLATiONS - '
C014iEHCIAt . : ' . . . . , •
INCLQDE 2 SETS OF AECHITECTORAL 6 STBOCTORAL PL9NS, •-. -
1 SEY OF SPECIFICATIONS AND 1 SET OF
ENERGY C9LCOLATIONS, $2,000 LANASC9PE _BOND
To Be Qsed Fors RESIDENCE Valuatioa: Date: O'A
Site Address 15-13 ?'i ?imsa,,??Ok•
Lot kl g Block J-- ,
Parcel/Sub THOMAS LARE HEIGHTS d?
Oxner NEW HORI7AN HOMES. INC.
Address P. 0. BOR 1367
City/Zip Code PiiPLS. MINN. 55440
Phone 420-3900 "
Contractor SAME '
Address
City/Zip Code
Phone -
Areh./Engr. D. GRISWOLD
iddress '
City/Zip Code
Phone # 435-7524
OFFICE OS6 OHLZ
Erect ? Occupancy ,Q 3
Remodel Zoning
Repair _ Type of Const
Addition
Hove - i of Stories
Length ?
-
Demolish Depth
Int.Impr. _ Sq Ft
Install
APPHOVALS £EES .
Assessmeats Permit
Water/Sexer Sureharge 3cP
Police Rlan Reviev
pire S9C
gngr Aater Conn ?
Planner Aater Meter
Council Road Qnit 290
Sldg Off S-/- 15reatment P1
APC Parks .
Variance Copies
TOidL
BOSE: ADDfiESSES FOH CORBEB LOTS - COH2RAC?OE/HO!(EOWHEH lIOS2 DESIGH9iS StHICH ADDBESS
IS DESIRED. HO CB9HGFS HILI. BE ALLOiiED ONCE BQILDING PEBMIi IS ISSIIID.
FOR SALE TOWNHOU383gg CITY OF EAGAN ?
0 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 N_ 11927
" PHONE: 454-8100 ???7 ?
BUILDING PERMIT Receipt# ?
Tabeusedfor 1 OF 4 PLEX Est.Value $60,000 Date MAY $ .1e $6
1583B CLEMSON DR y R3
Site Address Erect ? Occupancy
Lot 48 elock 2 Sec/Sub. THOMAS LAKE Remodel ? Zoning
Parcel No. HTS ZND Repair ? Type of Const VR
Addition ? No.Stories
W NEW HORIZON HOMES Move ? Length
Name P O. BOX 1367 Demolish ? Depth
3 Address Int Impr. ? Sq. Ft
° cin, MPLS phone 420-3900 Install ?
o SAME Approvals ? .
il? ou Name
Address
Assessment
? ciry Pnone Water & Sew
Police
?
W Name D GRT SWOID Fire
T
F
?
a Address Eng.
w 435-75 24
< ciry Pnone Planner
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Slatutes and Ciry of E yan dinanc .
Signature of Permittee
A Building Permit is issued to: NE HORI ZO HOMES
all work shall be done in accordance with all app?kabl tate of Minne a
Council
eid9. orr. 5/1/86
Var.
Permit
.00
Surcharge 30.00
Plan Review 156.50
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit 290.00
Tr. pi. 15 6_ 0 0
Copie 2 ,0 . 00
Total
on the express condition that
antl City of Eagan Ordinances.
Building Official `??T ?? ?c r? ? ??
Y.-iP%GY\L Tow m vzv` C',o. IVrJf 2L3-154
HEATLOSSCALCULATION$ HEATINGBAIii C011EDIYIOIUING CO. MINNEAPOIIS,MINN.
Weatherstrips A.S.H.V.E. Construetion No. Insulation
NTindows Doors Guide
Reference Out. Wall Int. Wall Ceiling Roo1 Floor Kind How Applied
Yes-No Yes-No 19_
FI. ,vlN4 _p fioam Leng[h 2,-4 Widih Heipht ? fl. ('nASTf BE,hRopn Length "/,O -WiA1h (i FleigM
YJindows and Doors-Crackage and Area Windows an d Doors- Cracka ge and Are a
No. W, dr?
ol qne HeiQht
of ene No. of
b hIS Lineel IL
of rack Area
ep. IL
NO' ?yldip
of ene Hmpht
ol ene Nn. of
h hts Lmeal /t.
of crack Area
9q. It.
1 ?? Z 2 a t G z 2? ??
1 ° a R g .2
2 b 1 1 O?
Coef Btu oel
C Btu
In/iItretion
31
1 3
Infiltration
2 ? 7
J Q
? J 4
Glass - 2q Giass !? C) S
Exp, wall ?4 a Exp. wall lO Y"
Nel exv. WBil 91 Net exp. wall r,: 9• 25$
-IfRC?4'df}- ocfr 1 l17 222 Int.wall
Ceiling ??-7C 12 2?p Ceiling 20&9 .2,S l
Floor . Floor - 19
Total BN. 7 5, Total Btu. p
J ?
Required sq, ft. E.D.R. or sq. ins. W.A. Leader area
FL Room Length Wid[h Meight Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. E, 'C"2•11tfl4om length I S Width I U Height
Ydindows and Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and Ar ea
No. il
of ene MwqM
al ana No. of
h ho Lmeal iL
of crack Arox
«
,
NO' W,Th
of ena
?f eoe
Hn"qM No, u1
b hts Leal I?.
olmcr ck Aiee
sa. ft.
:q`-'° .z 2 4 ? 1 5? %
y
Coet Btu Coe1 Btu
Inliltrstion
GIa55
41
S?
224()
U u
InfiltreNOn ? I
Glass
I?
3`"l?
`'n d
!.?S !U,
W
Exp. wall ?C j
Net exp. we11 sb
A19 Exp. wall -A,
Net exp. wall
Int. wall Int. wntl .
Ceiling ? X-?
Floor
5 1
2.S
Cei1mQ
Floor
t5
0 ,?,`'
)
?
1 "15
CJ ,
UU
Total Bta S iotal Btu.
Reqwred sq. (t. E.D.R. or sq. in5. W.A. Leader area' Reqwred bq, ft E.D.R. or sq. in5. WA. Leader erea
Room LengthWidth Heiyht Room Length ' Width HeiBht'?
Windows and Doors-Crackage and Area Windows and Doors-Crackaqe and Area
No. W.e,p Nei ht
f o No. ol
l
M Lineal It.
k
f bea
sp
h
NO' p?.mi1
ul ane H o"I
u1 oene Nn. ol
h hts l?nanl q.
of crack 4rea
80• ??•
of ane ane
o i
s crac
o •
• ?
?
Coel Btu Coel Btu
Intiltratio? Intiltratron
Glass Glass
Exp. wall Exp. wnll
Net exp. wall Net eKp• wall
Int. wall Int. wnll
Ceifng 12.k.1
Floor
,Z,
2 ? Q
Ceilmg
-
-'Floor
Total B[u. Total Btu. _
RBqutteJ Sq. k. E.D.R. or sq. ?ns. W.A. LeadF.r area t O RoquvgJ Sq. IL E.D.R. or sq. ins. W.P.. Leader area
?- -' -
:, .
HEAT LOSS CAICULATIONS
,. ?
.
H EATING 8 AIR
sedfaq?4
C011BDITIONING CO.
MINNEAPOLIS, MINN.
Weatherstrips A.S.H.V.E. Construction No. Insulation
VTindows Doors Gwde
Reference Out. Wall Int. Wall CBiling Rool Floor Ki? How Applied
Yes-No Yes-No 19_
gFl. 'Q Roan Langth ?Q Width Height FI. Room Length Width HeiBht
Windows and Doas-Crackage and Area Windows an d Doors- Crecka ge and Are a
No. WiA,h
al anu Helpnt
ot ene No, ol
1? hts ?ineal Ip
of crack Area
eV. ft.
No' W.A,n
DI ena Hoiphl
ol ena Nn. ol
Ii hte Lmeal /L
ol creck Area
nq. 11.
2 2 24 II?
Coet B W Coe! B w
Infiltration 7(y0 In(iltration
Glese Glass
Exp. wall Ezp. well
Net exp. well 2 Q Net exp. well
Int. wall Int. wall
Ceiling Ceiling
Floor ' 10 Floor
Total Btu. ? Total Btu.
Required Sq. ft. E.D.R. or Sq. ins. W.A. Leader area Required sa, it. E.D.H. or 5q. ins. W.A. Leadar erea
FI. ?M. Roon+ Length -)„ Width Height FI. ? Roan Length Width Heiyht
Windows and Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and Ar ea
No. W?tl?h
OI 3ne Meiqht
01 ane No. ol
li h(e L?nOel it.
al crack Aiaa
NO' WiNh
ol onB M1.;q?1
?1 Tnn No. ut
li ht3 Lineal It.
0f vBCk Alee
s0, ft.
r C,
?- *
Coef Btu Coe1 Btu
Infiltretion ? 11 7 2223 lnfeltreUOn
Glass a QQ(3 Glass
Exp, well Exp. wall
Net ezp. II 292 4.1 ( 1 Net exp. wall
U 2 InS. WAII ?
Ceiling Ceilinp
Floor 2-JC I I 42 . ? { Floa
Total Btu. Total 8tu.
R9quired sq. ft. E.D.R. or sq. ins. W.A, Leader area Required sq. it. E.D.R. or sq. ins. W.A. Leader area
FI. Length' 13 Width Height FL Hoom Length Width Height
Windaws a nd Doors-Crackage and Area W indows a nd Doors -Crack age and Ar ea
No. jW' sn o 8 xne No.ht l ft.
ol?c
k No. u1W? s?i?e u 1?:?»nn Ni?hls o?i?cr ack aieIt.
o
e a e
I
Coel Btu Coet Btu
Inh Itrahon Inh ItrALOn
Glass Glass
Exp. wall Evp. wnll
Net exp. wall 7 7Ct S6 9A ?y?? Net exp. wall
InL. WeII InI. WAII
Ceilmg 68, 4ng
_'.
Floar ]?..? 4? l 7 5 ? Fincx
Total Btu. Total Btu. _
RequireJ sq. ft. E.D.R. or sy. ins. W.A. Leader area RuquireA sq. 1t. E.D.P., or sq. ins. W.A. Leadef area
?
- CITY
SINGLE FAMILY DWELLINGS
INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATSS OF SQRQEY, 1 SST OF ENERGY C9LCOLATIOHS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNEH MQST DESIGHATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCfi BQILDING PERMIT IS ISSIIED.
MOLTIPLE DiiELLINGS - RFSIDENTI9L RE9TAL OAITS FOR S9LE 0?YIiS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF S[IRVEY - CHECB iiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CO.MERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
1 SET OF SPECIFICATIONS AND 7
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Rfe
& STRUCTURAL PLANS,
SET OF
J(aCUl°'
Valuation: .
Site Address l`J??? lleh'15ort UriVF
Lot LR Blnock
Parcel/Sub
Owner G"aV? ?;p?')')('r(r
Address SOh vY;?Q
City/Zip Code liLt ?l}1 rr ?? ? a
Phone (p qj ? ? ? ?-J
Contractor ?r'renlaCo
Address ? -5 Q
C?
1
City/Zip Code burnsvi)l-ehv 55?3)
Phone 990' ?3 6 9
Arch./Engr.
Address
City/Zip Code
On Site Sewage_
MWCC System _
On Site Well _
City Water _
6PPROVALS
Date: 7-11`0 7
Oecupancy
Zoning
Type of Const
(Aetual)
(Allowable)
4! of Stories
Length
Depth
S.F. Total
Footprint S.F.
FEFS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off 9 f1
APC
Variance
Permit 30 ,7 D
Surcharge /, UO
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL ? 7 b
Phone 11
CITY OF EAGAN N?: 1416 7
-?' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 7
7
BUILDING PERMIT Receipt # 7
0
Tobeusedfor FIREPLACE Est.Value $1,600 Date SEPTEMBER 14 1 9$7
Site Address 1583B CLEMSON DR OFFICE USE ONLY
Lot 48 Block Z Sec/Sub. THOMAS LK HTS 2N On Site Sewage _ Occupancy
MWCC System _ Zoning
ParcelNa OnSitewell _ Typeolconst
Ciry Water _ (ACtuap
a Name GARY SPENCER (Allowable)
w
z
Address SAME # ot Stories
°
City phone 681-0519 Length
Depth
S.F. Total
,p Name HEAT-N-GLO FIREPLACES FootprintS.F.
oQ Address 3850 W HWY 13 ppppOVALS FEES I
? CitY B'VILLE Phone $90-8367 qssessments _ permit ?30.70
Water/Sewer _ Suroharge 1.00
W W Neme Police _ Plan Review
? z
x -
?
Address Fire - SAQ City
o
aW
City phOnC Engc
Planner - SAC,MWCC
_ WaterConn.
Council _ Water Meter
I hereby acknowledge that I have read this application and state BIdg.Off. _ Road Unit
thattheinformationiscortactandagreetocomplywithallapplicable APC - TreatmentPl I
State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks
Copies
I Signature of Permittee iOTqL $31 _ 70
A Building Permit is issued to: HEAT-N-GLO FIREPLACES on the express condition that
all work shall be done in accordance with all app?' aState of M inn ota $t tute and City of Eagan Ordinances.
8uilding Official
_2
?.
1I CITY OF EAGAN
3830 Pilot Knob Road
? Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMITTYPE: suzLoiNG
Permit Number: 021903
Date Issued: 09 J09/93
SITE ADDRESS:
P.I.N.: 10-75951-460-02
1581 CLEMSON pR
LOT: 46 BLOGK: 2
THOMA3 LAKE HEI6HT8 2ND
DESCRIPTION:
Bwilding,,Permit Type DECK
6uild3ng Work Type ADDITION
,-?uilding Length 10
i Building Width?-,? 10
,
%
?• i/
\ r
0c)a]J
REMARKS:
FEE SUMMARY:
Base Fee $25.00
5urcharge $.50
Total Fee $25.50
CONTRACTOR:
BT1k-7rR' _ Applican
1581 CLEM30N OR
EAGAN MN
(612)681-0605
55122
I hereby acknowledge thaC I have read tfiis appl3cation and state that the
information is correct and agree tq comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
?
?
APPLICAN /PER? II EE SIGNATURE
tQtlll oill l
ISSUED B : SI NATUR
REACTIYATE _ CIIY OF EAGAN
PERMIT # ' (9?SL'1993 BUILDING PERMIT APPLICATION
'? 1467%9 681-4675 ?-?
n rr rrrJu uh. 9?7
w
SINGLE & MULTI-FAMILY 2 sets of plans, 3'registered site surveys, 1 copy of energy
calcs. ,
COMMERCIAL 2 sets of architectural 6 structural plans, 1 set of
specifications; 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month•
lot change 1s requested once permit
3
d
)
or
in which request is made, 2) address is change
is issued.
Date _r? / aO /-? Valuation of work
Site Address: lJ v b2'
LTREET C? &A7 ? 57? A1ITE 0
Tenant Name: (commercla7 only)
1AT BIACK LA?' EI
G
SUBD'i"?{D{l45
.
P.I.D. k
P
q
aND tI?ITIDIU
Descri tion of work: 9k'flW 1&3 OF IDXID6- Tb roxao DEC
The applicant is: Owner ? Contractor ? Other (Osecrl6e)
7"Z ??- Nr Phone 4/a ?? 069-
Name
Property LAST FIRSf
Owner Address ?6,e? 5cy?) J?2
SiREET CiE Y
City ?-??*j State /1-1 !j Zip
Company ? ca ? -e- Phone
C017tf8CtOf Address License l Exp.
City State ZiP
Company Phone
AfChltECt/
Registration I
Engineer Name
Address
City State ZjP
Sewer fl water licensed plumber . Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
of Hinnesota Statutes and City of
t
l
St
e
a
e
correct and agree to comply with 1 applicab
.
Eagan Ordinances.
?
?
??
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Nisc.
WORK TYPE
O 31 New
P32 Addition
? 06 Duplex
? 07 4-Plex
? 08 B-Plex
O 09 12-Plex
? 10 Multi. Add'l.
? 33 Alterations
O 34 Repair
? 11 Apt./Lodging
? 12 Multi. Misc.
O 13 Garage/Accessory
O 14 Fireplace
?15 Deck
p 35 Tenant Finish
? 36 Move
O 16 Basement Finish
D 17 Swim Pool
? 18 Comn./Ind.
E3 19 Coron./Ind. Misc.
O 20 Public Facility
0 21 Miscellaneous
O 37 Demolish
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. NWCC 5ystem
(Allowable) lst fl. sq. ft. City Water
UBC Occupancy ? 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total, Booster Pump
/ of Stories Footprint Sq. ft. Fire Sprinkler
Length /o On-site we11 Census Code ?
Depth /0 On-site sewage SAC Code
?
APPROVALS
c5
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site
O Wallboard
Footin9
Final
O Framing
? Draintile
? Insulation
? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAL
Water Lonn.
Mater Meter
Acct. Oeposit
S/W Permit
S/N Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
ZS.00 I valuation: $
.sv
SAC %
SAC Units
cu I -de-sac
PERMIT
-? CIRY-OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SEPARATE PERMITS ARE REQUIRED FOR ANY FLUMBLNG OR ELECTRICAL WORK
C, 0 19'§ 6
BUILDTNG
024533
09/16/94
SITE ADDRESS:
1581 CLEMSON OR
LOT: 46 BLOCK: 2
THOMAS LAKE HEIGHTS 2ND
P.I.N.: 10-75951-460-02
DESCRIPTION:
Building'Permit 7ype
6uilding Wdrk Type
/ ?.
'- t
.
`-
r
? /
- `
Base Fee $35.80
Surcharge $.50
Total Fee $35.50
^?
"
REMARKS:
FEE SUMMARY:
CONTRACTOR:
?
PERMIT TYPE:
Permit Number:
Datelssued:
BASEMENT FINISH
AITERATION
OWNER: - Applicant -
BAR7Z DAVID
1581 CLEMSON DR
EAGAN MN 55122
(612)681-0605
I hereby acknowledge that I have read this application and state that the
infiormation 3.s carreot and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
?I-) -
? APPLICANT/PE IT SIG URE
,J?»
f
ISSUED B SIG ATUR
I
14633
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
4._r _,-150
rt, Ja,A I -
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date / Valuation of work
Site Address: ?5$l &=AA``sc)/j bp-
STREET SUITE #
Tenant Name: (commercial only)
LOT LT BLOCK ? SUBD._j P.I.D. #
Descri tion of work: r/NI 81466M "(-
The applicant is: Owner ? Contractor ? Other (Describe)
Name &em b.4VlD t o.?iA Phone &9'1-0605:_
Property LAST FIRST
Owner pddress 1581 aEM'?OIJ 62,
STREET STE #
City QIG 4?j State mkJ Zip 'S?D a2;t
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply wi all ap licable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
? 02 SF Dwg. ? 07 4-Plex 0 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
? 31 New 0 33 Alterations ? 35 Tenant Finlsh
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Site O Footing
? Wallboard ArFinal
0 Framing
? Draintile
y>y
oi
i
-?
A Insulation
? Fireplace
Permit Fee vei,wt;,,,:
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Oeposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
5AC Units
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
O 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
3AC Code
Census Bldg
Census Unit
Assessments
11014
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST SS MADE.
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 SUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
uN 26 REGo
J
To Be Used For: ??Cr Valuat ion: Ii_.C_h? Date: 6?? D
Site Address 16?9/ 75 ['LCM Sb?J T)? OFFICE USE ONLY
Lot '-15 Block ? FEES
Occupancy
Parcel/SubI HaMAs`'4K'E NLIGM ZNp kD Zoning
Actual Const
Bldg. Permit
Allowable Surcharge ,.?
??
Owner /faT/AC D(f-7. L?r.? y.E # of stories P1an Review
Length fUX/a SAC, City
?7
Address LLEMSvn/ Dh) Ufr- Depth SAC, MWCC
S.F. Total Water Conn
City/Zip Code ?'A?AJ?r Mir'+' ar?lL2 Footprint S.F. Water Meter
Phone
On site sewage_ Acct. Deposit
S/W Permit
C W On site well S/W Surcharge
Contractor MWCC System _ Treatment Pl.
City water _ Road Unit
Address PRV Park Ded.
Booster Pump _ Copies
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone Planner TOTAL ?{L
Council
Arch./Engr. Bldg. Off.
Variance
Address
City/2ip Code
Phone #
CITY OF EAGAN NO ?$OS9
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121_
PHONE:454-8100 ??
f?
BUILDING PERMIT Receipt # ?
L
Tobeusedtor DECK Est Value $1,000 Date JULY 2 ,?g90
Site Address 1581-B CLEMSON DR
Lot 45 Block Z SeGSub. THOMAS LAKE HTS OFFICE USE ONLV
Parcel No. zND Occupancy _ FEES
2oning _
a Name RONALD G WINGE (Aclual) Const Bld
Permit 25- nn
w
3 Address 1581-B CLEMSON DR (qiiowabie) -
g
5
0
° Cdy EAGAN PhOne 726-2641 N oI Stones Surcharge .
i
, Pl
R
Length an
ew
ev
10
o Name SAME DeOth 10, SAG Ci
i
$F
Address
S F. Total ty
-
Clfy PhOf1B
S F. Footprinis SAC, MCWCC
-
? On Sne Sewage _ Water Conn
ww Name onsneweii
iz - WaterMeter
?? AddrBSS MWCCSystem _
i
aw
City PhOf1E
CityWater Acct Deposit
_
PFV Requirad - S/W Permit
I hereby acknowlege thal I have read this application and s1a1e that the Booster Pump
inlormauon is correct and agree to comply wnh all applicable Slate ot - SM/ Surcharge
Mlnnesota StaNtes and Ci Eaga dinanc85
? TreatmeN PI
Signature ol Permitee / G iGr.ez
e APPROVALS Road Unit
A euiiding Permit is issued to: RONALD G WINGE Pla""a' - Park Detl
on the express condnion that all work shall be done in accordance wrth all Caunal
applicable State of Minneso
taS
ta
tutes and City
o/l Eagan Ordmances. Bldg On. Copies
_
-
p
?
???.L1
BuddingONiaal l
r
Variance
_ 7p7qL
25.50
6.
HORIZON HILLS HOME OWNERS ASSOCIATION
ARCHITECTURAL CONTROL APPROVAL
According to the attached copy of your Architectural Control
Application dated for the addition/
alteration ot
approval is granted pe ing the receipt of a City of Eagan
Building Permit.
Once you have obtained a City of EagkIlBuilding Permit, please
mail a copy of it, along with any applicable drawings as required
for the building permit, to:
Horizon Hills Home Owners Association
Attn: Architectural Control Committee
Post Office Box 21423
Eagan, Minnesota 55121
As stated on your original Application, no work may begin until
the Architectural Control Committee has been supplied a copy of
your City of Eagan Building Permit.
The approved com letion date of this addition/alterat.ion shall be
_TlJ nf. 30? 1?2 6 . If your project is not completed
by t- is date, please contact the Architectural Committee for an
extension request. Failure to obtain an extension by the
approved completion date could result in HHHOA completing the
addition/alteration project and assessing the costs to you.
? ?
Date: Approved by:???yP,C4!-f-,i?2----"
?
/1 p r? W i.?C?
?.?GA?? i`??? ti.+-! ? S 12- 2
White Copy -(HOmeown)r/Canary Copy - Horizon Hills File
_ .?
,
\5)`,? ?lp?
?
O N6B? 9 3? pO A
' ' _`
"•,.
? ,.
' •`q?ol
\ •
/3B?)
r
,,F," ?L'EMSl
O
a
X 000.0
(OODA)
?--
/
Denotes Iron Monument
Denotes Wood Stake
Denotes Existing Elevation ' Proposed Top of Foundation Elevation-
Denotes Proposed ElevaNon Proposed Garage Fbor Elevation- 938.0
Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation- 93415
I tmreby cerlify that tAis is a true and corred represerrtation of a suney of Me boundaries ot
Lots 45 46, 47, and 48, Block 2, THOMAS I.AI.'E HEIGHTS 2ND ADDITION,
Dakota County, Minnesota.
And of the location ot all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 23Ta day oi Aoril ? 19 86
Paul A. Johnson
Land Surveyor, Minn. Reg. No.10938
40
.? ..?.
MeCOMBS-KNUTSON ASSOCIATES, INC.
ce?mtrui pw(nt 6 We tuRr[raAt 0 sin run[u s??Eiq
?wwEUOtc w wr[wrrsoN,w,attmw 7430
CERTIFICATE OF SURVEY
fiOf
NEyy i-iORIZON HOMES
E
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F
IZEC. D.
5/2z/89
May 17, 1989
City of Eagan
P. O. Box 21-199
Eagan, M 55121
Attn: City Planner
Sis :
We live in a taanliaase. As you can see by the enclosed addresses
have an apartment address. 'Iliis mess is caused by the fact that
our address is 1581-B Clemson Drive. The front unit also has the
saine address, without the "B". 7his seens to he the only area
that uses the "B" in the address. We even have trouble getting a
salesnazi to visit us - they go next door and if they are horne they
send than next door. I understand it has sanething to do with having
to many house rnmibers in one block. Hvwever, other cacrtrnanities cope
with addresses without sticking this silly "B" on it to canplicate
matters. We also get alot of mail fran realtors trying tA sell us
a house, which is understandable because air address on all mailing
lists has us in an apartment.
Also, you can see we get mail for Cletison Circle. tidzat is our correct
address? This is getting ridiculous! 'lhink of what the mailman is
going through. The people next door get our mail quite frequently.
We have lived in our house almost three years and in the next St Paul
phone book our address should be in correctly. I had to insist that
I wanted this silly "B" after my house rnmiber. The phone company didn't
want to add it and told me to talk to saneone abrnit changing my address.
I told then this wasn't possible and had.to talk to the Manager to
get it changed. So until it is changed we live next door!
Please respond.
Sincerely, _
-U)
??? ...?.
Mrs. Ron Winge C ?-? ? N• GEE?
1581-8 Clenson Drive
Eagan, MN 55122
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922158 1CB/179 15 FEH90
2WNG1 11581 CH490 GLF
RONALD G WINGE SL
1581 CLEMSOk DR
APT 8
SAINT PAUL MN 55122
4
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DEAN WITTfR nEY.VOLD5INC.
Normandale Lake Office Park, Suite 1150
8300 Norman Genter Drive, Bloomington, MN 55437
** CP.-F.T 5ORT-*****'rCR33
t'.P,. PONALD G NINGE
1581 CLEMSON DR
APT Li
SAI!7T Fl!UL HN 55122
A SPECIAL INVITATION
IS ENCLOSED
Discover°CaM Acceptance Form
YES! Fqe. sand me On, I
pre.aDDf;?ea Diu%'er Cara' I I cenity thal I am age 18 or altler an0 fhat the intorma7ion ?
SECOND OFFER! hm radtne importammrorma.
p?aea rs accurate. i
(qnpnMeEack laprretotlrose
PfE•3PProV8dCfCd'R:? $2,5130 hrms
terms
and to M
e
urrt tn
acroca
e 2? ?
) ? )
e
in
anac
e
so
?i
h'r Oes MO4E PnOxE BUSiNESS RqNE
Discover Cardmem6er Agreemem 3 ?
RCSpOtldby: ? 06/02/89 whmnluntlerstanemayoe fMPIAVfN xrrk I
ammded m tAe less I
No 11 returnrtryuM(s)wtNn ays < i
wo+? s?cuwrv xuMe[x
,
?, ol f¢ceiD[.
SX
uvuC?x ss?utuu ?
61PIW111 i1R5fNGYF MOOL M1uL US WWC I
RONALD G WINGE .qmrnccourrr-Como+e6m 5ae0 youxwbft apM
xcumandasecmaascwv?rraxd semces rardiswed.
1591 CLENSON DR APT B
SAINT PAUL. MN 55122 '
6q
J?a"
BOX 68
BIRCHWOOD
WISCONSIN 54817
RONAL7 G W??G=
APT 3
158:+ CLtMSDN Dn
aA:Ni PAUL CN 55122
U.S. Postage
PAID
Birchwood. WI
Permit No 2
1
.+;+}t
?i
?, - .,..,;',:"
: . . ? . , .i ?? .. .
? FREE GI FTS
LOOK INSIDE 800K FOR
YOUR ADDRESS ON CAUPON
BORDERS.
.,..
CAR-RS SOP.T .,r.Ck 2233 i
1581 DCLEMSON CIR ApT 8
ST PAUL MN 55122 I
CAR-RT-SORT
BULK RATE
U.S. Postage
PA10
Minneapolis, MN
Permit No. 10
**CR 2233
RESIDENT
1581 CLEMSON CIR APT 8
ST PAUL MN 55122
SnLD \
.
McMaid°
3989 Highway 13
Eagan Minnesota 55122
CAR-RT SORT **CA33
RONALD G WIDiCg
OR CIIRRENT RESIDBNT
1581 CyEMgON DR APT g
i:EAGAN MN 55122
FREE PLAY OR PLAYS FOR
4 k
CONTENiS E7-MILLION "INSTANT" GASH
MMI MAILING SECTOFl INSTFUCTIONS
? 51? AAA RATING ? G(IMPUTER GENERATEO
? SCCE
R'-
, OilWagonlH90s 1
? 1Qliry,p
4rtNr Rwb
?
_ 1.
J EILEEN HINGE
HEQPIENPS WWE
1581 CLEMSON OR ;:B
AODAESS-UNE1
pK FOR RELEASE ON VE cin
IFIGATION OF ADDRESSEE
n_.`_ASE AUTHOAITY
(?i?1BC.?
I ,Idmf
Cherg n.K. nrc
I I I ? we need to cell about,
Acwunlt x I I? E:p. Date
. --`.. _ ??
coill v $OFFICIAL ENTRY FORM
- Y S Fnter my name in the
? 06?09i89 CaroF?
nght 5200,000 Sweep-
? , s!akes And send me the great
? i Carci Wright iiems 65ted above I
, EAR?_Y 81Fl^ i unde:stand mv iame will be en-
? BCNUS BUCY.S i tereo n TWO annual drawings
? DEADLINE i wnh a Grand Pnze of $100,000
? ' each'
L Win en extra $2i500_; NO. i do not wish to ordec Enter
Place Early BvE Bonus Buck n:y name in your Sweepstakes
Stamp Here and tell me if I have won.
OF 484
e`.
?
'i •
i?
? i
'"-
?? '-
?AI('?
you
Y048 02/592 1
t1R RONAI:D G WINGE
1581 CLEM80M pR B
EAGAN FiN 55122
print name and address below if Incorrect above: /
- Mrs - Mi55 -i MS
RON61Ld G W Ii IGE
15£1 GLEh1SC7N DR.
APT B
SAZPIT PNt}L MN 55122
Tired of Housework?
Let McMaid,p Do It!
? 4'v4'-l S
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH iJTTIT.
NEW CrJ*IS'd'P.UL'I'ION
ADD-ON AJC
ADD-ON FURNACE 0
FIREPLACE INSERT
DATE 7,l 4-44
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTL.ETS (MINIMUM 1 @ $3.00 EaCH)
ADD-ON/REMODEL (Exis'rING CoxsTRUCI'ION) $ 20.00
STATE SURCI-if1RGE .50
TOTAL ?L .
STI'E ADDRESS: /?1?ej (?'/??`i.r.?rr„ 114
OWNER NAME: lh,l /, l y TELEPHONE #:
INsTALLER: SEDGWICK
ADDRESS: 8910 WENTWORTH AVE. S0.
CTI'Y: - STATE: ZIP CODE:
TELEPHONE #:
? SIGNATURE OF PERMITTE -2'70?
1994 MECHA1vICAL PERMIT (RESIDENTIAL)
C1TY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 681-4675
*dtV oF eagan
THOMAS EGAN
Moyor
February 23, 1996
MR DAVID BERTZ
1581 CLEMSON DR
EAGAN MN 55122
RE: 1581 CLEMSON DR
LOT 46, BLOCK 2, THOMAS LAKE HEIGHTS 2ND 1
BUILDING PERMIT #24533
Dear Mr. Bertz:
PATRICIA AWADA
SHAWN HUNTER
SANDRA A. MASIN
THEODORE WACHTER
Councll Members
THOMAS HEDGES
Ciry Adminlsfrafor
E. J. VAN OVERBEKE
CNy Clefk
The above-referenced building permit is currently active and you may proceed with
construction on your site as long as the project has not been suspended or abandoned for
more than 180 days. In court interpretations, one nail driven every 179 days constitutes
an active permit.
Should you need additional information, please do not hesitate to contact me at 681-4699.
Sincerely,
`6a16 ?J??'L?'?i'-''7
Dale Schoeppner ?
Senior Inspector
DSfjs
MUNICIPAL CENTER
3830 PILOT KNOB ROAD
EAGAN. MINNESOTA 55122-1897
PHONE: (612) 681-4600
FAX: (612) 681-4612
iDD: (612) 454-8535
THE LONE OAKTREE
THE SYM80L OF STRENGTH AND GROWTH IN OUR COMMUNITY
Equal Opportunity/Aftlrmative Actlon Employer
MAINTENANCE FACILIiV
3501 COACHMAN POINT
EAGAN. MINNESOTA 55I22
PHONE: (612) 681-4300
PAX:(612) 681-4360
iDD: (612) 454-8535
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIltED FOR EACH UNTI'.
NO. FIXTURES EACH TOTAL
I SHOWER
WATER CLOSET
BATH TUB
LAVATORY
1 KTfCHEN SINK
LAUNDRY TRAY
HOT TUB/SPA
WATER HEATER
FLOOR DRAIN
GAS PIPING OUTLET - minimum -
ROUGH OPENINGS
WATERSOFTENER
PRNATE DISP. • neway. uc.
U. ?? • e.u ?aa const.
??T . ATiONS • w aua i Q ?
?VVATER TURN AROUND
STATE SURCHARGE
TOTAL:
SITE ADDRESS: I'Jr$ I &.b-wo/N D12.
OWNER
t
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
1.50
5.00
20.00
3.00
20.00
20.00
a?-
.50
INSTALLER: NV1 I-) 8iqi2TZ,
ADDRESS: I 5g'I (?L.ek&%J ?2.
CTTI': tZAC7 ? N STATE: ZIP CODE:
PHONE #: ( (?( a) ?o gI "U(00? ?
Anr??-h
SIGNATURE OF PERMI EE
1994 PLUMBING PERMiT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
CITY OF EAGAN _
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*70'A':': PAST7F:NP OF FFE AT TIME pg
APpr.icAMoN DOEs riox CONSrITcrTE
APPROVAL OE' PFPt-IIT. .
. »**?,?x*#*******x*****.,?:*:?****##*
P ease Print
? 1) PROPERTy ADDRESS:
LEGAL DESCRIPTION: _ -4(p
%.,c,cia-Locxiauoaivision or rax Parcel ID g) .,'
IF EXISTING S1RCY.Zi1RE, DATE OF ORIGINAL BLZLDING PERMIT ISSCANCE:
Mon Year
PRESIIJP ZONING/PROPOSID LSE: --
.-..
Q CCH4ERCTAL/11ESAII./OFFICE R-1 SIIJGLE FAMILY
Q I''`TRIAL 2 DL'PLEX (ZWo IInits) -
".• .' _ ?[ INS"TIT(PTIONAL/C ?s....
OV? . ,'. rR-3 7DWP1fiW5E (Y7zree + Units.) ( L?ni.ts)
. [? R-4 APARTNffTTP/CONIDOMINI[M ( Units)' •
2)
, - _ NAME: New Horizon Homes
ADDRFSS: 13805 ti 6 t h ?
_CITY, STATE, ZIP: Minneapolis MN 55440,
PHONE: 42U-3900 ' .
' 3) y ?E; Thompson Rlum.bing ?r C1ty L52 .
Plurrbers License:
` ApDRES$c 12201 Minnetonka Blvd.
ylp;
-- Qq'y, $TpTE minnetonka MN 55343
, . tdot recorded
-- PliONE: 933-2521 ?= LICENgg#1763 M
S n tial
4) ?aaau•:u ?.uiw•
NAME:
ADDRESS:
- CITY. STATE. ZIP:
PHONE:
.
Same as If2
'$) ? '? r' " i f a?• • ?• • 0 • 9? U"YYy? - - - --
. ?
' ?01NAffX.TION 2O CITY SEWIIt )1pWIaIDCTION TO CITY WATER ? OTfIER '-
6) E] PLEASE HOLD APPROVED PEE2MIT FY)R PICK-UP BY ONE OF ABOVE
M PTEASE MAIL APPROVID PERMIT 7U 1, 2, C'D. AHOVE
,.o 11 ' (ciscle one) 1, '
IIVSPDCPION OF SESM ANID/C2 M'!ER
rnSrar.r.Amr0N6 WILL NOT BE SCIED-
tIM rnvrII. PERMr2 xns sEEN
APPxwm. .
7) r. n u• 1 /?AV Z
FOR -CITY USE ONLY
PERMIT # ISSUED
3713 d44 '
Pd w/Bldg. Permit FEES:
$ S D SEWER PERMIT (INCLUDE SLRCHARGE )
$ $ WATER PERMIT (INCLIIDE SCTRCHARGE) .
$ ?" ?• S? $ WATER MRER/COPPERHORN/OL'TSIDE READER
$ ' $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP "
$ GZ ACCOUNT DEPOSIT - SEWER
$ 0 J' ACCOCNT DEPOSIT - WATER °-
$ 5 00 "DO $ wAC
$ SAC .
$ $ TRCNK WATER ASSESSMENT
$ - -' S TRUNK SEWER ASSESSMENT
$ ? $ • LATERAL BENEFIT/TRLNK SEWER
$ $ LATERAL BENEFIT/TR[)NK WATER
$ ?.? ?v ?fJ $ WATER TREATMENT PLANT SL'RCHARGE
$ ----- . . - $ - OTHER:
$ ??/-Y•.J? $ ?/. G ?7 TOTAL
' z7- Z
RECEIPT RECEZPT
DOES LTILITY CONNE CTION REQUIRE EXCAVATION IN PLTBLIC RIGHT OF WAY?
? YES IF YES, THEN A" PERMIT FOR WORK SVITHIN PUBLIC
Q ROADWAY" MDST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY: tid
?J7t
2
J ?
-p
-y
.e
?z
TITLE:
DATE:
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
___
*10'PF': PAYMFT7r OF FEE AT TIIM OF
ArPLIcATIoN noES Nom CONsxITUTE
APPROVAL OF PEEPMT.
uvspncriorr oF sDM ANro/ax MM
irZSTAT7.A'ITONS WIId, Nl7P HE SCHID-
UI,ID OMZL PERMLT HAS Bgld
APPROVID.
? xx,.xxx?:,.xx=x,.xxx,.=,.,.:xx?w:,.,.,.w,.
, P ease Print)
1) PROPERTY ADDRESS : IC? ?-o ^
LEGAL DESCRIpTION: •-
. Lot S ock Subaiison or Tax Parce ID )
g' EXISTING STRL'C=, DATE OF ORIGINAL BLTILDING PatT ISSM?NCE: '
? . .
_- ' (Mon Year --
- PRESENP ZONiNG/PROPOSID LSE: , -- -.....
? /OFFICE ' 0 R-1 SINGLE FAMILY . Q IfIDi.'STRIFII, 2 DL?PLEX (4Wo Onits)
_ ? -.. _ _. . .- . ,
n INSTIIL?TIONAL/CAVERI?IETTP rR-3 20hM0L?SE (Three + Units) ( Dm.ts)
Q R-4 APARTPgS1T/CONxMINItM ( Units)
2) ? . -. .
" NAM; New Horizon Homes
• ADDRFSS: 13805 86th ?
`- CITSC, STATE, 2IP: Minneapolis MN _ 55440 .
' y . PxfkE: 420-39U0 -
•. 3) • ?:7• - Fbr City Use ..
_ DIAME: Thompson Plumbing Pltmber5 LiCenSe:
ADDRFSS: 12201 Minnetonka Blvd. ActiVe '`.
? -- CITY. STATEP ZIP: Mfnnetonkfi MN 55343 ?. N?pt T?ecorded
- PHONE: 933-2521 FASTER LICENSE# 1763M
- - Sta 'f Initi3l
: 4) •--
IVAME: Same as lF2
-" ADDRFSS: ' .
CITY. SPATE, ZIP: '
_ PFiONE:
M
-5) ?'? ?• ? ? r• ?• : a • a? - y?
(Eb CONNECTION TO CITY SE4JER ? CONNDC,TION RO CITY WATER ? pTHM '. ..
?6? ? • • i- ? PLFASE HOLD APPROVID PEE2MT FDR PICK-C?P BY ONE OF ABOVE ---------
PLEASE MAI APPROVID PERMLT 'lt? 1. 2,(!.?4. ABbVE
., ..
(Circ? one)
? ??? r. ru• - i r,M -ri , 7 ?,!
7) .
. FOR :CITY USE ONLY ' PERMIT # ISSUED
7?1V 7
Pd w/Bldg. Permit FEES:
$
S //.' • 5 L
$ $ $ • $
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (I[VCLDDE SURCHARGE)
WATER METER/COPPERHORN/OC'TSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ d ZJ ACCOUNT DEPOSIT - SEWER
< n ACCOL?NT DEPOSIT - WATER -
$ 1J?J O • U--o $ WAC •
$ .`?7 7S ? ? $ SAC
$ ' $ TRL?NK WATER ASSESSMENT
$ - S TRL'NK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRCNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
S ?5 la•CI d $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ 'y 'S? $ J ?• d tP TOTAL
...2 3 3 ?Z172--
RECEIPT RECEIPT
DOES UTILITY CONNEC TION REQLIRE EXCA VATION IN PIIBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A" PERMIT FOR WORK 6VITHIN PUBLIC
ROADWAY" MDST BE ISSOED BY THE ENGINEERING
Q
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
<
TITLE:
DATE :
APPLICATION FOR PERMIT
CITY OF EAGAN
SEWER AND/OR WATER CONNECTION
_________xx-
*10'PF': PA`1MF3lP OF FM AT TIME Op'
p,rPLxcATIorr nM raar aoNSTrnrTE
APPR(3VAL OF PERMLT.
INW=orr oF sMM Arro/oR Fm,TER
INSTATZMONS WIIS. NOT BE 9CHED-
ULID [7NM PIIZMIT FIAS BEQd
APPRWID. ' .
* . ?
'?**?rr,r***************3***?r,??:****,r?
, P ease Print
1) PROPERTY ADDRESS: I151eJ?j
LEGAL DESCRIPTION: -4-7 Z 1W)W*> '•-
-CLot Block Su division or Tax Parce ID )
,.. . _. -
IE' EXISTING STRC'CiTJRE, DATE OF ORIGINAL B[7ILDING PERMTT ISSC'ANCE: " -
?
' Mon ear _
pRFSErlP ZONING/PROPOSID LSE: . ? CavERCIAL/RETAII,/OFE'ICE ? IPIDI'STRIAL
? INSTIMMONAI,/COVERNMENP
? R-1 SIIJGLE FANIILY •
W2 DL?PLEX (? Lnits)
it.
R-3 10WNhi0L?5E (Three + Units) ts)
L?.1
R-4 APARZPIENT/CObIDOMINILTI Units) 2) ? -
NAME: New Horizon Homes
ADDRESS: 13805 86th ,
CITY._STATE, 2IP: Minneapolis MN 554_40
~ PHONE: 420-3900
3) • u i: ?•
NAME= Thomnson Plumbing
ADDRESS: 12201 Minnetonka Blvd.
CITYr S1'ATE, 2IY: Minnetonka MN 5?343
PK0NE: 9 3 3- 2 5 21 MASTER LICEDISE# 1763M
4} .oaaa•:.? ?,.w?:
NAME: SameO'as /l2
ADDRESS: '
CITY. STATE. ZIP:
PHONE:
.
Plwbers License:
Active
FScpired
biot z'ecorded
St 7nittal
-5) i .? at a• • ?• : ? • a? - a?
?ErMNNECTION T6 CITY SEWER r-%V CONNDCiZON SO CITY WATII2 OTq-M '. .,
6) " ?• • r [? PI.EASE HOLD APPROVED PEEtNIIT F'OR PICK-CTp BY ONE: OF 11BDVE _.-- •--. .--
?LEASE MAIL APPROVID PERMIT 10 1, 2,4. AHOVE
.! (Circ one)
7) !' I• •• _ ' ? ??? ???/lP N/? 1? 101_YY+f:? L:?
!i-Yl n •
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PERMIT # ISSUED
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Pd w/Bldg. Permit FEES:
$ $ ?G •,`>??' SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT"" (INCLUDE SURCHARGE) .
"
$
?p 3 S?Q
$ ?
WATER R/COPPERHORN/OL'TSIDE READER
$ ' $ WATER TAP (I C LLN DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOLNT DEPOSIT - WATER
S 560•CJC7 $ WAC
$ 0-fl $ SAC .
$ $ TRUNK WATER ASSESSMENT
$ TR[!NK SEWER ASSESSMENT
$ y $ - LATERAL BENEFIT/TRLNK SEWER
$ ' $ LATERAL BENEFIT/TRUNK WATER
WATER TREATMENT PLANT SURCHARGE
$ OPHER:
$ i v?- ? y • .S fi $ ;S?i U' "l? ` TOTAL
. . 73 .. . ,. Z.172__ , . .
RECEIPT RECEIPT
DOES UTILITYCO NNECTION REQUIRE EXCAVATION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A" PERMIT FOR WORK WITHIN PDBLIC
ROADWAY" MUST SE ISSUED BY THE ENGINEERING
Q
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CbNDITIONS:
z
APPROVED BY:
TITLE:
DATE :
;
CITY OF EAGAN
. . .. . ,. ... °:,? .
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
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'DOES,LTILITY CONNECTION REQOIRE EXCAVATION IN PLBLIC RIGHT OF WAY?
.:.-., _. . _
Q-YES IF YES, THEN A"PERMIT FOR WORK WITHIN PIIBLIC
ROADWAY"
MUST BE ISSLTED BY THE tNGINEERING
NO ,
;
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? Dl C, I 2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3530 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reauiremenis Remodel62eoair Reauirements Offlce Use OnN
3 2gistered sile surveys showing sq, fl. of lot, sq. ft ot house; and all roofed areas 2 wpies of plan CeA of SuNey Recd _ Y_ N
(20°h maximum lot coverage ailowed) 1 sef of Enertgy Calculations for heated additions Tree Pres Plan Recd _ Y_ N.
2 copies ot plan showing beam & window s¢es; poured found design, etc. 7 site survey for additbns 8 decks Tree P2s Required _Y _ N
t set of Energy Cakulafwns Addfion - mdicate 'rf an-sde sep6c sysfem On-site Septic System _Y _ N
3 copies o( Tree P2servaUon Plan if lot platted a8er 711193
R'on Joist DeUD Options selection sheet (buldings with 3 or less untts)
rA
Date L-
tion Cos - 3?
SiteAddre - -/'S/ ` .3 ? UniUSte #
1
Description of Work tllNy( Si?l? S?fa ?? ia ' W)n/OQra 12 / O
Multi-Family Bldg ?` Y_ N
i? Fireplace(s) _ 0 _ 1 _ 2
O `
n
? frAv?h-
Telephone # W7 -o$ 7 / ?S%'i?mrrnl
wner P
Property o
/
Contractor V1I<l N/q R'?/'/D/S -
Clty / 1utl-
Address
State,rl?,/?U? Zip .?5"v Telephone # (65-] ),)S? -I06 I
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category i Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
In the last 12 monihs, has ihe City of Eagan issued a permit for a similar plan based on a moster plan8
_ 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 wluch requires a review and
approval of plans. ?? ?
?? ?) ?? ?I "k?
Applicant's Printed Name
J°?51 1 ,
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
,
Date 2 1 ) 4 ! o5
Site Street Address ?`D E G ?-'rnso Yl Unit #
Property Owner \-1a- r 1 Telephone #(b51 j?A.5a'56H5
Contractor Tl Y 1' 1k-Lk-V7 0 r V-S Telephone #(bS O 365 - l3LI ll
Address 2Aolo U[.C.4d RI-I City Q Gc. StateLjLj_ Zip ?5s Ia3
The Applicant is: _ Owner ??Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes putting in a water softener and/or water
heater at the same time. If vou are installina onl a water softener and/or water
heater, do not complete this section. Move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
J Water Softener ?W ter '"
/ $ 15.00
replacement
_ new V
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the 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 approved. f?
??1S1? I en ApplicanYs Printed Name ApplicanYs Signature ? ' ``? •
4 g7D
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagan
3830 Pilot I{nob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCUon Reauiremenis
3 registered site surveys showing sq. ft of lot, sq. ft. o( house; and all roofed areas
(20% maximum lot coverage allowed)
1 Soils Report "rf proposed building is lo be placed on disturbed soil
2 copies of plan showing 6eam & window sizes; poured found de5ign, etc.
1 set of Energy Calculafions
3 copies of Tree P2servation Plan if lot pWtted aRer 711193
Rim Joist Detail Options selecGon sheet (buildings with 3 or less units)
Minnegasco mechanical ventilation fortn
C9.va
RemodeVReoair Reaui2meMs 0(fice Use OnN
2 copies of plan shaxing footings, beams, joisls Cert of Survey Reoi _ Y_ N
1 set of Energy Calculations for heated additions Soils Report,_ _Y _N
1 sitesurveyforadditions8decks TreePresPlanReed _Y _N,
Add'rtion-indicateHOo-sdesep6csystem T1eePresRequired _Y _N
On-siteSepticSystem _ Y _N
? / ?
Date q / ?? ?
Construction Cost ? /?a ?
?
SiteAddress I'lg h C LtMSL`U rb, UniUSte #
Description of Work I/ECGC 4nj j iGlkJ
Multi-Family Bldg ? Y _ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner HUR12ouV 4LI..S `SCG'T-1 ?AlLO() Telephone#(651) 22`-I`5v1E2
Contractor 1 HE DtCk ¢%coYC CGVHYAww
Address F'ck IZGW Kl\, I-_ L` _ City (;9GVE ?M6?
State m1? Zip 5 G 7 7 Telephone 9 ("1ri`2 ) t-132-231I EkT I5?
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
(q submission type) Submittetl Submitted
• Energy Envelope CalculaGons Submitted
In ihe last 12 months, has ihe 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 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.
M IhG
Applicant's Printed Name Applicant's Signature
DO NOT WRITE BELOW TI-IIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dweiling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex p 18 Deck ? 23 Porch (screen/gazebo/perola) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex ? 12 12-plex ? 25 Miscelianeous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demoiish Building' ? 43 Reroof ? 46 WindowslDoors
IFP 34 Replacement 'Demolition (Entire BIdg) - Give PCA handout to applieant
De5Cfiptl011: Water Damage _ Yes
Valuation DIDDI ° Occupancy R-3 MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const ? Width
REQUIR ED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
_ Footings (deck) FinaUC.O.
_ Footings (addition) FinaUNo C.O.
Foundation HVAC
Drain Tile Other
Roof _ Ice& Water _ Final _ Pool Ftgs Air/Gas Tesu Final
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ A'u Test _ Final Windows
_ Insulation _
_ Retaining Wall
Approved By Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Piant
License Search
Copies
Other
Total
. . ?
N N
?i0 A
N '?-
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a
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m
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(93Z5)
3a.0)
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3S?s F
ry? 3A'(09
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? /ry
0. ? ,' ?`\o d
9 3 q
N-`
C \ `? 1
O? >p \ ? ?' ' ,29?
hl e• \ ?? ?,Q ,..? \\
o ?.
1?04?? P N, A``
Op D •3 `
o N6a:?, . ?? F
o\ r o
?
? o° 51
a? lq?b.
ti
• ?,
QO
. ,
0? ?
lQ?b. `3
?C?'1CCG lrJ??
l5?
i
i
? C2 EMS
F94? D?ivE
O Denotes Iron Monument
0 Denotes Wood Stake
X000.0 Denotes Existing Elevation
(OOO.D) Denotes Proposed Elevation
E Denotes Direction of Surface Drainage
/28
r
?
' Proposed Top of Foundation EYevation=
Proposed Garage Floor Elevatiort= 938.0
Proposed Lowest Floor Elevation= 938.5
i hereby certiy that ttiis is a true and correct represernation of a survey of the boundaries ot
Lots 45, 46, 47, an 48 Block 2, THOMAS LAKE HEIGHTS 2ND ADDITION,
Dakota County, Minnesota.
And of the location of all buildings, if any, thereon, and all visiDle encroachments, if any, tsom 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 23rd day of April , 19 86 ,
(;; '-?2
Paul A. Johnson
Land Surveyor, Minn. Reg. No.10938
?? 4D- CERTIFICATE OF SURVEY
wgw ? •?E for
McCOMBS-KNUTSON ASSOCIATES, INC, ?w ?¢M' ??
COMSU[IYIG EMGIMfIl13 0 WO SYeYFYGIIi / SIT[ I{AMNFRS fILEM4 V1 ?1
- wxnF??OLKwMVICMixSpN,M1IWFSQTw ?A?O
T
Use BLUE or BLACK Ink
Use
F
of Ea an I Permit
I
.4 't
Cl Y E
3830 Pilot Knob Road Permit Fee:
Eagan MN 55122
I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff:
- - - - - - - - - - - - - - - - J
2010 MECHANICAL) PERMIT AP ICATIION
Date i~ n Site Address: / Y h 0 l l
Tenant: Cl n~s Y V-\ Suite
RESIDENT / OWNER Name. & \J ' A) 62 E /u C Phone:ln / 11P
Address /City /Zip: C le
Name t C )'1'L l V nse
CONTRACTOR
Address: e pt 7- i) = ity: Arun k-er-, '
State: ~ Zip:. Phone: 7 4 0
~ dZg/ ~maiC i
ContaC1)f)' 6Y__
TYPE OF WORK New 2L--Replacement Additional Alteration Demolition
Description of work: ~`Li~ Y%'~ cA
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
PERMIT TYPE Furnace New Construction _ Interior Improvement
Air Conditioner - Install Piping _ Processed
Air Exchanger Gas Exterior HVAC Unit
_ Heat Pump _ Under / Above ground Tank Install / _ Remove)
" When installingfremoving tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50.50 Minimum (includes State Surcharge)
Permit Fee'
- If Permit Fee is less than $1,000, surcharge is $.5p.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.-gopherstateonecall.org
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
Eaga , at I understand this ' not a permit, but only an application for a permit, and work is start without a permit; th t the work will be in accordance
with t e a proved plan in t e se of work which requires a review and approval of Mans.
X c e e Yr YV, V X
Applicant i d Name Applican s a re
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground _ Rough In -Air Test -Gas Service Test --In-floor Heat -Final
Exterior HVAC Screening Inspection
x~G
j~~~' ~
Use BLUE or BLACK Ink
R#~.` 1R. i.w • i---- se-----------
Kam=
y City of Eakan Permit#: 11
3830 Pilot Knob Road I Permit Fee: ~(~tJ. 00
Eagan MN 55122 I I
Date Received: 2
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
2011 RESIDENTIAL PLUMBIN PERMIT APPLICATION
Date: Site Ad Pss: ,
Tenant: D D-41 -o- Suite
RESIDENT I OWNER Name:J4.,f ) I~a(A - Phone:
y,
Address / City / Zip:
CONTRACTOR Name:.MILBERT COMPANY wcdba CULUGAN WATER
Address: 1801 50THST EAST City MVER GROVE HGTS
State: MN Zip: 55.077 Phone: 65.1 ;45.1.-2241
Contact: BILL..MILBERT:t . Email:
TYPE OF WORK _ New replacement _Repair -Rebuild _ Modify Space - Work in.R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Pwater Softener
Lawn Irrigation RPZ PVB) Add Plumbing Fixtures C_ Main / _ Lower Level)
Septic System Water Turnaround
-New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tumamund* (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 if a 518" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities.- www.aooherstateonecall.oro
I hereby acknowledge that this information is complete and accurate; that the work will be In conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved playa in the case of work which requires a review and app I of pla
x 4
Apple ants Printed Name /Yf ! Appliant's Signature
I
r :M M p wr, r Reviewed By ~s,~« tye~atDate
[Requ OR OFFICE'USE'"
r,eykyr'~l,Yny;d,~ ~L X3>>,ti ~V~t`4~de ~~"h _'~it "q ~3. t11c .y6e< a iY M'>r^r3c
( red„Inspections, „sue-r,Uncir C roundx a_y'Rougf•,
. In AiTest,~~ ~(as Terr'r~F na'k
Use BLUE or BLACK Ink
fi For Office Use
'1 j permit 0 I
r I 1
I
3830 Pilot Knob Road Permit Fee: O 0
Eagan MN 55122
Date Received:
Phone: (651) 6T5-5675 i I
Fax: (651) 675-5694 I
I Staff: Y I
!
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: ZL~ 15 ) gag(~~ 8 i'~~j
e,
Name: ~Clt3/~ i t! /71_x+ Phone: •2L-
S tGe_-
Resider~tl
Owner Addrs ! City / Zip:
Applicant is: Owner Contractor
P@ o'f Work Description of work: -Rena
Ty
Construction Cost:--+ Q6, 88 4 Multi-Family Building (Yes No
Company: -_~T~UG yd~
- Contact: ~~,g~-_----
_3 D
Contraetor Address: O I t ch"a ----city: 1 [Ln c~~ ,S~c
State: 2AL- Zip: J~a ~ Phone:
License - I y L 0 io 2- - Lead certificate AZ41- 2 ~9
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: - T
- Phone:
Mechanical Contractor:
Phone: _
Sewer & Water Contractor:
Phone;
NOTE. Pla is and supporting -documents that you submit are considered to be public information. Por0ons of,
the Worrr)#thon maybe classh7ed as non-public if you provide specific reasons that would
conclude that the are trade secrets. ps~nrrit,tl;te Glty to
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cal 48 hours
before you intend Co dig to receive locates of underground utilities. www.oooherstateonecall ono
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 authorbvd by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance,
Applicant's Printed Name tT Appllca s Si n
g
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use
'dj. Permit#:
City of Ratan Pem-lit Fee: I 147'
3830 Pilot Knob Road -
Eagan MN 55122 Date Received:
Phone:(651)675-5675 JUL 1 4. 7 Staff:
Fax:(651)675-5694 L
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7//3/1/7 Site Address: / d t t $c1 441, Unit#:
Name: 144,2074 (7"S'_ _ /ffZ' v lit aPe• Phone:
Resident/
owner r Address I City I Zip:
Applicant is: Owner A. Contractor
Description of work: r
cam. 14.,641," L to z�. r
Type,o#Work
Construction Cost: ,>UV Multi-Family Building:(Yes fie:' /No )
Company: Ayr 4i?. .TZ'/ . P"- Contact: L t4 r
Contractor,
Address: /(67/).- t o4Y.rt City: /y V? ger
State:Aih✓ Zip: 95-71)-V Phone:467-Ata ' f Email:b. r-10/I7' ,,
License#: ise 2z-9f 2L, Lead Certificate#: ivAtr F/t>,Oft/ /
If the project is exempt from lead certification, please explain why:
/;4 41e444 (97‘.
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 Suppressiont� (Contractor: ■� Phone:
the
N �y!�'rp.':�t/P�lrans fil ,.d�{y /i.
the,i rfotl�� `ice �+p , you W p(,� £3b Y 3 -Y. = of
deewat t,y�'.°�„id,
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.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 -te Building Code st be completed within 180
days of permit issuance.
y�
x ?Ater .. floyf x # /..i :-_ • L i
Applicant's Printed Name Ap'icant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE (`f f,q 7
` SUB TYPES
_ Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi 20 Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
_ 01 of__Plex Lower Level _ Pool __ Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation 3, oc4)• — Occupancy ►2C- 3 MCES System
Plan Review Code Edition M/1 20r SAC Units
(25%_ 100% )4) Zoning X17 City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V 17 Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) xD 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: 'TO 'Vt yyi.l I7 , Building Inspector
RESIDENTIAL FEES ,
Base Fee & /. iS9 • fes•
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA158852
Date Issued:11/05/2019
Permit Category:ePermit
Site Address: 1581 Clemson Dr
Lot:46 Block: 02 Addition: Thomas Lake Heights 2nd
PID:10-75951-02-460
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kristina A Frazier
1581 Clemson Dr
Eagan MN 55122
(651) 687-1346
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature