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1589 Clemson Dr ‘,.......ErvED For Office Use '7 i Permit#: `"[ b b(�/(�to "7 E AGA N APR 2 3 2018 Permit Fee: Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buildinginspections(a�citvofeagan.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 0341 Site Address: l cgy � t� Unit#: Name: 44.r2-6,-Aic S /tir niece,'/ ' / c ,kRHione: esident! pawner Address/City/Zip: ;= Applicant is: Owner "Contractor fa /f j Description of work: � 1.t� thry Type of Work � �) a Construction Cost: ( Multi-Family Building:(Yes /No ) Company: f rl r 'e_ Contact: ?Ate_ in. '17- 44/ Contractor Address: Ic/I? /1-Ve, City: c.t" 14 State:POWZip: ��-� Phone:(57;�y '�� Email:�C)074147XaeizerAd ' e al....,em License#: 6e—22-4V 2_ Lead Certificate#: If the project is exempt from lead certification, please explain why: //19W-11 /v '77/A474-/ /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 Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.000herstateonecall.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 wor is not to start without a permit; that the work will be in accordance with the approve plan in the case of work which requires a review and approv o plans. x Pifita ,ekv x G Gv► Applicant's Printed anA Applicant's Signature 41 g-Ke DO NOT WRITE BELOW THIS LINE /589 0 Af to 7 ! /Y 7 SUB TYPES Foundation Fireplace Porch (3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage — Porch(4-Season) — Exterior Alteration(Multi) — Multi rDeck _ 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 'e Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation $ /‘W ' Occupancy -LIZ e 3 MCES System Plan Review Code Edition /I9n Zo OS SAC Units (25%_ 100%?) Zoning p.D City Water Census Code Stories Booster Pump #of Units Square Feet /490 PRV #of Buildings Length /1 * Fire Suppression Required Type of Construction V5 Width M REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final I C.O. Required Footings (Addition) 1.14 Final I 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: / Ilin /92i/tf 9it , Building Inspector RESIDENTIAL FEES 015 [4g Xx:5 7,-4 c fc7d( /W15 Base Fee Surcharge /� "74".ic. d f1 ;9. / . Plan Review l MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3 . ?? , . a Site Address l Lot Block m Name _ ? Addrass c City _ • PERMIT # 4/ , MECkIANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE PHONE:454-8100 BLDG. TYPE WORK DESCRIPTION Sec/Sub ? , _ ...tr7 ? o ReS. ? NeW vi . l• . , „ M ult Add-on , ;. i' Comm. Repair 4Re Other Name L c v Address p City Phone_ TYPE OF WORK Forced Air 5 U M BTU Boiler M BTU Unit Heater M BTU Air Cond. M BTU Vent CFM Gas Piping OuUets # ? Other _ FEE S/C: TOTAL• 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 y ? BEYOND $1,000.00) J'y, II 51GNATURE DF PERMITTEE FOR: CITY OF EAGAN CITY OF EAGAN ' s? 3830 InHot Knob Road, P.O. Box 21-199, Eagan, MN 55121 _ • PHONE 454-8100 ? BUILDING PERMIT Receipt q To be used ror 1 OF 4 PLt:X Est value $60,000 Date ?`lAY 8 19 86 Site Address 1589 CLEAISUN DR Erect EY Occupancy Lot 54 Block 2 Sec/Sub. THOi'1A5 IaAKL-' Remodel ? Zoning Parcei No. HEIGHTS 2ND Repair ? Type of Const. Addition ? No. Stories ¢ Name r30RZLO?J HO1?S Move ? Length dd W Demolish ? Depth P.O. aox 1367 a Address 26- " Int. Impr. ? Sq. Ft _.. :cnr n __ •-sn ?nnn o Name SAi1r" Approvi ? < Address Assessment _ s ' cih+ Phone Water & Sew. u¢ W W ? W UV a WZ ? Name D. GRISWC7LD Police Fire Address Eng. - ciry Pr,one 435-7524 Planner Council I hereby ack information Signature of A Building Permit is issued to: C' i-A r. all work shall be done in accordance with all Building Official ation and state that the all applicable State of State Bldg. Off. 5l l/ 8 6 APC Var. Date Permit $ 313.00 Surcharge 30.00 Plan Review 1 S 6. S 0 sac 575. U O Water Conn.?kQ-.-00 Water Meter 63 . 50 RoadUnit 290-00 Tr.PI. 156_00 Parks Copies Total $2, 084 . 00 on the express conditian tfiat Statutes and City oi Eagan Ordinances. - Permft No. Plrmit Holdsr Oate Tabphons M Alumbfny a.- 5 (p M.V.A.C.,. 740 ?se o e_? k,• ? ?? g M b ENctrie So1MnN Inapactlon Dots Inap. Commenb Footlnqt I -r IFootings II IFounclation Frsminq Roollnq Rouyh Plby. ? ? Rouqlf Nby. Iniul. f 4 IF[repl*ce Find Nty. Final Plby. Gp?? 81dy. FMaI CKI.Oec. / Dock Fty. Oock Frtny. WOq Pr. Dbp. Ii - . . PERMIT # • • PLUM8ING PERMIT RECEI CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: Site Block MA Sec/Sub a? ?a ,. m c m c 3 O FEES COMM/IND FEE - 196 OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/1ND FEE - 20,00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) OF B?LDG. TYPE WORK DESCRIPTION tv " New ? Mult Add-on Comm. Repair Other NO. FIXTURES TOTAL Water Closet - $3.00 S - Bath Tubs - $3.00 ? TLavatory - $3.00 ? Shower - $3.00 ? ' Kitchen Sink - $3.00 ? Urinal/Bidet - $3.00 Laundry Tray - $3.00 ! ` Floor Drains - $1.50 ' 7 Water Heater - $1.50 ' > Whirlpool - $3.00 ?' Gas Piping OuUets - $1.50 Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 'y FEE vU I, J STATE SIC: GRAND TOTAL: ? ? ?? FOR. CITY OF EAGAN ' ' ?l«'. . • ,?, ., ? ,, ' 'RERMIT # MECidWICAL PERMIT 0 CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE ?% d S PHONE 454-6100 Site Address BLpG, npE WORK DESCRIPTION LOt -' ? BIOCk SBC/SUb Res. New m Name RED ? Mult Add-on .q Address ^' _. • Comm. Repair J c City M I N N F G Pl1I I C Rbpne . Other 1 m c 3 O Name _ Address City _ TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other MBTU M BTU M BTU M BTU CFM / FEE S/C: TOTAL• 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 SlC IF PERMIT PRICE GOES BEYOND $1,000.00) ' SIGNATURE OF PERMITTEE FOR: CIN OF EAGAN PERMIT # PLUMBING PERMiT RECEIPT a CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: Site Address LotT . ? Block TYPE WORK DESCRIPTION ? New 4 m ? ? c FEES COMM/IND FEE - 1% 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) SIGNATURE OF FOR: CfTY OF EAGAN Mult Add-on Comm. Repair Other NO. FIXTURES TOTAL _Water Closet - $3.00 ? ' Bath Tubs - $3.00 'T _?.Lavatory - $3.00 T_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: ?J GRAND TOTAL• -7 ??? Pilot Knob BU1?-DIMG PERMIT 'L 5:3` To be used for Z OF ," , Eagan, MN 55121 11 910 Receipt # Site Address 15$9B Cl+?-?^TSON UR Erect CF. Occupancy ? 3 Lot 53 Block 2 Sec/Sub. TH4MLAS A kF: Remodel ? Zoning ?i Parcel No. HEICiHTS 2 ND Repair ? Type of Const Vii Addi6on ? No. Stories W Name i? ='W HORIZON HOi?1ES Move ? ? Length 44 = Y Demolish Depth 267 o • O• ?)X 1367 Address -- I I ? Ft S nt. mpr. q. City MPZ+S Phone 4 2 0- 3 9 D 0 Install ? o Name SAME wpprovais ? i Address Assessment ~ City Phone Water & Sew. ?W Name D • GRISWOLD Police Fir e ? ? Address E ng. i W City Phone 435-7524 Planner Council Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe Bldg.Off. 5f1L86 information is correct and agree to comply with all applicable, State of Minnesota Statutes and City of E.?tjan Ordinances. ' -APC %//1. ? ,? ;•' ? ? Var. Date ?, ? Signature of Permittee •J'??? . ?? ? ??? Permit $ 313 . 00 I Surcharge 30 . 00 Pian Review_156-50 SAC 575-UO Water Conn. SUd - 00 Water Meter b3 - 50 RoadUnit 24Q-00 Tr. PI. 156 _ 00 Parks Copies Total $2, 084.00 A Building Permit is issued to: ?' VAzw nvrc tlivtv nVrlr."l on the express candition thet all work shall be done in accordance with all applicable 5tate of Minnesota Statutes and City o( Eagan Ordinances. Building Official ?`'-? - I Psrmk No. Pwmit Mdda DoN TMephone k PlumWnq H.V.A.C. tJ . j ??!1 . c?Q C?. 4-+ ? C/? ?/?? Ie $O"*r.? Inspection Dab Insp. Comm?nb Foodays l ? ,?o Footlnps II Foundatlon ' I Fnmlnp / Rootinp Rouqh Plbp. RouyA Htq. I inmwu i. Flreplace Flasl Hty. ? r Flnsl PI6q. &dq. Fhd Grt. Occ. IDock Fty. IDeck Frmg. WNI Pr. Dhp. ?LfaS q ?'' PERMIT # ,?l _ ME,CFWNICAL PERMIT RECEIPT # CITY OF EAGAN -? 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CaNTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot? Block c/,Sub Se n Res ? New ? . Name nG WIrK FITG. & A Mult Add-on ? ?v Address Q WENTWOR . 5 0- Comm. Repair ? ? Ciry MINNEAPO . mr'. S 1- - Other ' FEES ? Name ? RES. HVAC 0-100 M BTU -$24.00 3 Address ADDITIONAL 50 M BTU - 6.00 O City Phone (RES. HVAC WGLUDES A/C ON NEW CONSTRUCTION) GA5 OUTLETS MIN UM ER PERMIT 0 A ( - 1 P ) - 1.5 . IM E TYPE OF WORK COMM/IND FEE - 1Q/o OF CONTRACT FEE Forced Air ' M BTU APT. BLDGS. - COMM. RATE APPLIES Boiler M BTU $ TOWNHOUSE & CONDOS - RES. RATE; APPLIES - MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU -I t y REMODELS - 12.00 Air Cond. ?j M BTU j MfNtMUM COMMERCIAL FEE - 20.00 ? Vent CFM ? STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GaES Gas Piping Outlets # BEYONO $1,000) Other FEE: S/C: SIGNAT TOTAL: , 5 S .4 S? BUILDING PERMIT r., 1-- -A F... 1 OF 4 Site Address - Lot5 5 Block Parcel No. ..,?. Road, P.O. Box 21-199, Eagan, MN 55121 ?19") 2 PHONE: 454-8100 ? Receipt # L value $60,000 pate ?LAY $ ts 86 W Name NEW HOR I ZON HOMES ; Address p• O. HOX 1367 ° citY MPLS phone 420-3900 Minnesota = o Name S1k"?% Approvals Fe 0 ? Address Assessment Permit ? ~ City Phone Water & Sew. Surcharge W W rvame D. GR I SWOLD Police _ ? Z Fire - ? Z5 Address Eng.- Z a W C[cy Phone Planner I hereby acknowledge that l have read this application and statethatthe information is correct and agree to comply with all applicable State of Minnesota Statutes and Ciry of Eagvr''Ordinances. Signature of Permittee A Building Permit is issued to: / NE4 HORIZO HaMES all work shall be done in accordance with all Erect DC Occupancy R 3 Remodel ? Zoning D } Repair ? Type of Const. Vsi Addition ? No. Stories Move ? Length 44 Demolish ? Depth 226 Int. Impr. ? Sq. Ft. Install ? Plan Water Conn. Water Meter Council Road Unit 290.00 Bldg. Off. 5/1186 Tr. PI. 156.00 Parks Var. Date I Copies Tota, $a, 084 . UO on the express condition that Statutes and City of Eagan Ordinances. PsrmH No. PKmit NoWor Daw T~one M PlumMny ,--_, - IHAA.d. 7 1/0 L ' t? ' d¢ Gtl i C_ ?I7 /O (? Elechic a- - SOIlMlf Inspeetlon Date Insp. Commenh Foodnqsl ? v Footlnys 11 Foundatbn Framiny g/ Roollny Rouyh Plbp. Rouyh Hty. Imul. / E/LO/U4/ Finplaee Flnal Htp. Final Plbp. ??•?' - ( ]` Bldp. Final ? Cert. Oee. D?ck Ftp. D?ck F?my. Wdl Pr. Dlsp. 11 a Site Address Lot Block ? Res. PERMIT # RECEIPT # MN 55121 DATE: _ TYPE ? Name Muft os Address Comm. c Ciry ' Phone ? Other ? Name 3 Address p City Phone FEES COMM/IND FEE - 1% OF GONTRACT FEE MINIMtJM - RESIDENTIAL FEE - $10.00 MINIMUM - COMM/IND FEE - 20.00 STA7E SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE FOR: CITY OF EAGAN WORK DESCRIPTION New Add-on Repair NO. FI%TURES 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: • MEC16yICAL PERMIT " CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 ONTRACT PRICE PHONE: 454-8100 Lot "iS Block CR Sec/Sub S. ? Name ULU. ' i:. . , N ?o Address 1001 X E "?I;'•. c Ciy MINNEAPOL??iX?e:. ?J 5' ? - ? Name C c Address ? p City Phone TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outldts # Other d ? M BTU M BTU M BTU M BTU CFM FEE S! C: TOTAL• PERMIT # RECEIPT # ??'?5•? -3 p? DATE TYPE Res. Mult Comm. Other WORK DESCRIPTION New Add-on Repair 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 - 146 OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $50 S/C IF PEfiMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN 57•73••3 1 PERMIT # - /' MECHANICAL PERMR RECEIPT # 5CITY OF EAGAN a; 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE RICE' r ? PWAIdF dSd_Atf1A Site Address 8LDP, nPE WORK DES Lot Black SeclSub Res. x New X Name ? ? nne?a sCo m 7.? n ,' e n . v? Mult Add-on - ? Address ' ? Comm. Repair _ c Giiy ` ? `• • Phone 3 4 ') Other ? m c 3 O Name _ Address City _ TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Oudets # Other , f-I s±. <i n ¢ i n st, r-ryer Phone " `'.: • M BTU ? M BTU $? M BTU ? M BTU ? CFM ? ? ? J .?- FEE _ S/C: _ TOTAL - 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) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN . . . CONTRACT PRICE 5ite Address Lot ?S h Btock Name bLU. G HEAT' ?o Address 1001 XE?,ii c City MINNEALOL ?:L c ? Name c Address p City TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent. Gas Piping Outlets # Other MECFJ,QNIC/LL PERMIT "'?ITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 Sec/Sub Phone MBTU M BTU M BTU '-• ??` ?._ M BTU CFM / FEE: S/C: TOTAL: WORK DESCRIPTIDN New ? Add-on Repair FEES RES. HVAC 0-100 M B7U - $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 SURCFiARGE PEA PERM17 - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE ? /Y12G?i/ PERMIT # RECEIPT # DATE BLDG. TYpE / V Res. Mult Comm. ? Other FOR: CITY OF EAGAN PERMIT # /7 ' ' • r ' PLUMBING PERMIT qTY OF EAGAN RECEIPT # -, 3830 PILOT KNOB ROAD, EAGIW, MN 55121 DATE: 5 CONTRACT PRICE PHONE 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub ' i + -- Res. New m Name Mult Add-on m Address 11 Comm. Repair c City Phone Other ? Name _ c Address p City ? 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) FOR: CfTY NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 ' Lavatory - $3.00 ' Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.04 Laundry Tray - $3.00 TFloor 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• -,; nob Road, P.O. Box 21-199 Ea C S3 s"?; s's`'F S , 9an, MN 55121 M^ 3 PHONE: 454-8100 f BUILDING PERMIT Receipt# --J To be used ror 1 OF Jf PLEE Est Value $ 6 0, 0 v Q Date i4AY 8 , t 9 66 SiteAddress I593 C:LEMSON UR Erect EIX Occupancy .1t3 Lot_56 Block 7 Sec/Sub. THO A?; i „>KF Remodel ? Zoning -q I Parcel No. HR7(SHTS 2ND Repair ? Type of Const.-Va Addition ? No. Stories N?' l II03ILON EIOuEs Move ? Length 44 W l Name Demolish ? Depth 26 ; Address P• O. BOX 1367 ? o Int Impr. Sq. Ft City 1-21S Phone 42,0-3 y 0 t1 Install ? m o 2U V 4 ? ? ? Wa U ? W U? 4W Phone 435-7524 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 ot Permittee ???? ?y? ?'-?=-=--1?'•?? A Building Permit is issued to: NZW HORI Zt3lV FiU[,LFS all work shall be done in accordance with all applicable State of Minnesota Phone Assessment Water 8 Sew. Police Name il. C:Z i SWOL.n Fire Planner Council BIdg.Off. 511/$6 Var. Date Permit q JiJ . V V Surcharge 30,00 Plan Review 156.50 SAC 575.00 Water Conn.SOO:QO Water Meter61 - 50 RoadUnit 290-00 Tr. PI. 156.00 Copies Total $2 ,G34 . 00 on the express conditlon that and City of Eagan Ordinances. Pertnk No. MrmN Holdw DaN TNphoneN Plumbing IH.V.A.C. 7 Sollsrw Impsctlon Dab IMp. Commenh Footinys t 30 Fooqnqsll Foundatbn Fnminq /.,/A Roofin9 Rouyh Ptbp. S -? Rough Fltq. Intul. ?? A-I Q El? 6 X?f Fireplace Flnsl Hty. IFI" Plbq. Bldp. F" CNt. Occ. Deck Ftp. Dock Frmy. YIleli Pr. Disp. CITY OF EAGAN , Remarks Addition Lot s s7' Blk Ift -1- Parcel #10 Owner street - 1589 Clemson Drive state Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ? 8 AO 2 --S ' STREET FESTOR. GRADING SAN SEW TRUNK ;i •) ? *SEWEfi LATERAL 1981 ']' $2 15.05 AOIZZ 2 - -S WATERMAIN +WVATER LATERAL WATER AREA j 4.61 A0121 2 --8 STORM SEW TRK 249. 9i A0321T2 --83 ASTORM SEW LAT 981 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDIPIG PER. SAC PAR K CITY OF EAGAN Remarks Addition Lot Rlk Owner Street 1589 B ClemsOn DriVe 551 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 111.8 STREET RESTOR. GRADING SAN SEW TRUNI? ? *SEWERLATERAL ,;? 1981 37.61 . 7.52 1.0 0121 2 --8 WATEFiMAIN *VVATER LATERAL 1981 WATER AREA % 1981 136-17 27 -30 5 4.63. AOZ 2 5-1-- $3_ STOFiM SEW TRK 1981 312 2O. g3 A0121 2 --$ ASTORM SEW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK i CITY OF EAGAN -. ? Remarks ,4ddition Th&IDaq Lake Hei,ghtc.i Addj t9 nn Lot JIL .0- Parcel # 10 'MIC X Street 1591 Clemson Drive State Eagan, MN 55122 Owner Improvement Date Amount Annual Years Payment Receipt Date ' STREET SURF. b' ' 111.89 ADZLZ 2 --8 STREET RESTOR. GRADING SAN SEW TRUNK IGEWER LATERAL 198, . 2 1 .4 A0121 2 - -a WATERMAIN IMfATER LATERAI 19$1 WATER AREA S 1981 136 53 27 30 4.61 A01212 --8 STORM SEW TRK 249.91 A0121 2 - 8 16TORM SEW LAT 1981 CURB & GUTTER 51DEWALK STREET LIGHT WATER CONN. BUILDIWG PER. SAC PARK CITY OF EAGAN ? 9013 Remarks Addition Thomas Lake HeiAhtsAAddition Lot ?.rL a,k ? Parcel #IO Owner Street 1593 Clemson Drive state Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 111.8 A0121P --S STREET RESTOR. GRADING SAN SEW TRUNK c? 7 3 *SfeWER LATERAL j; 1981 •? 52 7 1.0 AQxi1 2 -8 ? . WATERMAIN #WATER LATERAL 1991 WATER AREA , 5 4.61 A01212 --8 STORM SEW TRK 1981 312.37 20-82 24().91 AQU' 172 _...83 *STORM SEW LAT 198 CURB & GUTTER SIDEWALK STREET LIGHT WATER CQNN. BUILDING PER. SAC PARK GEO. SEDGWICK HTG. & AIR COND. HOUSE HEATING TEST RECORD ADDRESS C L&r'V) 50/4 ?1:3( Vi?L CITY "J OCCUPANT OWNER /4E,,-J 1???t7_of-J HEAT LOSS -- DATE HTG. INST. --- SOLD BY `-? INSTALLED BY ti-I ic K Electrical Work By _e_1i__r117Z7, Gas Line By TYPE OF HEAT GA_ FA = HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DE5IGIV CONVERSION MAKE F2P_\r A-,J-T"- MAKE OF BURNER - Model 3 9 y? ? ?.J ?? 3-I v SC> Model Serial n G E lo A C oP 7 -7 Max. BTU Rating INPUT 5C", Oof'-) MAKE OF FURNACE CONTROLS THERMOSTAT >? '4- Heat Plug -- Valve ?X 3Ll S / zl ?Z? e-: )l- ? Limit r n Limit Setting F Fan Setting- I OC ?° (_ Pilot Type -?.? ?T?t??.? + L PilotMake - SE'tl ??l?. 1C?rJt?Z Pilot Model C ( Pitot Timing - I r"! 5 T c':. Q T- L.W. Cut Off - - - `-? ' Pressure r ?. C, ? . c Percent C0 Input CFH `4 -7 2 Percent OZ Stack Temp. I? ri Percent CO N?? Vent Size co KIND OF LINER SIZE NONE Draft Hood %N -) u- c? V Regulator jl/t- -, Fitters Size Number f Chimney Location Inside Outside Chimney Construction ?=? •? ? ?> t'- Smoke Bomb - Wiring _ ?K Draft Test Tag 4 G S Door Pressure Lighting Inst. bIS-- Date Tested L4- 14 - Company Testing c? "i ?? Name of Tester ?53 1 " SEDGWICK HEATING & AIR CONDITIONING CO. `? y HOUSE HEATING TEST RECORD ? J42, ?G(9lll???/?- 4L ADDRESS 6_? 93 C(_C-W1S0?iJ , . , . . . ,Pv CITY GL 6-, C-,?°, r--? OCCUPANT ' OWNER vut ? HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY Electrical Work By - 3?F11? Gas Line By :!-->r=-? ?= ? C-y- _ TYPE OF HEAT GA _ FA X HW_ ST EAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE ???I -j `+ MAKE OF BURNER ---------" Model 3 9?-4 G w w01 40 ?? 0 Model Serial OG 9 ?, A ba f379 Max. BTU Rating INPUT 0 40 MAKE OF FURNACE -' CONTROLS THERMOSTATT-B ?' L Heat Plug Valve IS X 3t-1? IVSr>X- ? Limit- ?-r-4? mc o Limit Setting _ a SD° F Fan Setting tvo° ;=- Pilot Type L?- U4:-c -rczC, r-1 << PilotMake Sej°ksZk t C,N 4T2?v2 Pilot Model ?-? 5 c 1 Pilot Timing i ?iSTK+../T L.W. Cut Off Pressure 3 -S " '-J • C . Percent CO 2 Input CFH 443 Percent OZ Stack Temp. c;?-"? I ° G Percent CO ? ?r-Jc-?- Vent Size ? KIND OF LINER SIZE NONE Draft Hood I r-? r-) LA, Regulator j:j?_- ?- Filters Size Number I Chimney Location Inside IX, Ouuide Chimney Construction ie> Smoke Bomb Wiring C?- K Draft Test Tag Door Pressure Lighting Inst. 044- Date Tested 'E? - Company Testing ?t= C)?Ct{-+ or !L Name of Tester C--o ?.j ?z??? __ Form 235 GEO. SEDGW ICK HTG. & AI R COND. CO. ??2-?j ?> 7 I HOUSE HEATING TEST RECQRD -P W--- ADDRESS ?C.,!L6ti1 Gn/Q CITY r QCGUPANT OWNER 1-Ec?LfztzorJ l-?ric ? HEAT L05S DATE HTG. INST. - SOLD BY -?- INSTALLED BY Sc i) c-.? Electrical Work By ?•r3 rZ Gas Line By TYPE OF HEAT ?GA_ FA HW____ STEAM SPACE HTR, UNIT HTR. OTHER GAS DESlGN CONVER510N MAKE rV\j -?_ MAKE OF BURNER °----?J' Model 39 `1 f-?J1, `I (`) ;_L-4 G ? O Model --? Serial 7 f.` (r, A4 8 R 9 G 14 Max. BTU Rating INPUT ? c, cMAKE OF FURNACE ? Model - CONTROLS THERMOSTAT ?S _,11' Heat Plug -?-` Valve 6 4-16 4 -- 5l Limit 5 T? i C4 C a Limit Setting Fan Setting Pilot Type Pifot Il4ake Pilot Model C- ? Pilot Timing ?N ?T 1-1 "l T L.W. Cut Off ------ , ?' A ? Pressure 3.S- LU, t. Percent CO ? z Input CFH Percent O ?? f6 /5`]Z Stacktemp. PerceniCO Vent Size L.0 KIND OF LINER Draft Hood SIZE NONE Regulator Filters Size Number ) ' Chimney Location Inside '_ Outside Chimney Construction C_ L-'??_ `:a i? Smoke Bomb Wiring b)<- Draft Test Tag ? s Door Pressure Date Tested Lighting Inst. Company Testing ? I c < Name af Tester Cc ?`? ? ?---, ' J CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 ' SITE ADDRESS:? ? ? ? ? ? ??•,?,?? i??? PERMIT SUBTYPE: !-.4 Fl ! $ir a PERMIT TYPE: Permit Number: Date Issued: APPLICANT: . ?; TYPE OF WORK: Jitl I 1 11 t hlot A`i4',4/ 0:" IiC4 Ju4; INSPECTION ., . .• I I f A tV It f V l i t,J i 1) Fs y lJ !1 Y h1 f 141 t! f- F? ? i'E ItA i t i°I Wh9 i 1 I,f l11.111?Fii t ftr; AIyY !'! !lMti 1 fJt. 411110, ? !. I! i?, 1. , ?i rl ? ;•I tti !' ?i.;', i' l i l 0;: (' } t1 J? t it' L ? - - - ----- - - - - - - - - - PermR Holder Date Telephone N SEWER/ WATER PLUMBING HVAC Inspection Date Insp. CommeMs FOOTINGS FOUND FRAMING ? hq u ROOFING ROUGH PLUMBING PL6G AIR TEST ROUGH HEATING ? GAS SVC TEST INSUL GYP80ARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DpMESTiC METER IRRIGATION METER FLUSH MAINS coNOUCTivirv TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAI DECK FfG DECK FINAL INSPE ? CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (651) 681-4675 I SITE ADDRESS: ' APPLICANT: II1?M/17; l HF' L N 1 PERMIT SUBTYPE: i ? ? --- + 0 r k : ? eo?- ? • ? ??? i ?F?3N1 TYPE OF WORK: P1 ;; t'. J2 1 F f i n N Al lrI:ai;anM tin?; f N`;f' f< t ii'-. 1 f N( F L J ------------------------------- ? :?Ith y r CHiMWFY 11' i 11f MU?; ? t?f rN^r?rr i r n tq F r•ri ciF- rti r; Permit Hdder Date Telephone # SEWER/ WATER PLUMBING HVAC Inspection Date inap. CommeMs FOOTINGS FOUND FRAMINC3 ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METEfi IRRIGATION METER FLUSH MAINS coNOUCnvm TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTO DECK FINAL INSPECTION RECORD ' CITY OF EAGAN PERMIT TYPE: ? 3830 Pilot Knob Road Permit Number: ? Eagan, Minnesota 55122-1897 Date Issued: ?. ? (651) 681-4675 ?, ;. . . , SITE ADDRESS: APPLICANT: r?s?i?? r+? ? .,, ; , : ,??; ; ,, , ? ;T EilWi '> Nfl (612) H61. ...19o1 :s -., , ..t•????,?`??`.!?rQ PERMIT SUBTYPE: riitt. rh1 IF TYPE OF WORK: F? ?t?etr?? i??n nI ":U Ir i Pf 7 rrN riq:z t NH IAA'+ I I NI i tl A t J';r'F? C 1 f 1) Nf. ( nRf 1' 1)N( t=A 1 'I N,', ? IL J t PermR Holder Dete Tetephona # SEWER/ WATER PLUMBING HVAC Inspection Oate Insp. Comments FOOTINGS . FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC FEST INSUL GYP BOARD FIREPLACE f ? FIREPLACE AIR TEST ?? )l FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRFIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF E:AGAN WATER SERVICE PERMIT 38d0 Pilot Knob Rosd ??.??] , P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoninp: P I No, of Units: -P ex Owner , cv :?arizon :?u.oeG Addross: Si» ??: 1593 C emson Drive T, ,_- "?', ??mas L t ts I Plumber ompson P um ng _ Meter No.: C / rjd*n Cl+arfla: ?? '•'? Pt-I Size: 5' y., p??? 15. p,, Reodar No.: P ??_- t, . P c, I yrw /o aewpFj wi1i? ? Citi of E._,pWMgll,?$?? ? ._' P - - By Rot. Paid: OoM of Insp.: Irup.: /o- La -86 CITY OF EAGAN SEWER SERVICE PERMIT " 3830 Pilot Knob Road P. O. Bcx 21199 PERMIT NO.: , Eagan, MN 55121 DATE: ? 2onirp: No. of Units: ? O1Mflef: elJ n 'r,?i •1?.- . Address: - ? Site Address: F?°?? ?len!?on Prive -•"_ •^ i i Plumber: I ym te esm* wNr NN Clhr of fep. Conr+ectian Owlw: r:, . OC1r?, , ) • nrl ?r' onuN11qi. ACOOUnt QEposif. Permit FM: ' Surcharps: By Miic. Choross: Dcte of Irqp.: Tofal: leaa? Dotf Pa1d: CITY OF EAC?AN WATER SERVICE PERMR 3830 tilot K nob Rosd `? ? P. O. Box 21199 ' PERMIT NO.: - Esgan, MN 551 21 - - ? ?: DATE: ` , ZaninO: No. of Units: -p ex, Ownsr: or zon /lddrsss: Sito ??: i `? .? . ?^,.Lemso?? Dr ve ? lo.<<as c _t s II Plumbar• - ?ot:?-,sot? P Meter No.: 00 t , p` - - S(ze: 8 n ? 7 1 ?.., P?: Readsr No.: 11?95 1lS9 `rmit ? w -•'?' 149108 eo a e i.PlP wMb *10 c l e p P Misc. Ciarges: Totol: S)Fd metel- 8 Data Paid: dota of Insp.: Imp.: CITY OF EACAN 3830 :`ilot Knob Road P. O. Box 21199 Eagan, MN 55121 Zoninp: Owner: Addrcss: Site Address: PlumbGr: 1 Nm to ampl) wilh !V Ciyr of tqpo OrliNneN. By Date of Insp.: SEWER SERVICE PERMIT PERMIT NO.: , DATE: . No. of Units: na Ca+nsction Chorqe: . AcoourM Deposif: - Pe?mk Fee: Su?chorpe: Misc. CFarqss: Totol: DoM Pold: 'F EAGAN ?NATER SERVICE PERMR lot Knob Road ?f - )x 21199 ? " PERMIT NO.: NN 55121 DATE: ?`3 No. of Units: +•- p e? New Horizon iomes 51te Add?• l s' ''° ?lemson Drive L_ B2 iomas Lt- T.t4 IT ???r ? I'hompson Plum ing _ Meter No.: U+o.fla: Siza: " ee ?it: . 0 . pd IUW 2 di ing _ m 1 n ; n ?,? ?der ? ? ??.? _ I pd 1 qrw /o eompy w4h tM wQbhr I 7. . i..,a Tr BY Date Poid: Date of Ins .. Intp.: /o -'/?- YG CITY OF EAGAN 3830 Pilot Knob Road SEWER SERVICE PERMIT BOx 2119" O P PERMIT NO.: . . Esgan, MN 55121 DATE: Zonjng; No. of Ur?its: , r .? .. ?. O wrwr: /lddress: - SIM Addroas: Plumber. _ -? ,?•. _ , -? ,.,z, ? -, ? - I?!e th wil6 lw Cft of Eye¦ Connection C}wrpe: OrlIMuoM. ACCamt DepOfif: . P?miit FN: SurcF+o?0e: gy Misc. Chorpes: Date of Irnp.: Totol: Ir?sp.: Da" Paid: ?F EAGAN WATER SERVICE PERMIT Iot Xnob Road (1 , ';, ax 21193 PERMIT NO.: ' NN 551?1 DATE: '---?- p? No. of Units: -P ex Yew orizon tlomes No.: 115-W `f.5 te ao.py W" K. CITY OF EAGAN REG??1qj?1.-'_04 ? , Date Pnid: 3830 Pilot Knob Road -"-° "`°VW%'46 P. O. Rox 21199 PERMIT NO.: Eagen, MN 55121 p^TE; ZON^o: No. of Units; O?vner. - :?L'•:; !TZ:TJ"I.L?t'_ ilc - Address: Sia Add?css: ?-5 :9 Cle.mmor._ T'rive Plumbor. ThOmi!90II ? I?lrM N eoml? wll6 !iw Ciyr of iqs¦ ? OfdIMwON. ey Date of Insp.: GwrNCtlon QWfps: 'i . n•"? Aoooun! Deposit: ' Parmit FN: SurcFwrpr Misc. Chorps: Totah Date RaFd: FOR SALE TOWNHOUSE CITY OF EAGAN .t • . 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 N2 11922 PHONE: 454-8100 ?a ?s? BUILDING PERMIT Receipip 7o be used for 1 OF 4 PLEX Est. Value $ 6 0,0 0 0 Date MAY $ ? 9 S 6 SiteAddress 1591 CLEMSON DR Erect 13 Occupancy R3 Lot 55 Block Z Sec/sub. THOMAS LAKE Parcel No. HEIGATS 2ND tAddr:ss NEW HORIZON HOMES m Na o P. O. BOX 1367 ciry MPLS pnone 420-3900 o Name $AME $ Q Address ? CityPhone UQ ww t uo az aW SWOLD Remodel ? Zoning Rl Repair ? Type of Const yn Addition ? No. Stories Move ? Len9th 44 Demolish ? Depth26 Int Impr. ? Sq. Ft Install ? Assessment Water & Sew. Police Fire Address Eng. _ city Pnone 435-7524 planner I hereby acknowledge that I have read this application and state that the information is correct and agree to cpmply with all applicable State of Minnesota Statutes and Giry of Ea 6n Or nance Signature of Permittee ? ? A euilding Permit is issued to: NET?1 HORIZO HOI+IES all work shall be done in accordance with all applicable St f Minneso Council Bldg. ON. 5/1/86 APC Var. Date Permit $ 313.00 Surcharge 30.00 Plan Review 156.50 SAC 575.00 Water Conn. 500.00 WaterMeter 63.50 Road Unit 290.00 Tr. PI. 156.00 Copies Total $2.084.00 on the express condition that and Ciry of Eagan Ordinances. Building FOR SALE UNITS CITY JF EAGAN TO?NHOUSE 3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N0- 11920 PHONE: 454-8100 ?JJS? BUILDING PERMIT Receipt# ?!°? Tobeueedfor 1 OF 4 PLEXEstValue $60,000 Date MAY $ 86 SiteAddg s 158ZB CLEMSON DR Erect C? Occupancy R3 3 Lot Block Sec/Sub. THOMA$ LAKE Remodel ? Zoninq R1 Parcel No HEIGHTS 2ND Repair ? Type ot Const. yn . Addition ? No. Stories w Name NEW HORIZON HOMES Move ? Length da = o Address P.O. BOX 1367 Demolish I t I 1:1 ? Depth26_ Fr S Ciry MPLS phone 420-3900 n . mpr. Install ? q. A Name SAME Approvals Fees ? Q Address ? ,.... W W ? so UZ ? W Phone Name D. GRISWOLD Address water & Sew. Police - Fire 435-7524 Eng. Phone Planner I hereby acknowledge that I have read this application and state that the in(ormation is correct and agree to comply with all applicable State of Minnesota Statutes and%ty of V gan rdinanc?? Rinnnh?ra nf Dn?miNUn i'L Cn'/ ? A Building Permit is issued to: all work shali be done in accordance with all ap icable St te o inne.&o Building Official -?zz-, Council Bldg. Off. 5/1/86 APC Var. Date Permit $ 313.00 surcn8r9e 30.00 Plan Review 156.50 SAC 575.00 Water Conn. 500.00 WaterMeter 63.50 RoadUnit 290.00 Tr. PI. 156.00 Copies?? Tn1o I T??°??• O O on the express condition that Statutes and Ciry of Eagan Ordinances. SEDGWICK HEATING & AIR CONDITIONING CO. TES"T Recoao JOB NO:.??3 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 ADDRESS CITV OCCUPANT OWNER r? SOLD BY 5??C ":?ZJ INSTALLED BY MAKE L - C,?J.Ga?,e MODEL SERfAL NO. JOeO Y? 5r 09 INPUT_ THERMOSTAT " S63 VAWE LIMIT 444!48?1 LIMITSETfINGIi " a FAN SETTINGS! rq PILOT TVPE ??'?S«a?Fa?v i IGNITION MODEL 9? PILOTTIMING ?`?-- PRESSURE?X(' - PERCENT INPUT CFH gY-,e" PERCENT Oz STACK TEMP. 16 G C PERCENT CO FOPM 235 (REV. t VB9) ?e N r.,C)(-L ('KOCshE 36/4-O 0 cJ 'U !/ VENT SIZE `r TYPEOFLINER LINER SIZE FILTERS: SIZE L205' NUMBER TAG IIGHTING INST. DATE TESTED ' g'/ / /C3 y COMPANV TESTING NAME OF TESTEp FORM IBUTIIXJ: WNRECOPV - JOBFILE YELLOWCOPY - CITY REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi.oa 1 See inshvctions lor comDleting thia farm on Eaek o7 vellow eopy. gn "X" Belnw Wak Covered by This Request ? s?3 S- MawJpAtlj flep.1 TYPe o1 euilding I Apolianms WireE I Equiumant Wired I I 1 I I Duole.x I I Water Heater M Liahtina Pixtures I ?ommeraai eiay. ? rumace 1 ? aiio unioauer ? ? ? I I Indusirial Bldo. Air Conditioner Bulk Milk Tank ? M fae ServiceEntreneeSixa !1 Fae Fendees/5ubieeders # Fan Circuita ? 0 to 200 Am s 0 to 30 Am s 0 to 30 Am Above 200 qmju 31 to 100 qmps 31 to 100 Amps Swimmin Pool Above 100_Amps Above 100_Am s 7ranstormers Irrigation Hooms Partial.bther Fee aigns Speaal Inspection 5 TOT FEE C? NemSrks ??? _ • ? VLI-V , certify that tha nbove nal D^G1) -S)pspection has been mede. TMSrpuestvoi018montMirom °'_. '_' FOA_ yALE TOWNHOUSE CITY OF EAGAN N0 3830 Pil t K b R d P O 11923 o no oa , . . Box 21-199, Eagan, M _ N 55121 PHONE:454-8100 BUILDING PERMIT Receipts ? To be used br 1 OF 4 PLEX . Est. Value $ 6 0,0 0 0 Date MAY $ , 79 $ 6 Sii9 Address 1593 CLEMSON DR Erect C? Occupancy R3 Lot_1Fi Block 2 Sec/Sub. THOMAS LAKE Remodel ? Zoning Rl Parcel No. HEIGHTS 2ND Repair ? Type of Const Uri . Addition ? No. Stories w Name NEW HORIZON HOMES Move ? Length 44 BOX 1367 Demolish ? P O Depth 96 ; 3 . . Address mt ? l S Ft °- . mpr. MPLS -3900 City Phone 420 Install ? q. . = o Name SAME Approvals Fees o¢ Adtlress . ? Ciry Phone ? W ?w U? P'W a Assessment Water & Sew. POlirw Name n_ (+RTSWOT.D Fire Address Clry - Eng Phone 435-7524 . Planner I here6y acknowledge that 1 have read this application and state that the inlormation is correct and agree to comply with all applicable State of Minnesota Statutes and City of Ea n Ordi ances. Signature of Permittee 5' A euiltling Permit is issued ta: N96 HORI ZON HOMES all work shell be done in accordance with all applicable Stajp of Minnesoo. Council Bldg. Off. 5 /1 / 8 6 APC Var. Date Permit $ 313.00 Surcharge 30.a0 - -' Plan Review 15 6 : S 0 SAC 575.00 Water Conn. 5 0 0. 0 0 Water Meter 63.50 Road Unit 290.00 Tr. PI. 156 . 00 Parks Copies 2?00 Total on the express condition Mat and Ciry of Eagan Ortlinances. Building sALE TOWNHOUSE CITY OF EAGAN 0 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N° 11921 ? PHONE:454-8100 ??5? BUILDING PERMIT Receipt# Tobeusedfor 1 OF 4 PLEX Est.value $60.000 pate MAY 8 is86 SiteArJdress 1589 CLEMSON DR Erect Iff Occupancy R3 Loi 54 eiock 2 secisun. THOMAS LAKE Remodel ? zoning Rl Parcel No. HEIGHTS 2ND Repair ? Type of Const. Un Addition ? No. Stories W Name NEW HORIZON HOMES Move ? Length 44 3 Address P.O. BOX 1367 Demolish ? Depth 26 ° c;ty MPLS phone 420-3900 InshallPr. ?? sq.Fr o Name SAME APM°V1 $ ? Address AssessmenL Ciry Phone Water & Sew. W W Name D. GRISWOLD Police - . i Fire ? Atltlress <w Ciry Phone 435-7524 panner_ I hereby acknowledqe that I have read this application and state that the information is correct and agree b comply with all applicable State of Minnesota Statutes antl Ciry of E ean O inanc Signature o( Permitlee ? ? •? A Building Permit is issued to: EW HORI ZON HOMES all work shall be done in accordance with all Stafe of Councii BIdg.On 5/1/86 var. Feee Permit a J1j .vu Surcharge 30.00 Plan Review 156.50 SAC 575. 0 Water Conn. 500.00 WaterMeter 63.50 Road Unit 290.00 Tr. PI. 156.00 Copies- -- ?,_0 0 Total ?L U254 on the express candition that and Ciy of Eagan Ordinances. Building 'This request void 16 nwnths fram 0 80 903?,5?,?> .Feituesi Date I Fire No. ?R?nup'??,Insper,linn ReadY Nuw QWill Nntity Inspec- ?1'es ?NO lor When Ready Licensed Elecvical Convactor 1 hereby request inspection ol above ? Owner elactrical work installed aY Street Address, eox or Route No. CitY ?' ?rlUC ? e?.J ecLOn o. Townshio Name or No. Renge No. Countv ?KO ?4 OccuVant(PHiNT) Phonc No. /i-?dd Pnwer Sup0lier Address ' ? ? 7 ?C / d eG + /: c a a ElecVical Contractor IComDany Namel Cont a.mr's ir.ense No. ??r?.J Le.cSZi?c MallinA .4tlJress (COMrac[or or ?wne, Makiny Installation) T ?? ! OIMf/ ' a2 Authorized ie?ature lCO ctor?Ownar Making Installation) Phone Number ?? iiX MINNESAYA STqTE BOAN6 OF ELECTNICITY Griggs-Midwey Bldg. - Noom N•191 1021 Universitv Ava.. St. Paul, MN 55104 Phone (612) 642-0800 THIS INSPECTION REQUEST WILL NOT BE ACCEPTEO BY THE STATE BOAHD UNLESS PXOPEN INSPECTION FEE IS ENCLOSEO. This reQUest void 1H m?on(hs from Fepuest Date Fire No. RouPh-in InsUec[ion e rted? . ?fleady Now ill Nouty. Insoec- or When Ready J /Yes ?No _:E5ZLicensed ElecVical Contrector 1 hereby repuest insoection of ebove fl n...- einctrical work insfalled a<: Streei Address, Box or Roufe No. C? / ? ecvon o. ownship Name :orNo. Range No. County Occu n IPqINTI , Phone No. ? _ 1r}'li° ` Power pol er Atltlr s ? ? IJ ?, ?-?t? G ? ? ?cTT ' .r, r? n ?.T-?T.?fi ? Electri onvactor (ComDany Name) Contra tor?s License No. ? Mailing AdJress (Contra mr r wner Making In lailation) h / ? iia .4uthorizetl Sig^a[ure IConttactor Owner Making InstailatioN Phone Number MINNESOTA STATE BOAND OF ELECTRICITY ` BE 'ACCEPTEIi 9Y THE STATE•BOARO Grig9s-Midway Blde. - Ronm N-191 UNLESS PROPEN INSPECTION PEE IS 1627 University Ave., St. Peul. MN 55104 ENCLOSED. Phane (612) 297-2111 TFis request void ? S7 7 -- 18 mon[hs trom ?/? // q 7S74j ? D 18670 "' -?`?t. AP?Oelt ??? ? Fire No. Ro ? uNh-in InsVectinn? _ ?] / fle?ry red? Heatly fYOw Q Will Notify Inpec- l ? yes ?? lor When HeadsY ?Licensed Elearical ConVacmr ? Ow 1 hereby request inspection oi above ner .., Street A/dd?ress, /e?ox or Route No. ' /\fn '..n City ectwn o. 7ownship Name or No. Range No. County V OccuOant (PRINT) NUNEZ Phone N (v8/- /87.5 Pawer $upDlier Adtlress Elecvicai Contracmr (COmpany Ndme) HARRISON ELECTRIC I Conhar.mr's LicenSe No. nc 421867 Mailing AdJress (Contracmr or Owner Makine lnstailation) 3640 organ Avenue No. Mpls., hIN 55412 A? on ed i'a[u e 1 0? wner MakinB Installatinnl Phone Number l 521-0520 -°- • cvwn. vr ucc,nici[v Gr iggs-MiAwaV eldg. - Noom N-191 1821 Universitv Ave., SL Paul, MN 55104 Phone (672) 642-0800 I rvortc i iurv xtUUEST WILL NOT 6E ACCEPTED BY THE STpTE BOAFD UNLESS PflOPEF INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ee-oooo/i?-os 1 See insvactions lor comDleti?g this torm on back ot Yeliow mpy. ? 1 RR7 n "X'" B;, low Work Covered by Ihis Request Nativ AAd Rep. Type ol Bu1lUing Apotiancxe WireE Equipmenl Wired x Home Ranye Temporary Service - Duplez Water Heater Gyhting Fixtures Apt. 8uilding Dryer Electric Heatin Commerclal Bldy. Fumace Sllo Unloader Industrial Bidg. Air Conditioner Bulk Milk Tank farm Othei peciiy 01her ISnenly) t or Suecify Othor OtM1r,r (.OIAOU(B !l15DeCU0Ah@2 KBIOW # Fea Service Entrence5iie H Fee feeders/5ubleeders k Fee Circuks 0 to 200 qm s D to 30 Am s 0 to 30 Am s Above 200 Amps 31 to 100 Amps 31 to lU0 Am s Swimming Pool Above 100_Amps Above 100_Amps Transformers Irrigation Booms Partial-'Other Fee Signs Special Inspection $ /ly TOT flercwrks C7 2 /[/Ll AL F /n • a6 Rough-in Dite I, the Elecbical InsDectoq hereby certif tM1at the ab Fina1 ? ?'??f7 y ove soaction has eeen t aa. mia reQuesl vo101B manliM Irom This reQues[ voiC / G 18 months from -? ?3 S_ 3 6 9?1 C3 ? ?j/?V?-, ,Aeyuest Datei' J??? / 8? ? ? Fire No. Hoaph-i Insper,fion Requuetl? Y ?? ?Heatly NowypWill Notily Inspec- ??[n Wh K f es ?NO r en ReadY _?censed Electrical ConVacmr ? Owner 1 hereby reQUast inspection oi abova electricel work installed et: Slreei AdAress, Boz " Na ° ?, ec o . Townsh'D Name or No. RanBe No. Counly Occ? nt (PPINTI Phone No. PCe?? ? r 7G' / e Power Pplie? Adtlires Elec[U? Contractor I COmpany Na m el Contrar.t r's icense No. ? y ? l? 1( ? / I Mailine O.ddress ICo ractor or wner Making Instdilaiionl ? ?lU ,: , . Ai}? rzed SignaWre IContractor/Owner Ma " king Instaliatinn? - Pho?Number j .? ` +ls.. .. » . . . \.. s& . . . ? MINNESOTA STqTE 90ARO OF ELECTRICITY Grigas-Midway Bldg. - Noom N•191 1821 Universitv Ave., St. Paul, MN 65104 Phone (612) 297_2111 THIS INSPECTION flEOUEST WILL NpT BE ACCEPTEO BY THE STATE BOAHD UNLE55 PNOPEN INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ee-ooooi.oa ? Sae instructions tor completinp this iwm on beck oi vallow coOV. 8elow Work Covered by This Request ?113? , tiAd Feo. TVPe m Builaine Aooliancee Wi.ed ? Equiumeni Wi.ed Home Ranye Temporary Service Duple.x Water Heater Lightiny Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader Industrial Bldg. . Air Conditioner Bulk Milk Tenk Farm otner oeci v .tnF? ISner.ifv) t r Suou v thc. Othor ompute lnspectfon Fee Bebw N Fee ServicBEnlrancaSize H Fee Feeders?5u?taeders a Fee Circui[s ?to200qms Oto30Ams 0 to30Ams Above 200 qm ns 31 to 100 Amps 31 [0 100 A s Swimming Pool Above t0U_Amps Ahove 100_Am s Transiormers Irngation kloorc?s PartiaLOlher Signs SpeciallnsUection $ pemark5 a, p? TOTAL rfi?7 Rough-in ? Dn?e ?,Ihe Ele Inspecror, heraby Final rtify Ne4tM1e above inspeclion hes been Made. ThIS repuesl mltl 18 monlhe Irom This reqvest void Ln!?? ?. 18 mon[hs tmm . '? ?- J ?6919 Request D 1 Fire No. FouPh-in Inspectian ?./ ? / fl q red? ?AeaGy Nuw QqWill Notity Inspec- ?r ? ?es ?NO ??or When Headv K..J 'icensed Elecvical Contractor I hereby repuest insOactian of ebove n Owner elactriwl work installed et Sv et Address, Boa or Poute N C ????r'! ecuorl o. Townshi0 Name or No. Range o. County ' Occu ?tIP"HINT) Phone No. &f d s tAd i Ele Convactor (COmpany Name) . ? r?n ? ? E'(? + ense No. Contr3qto ?s Li? Mailiqe AdJress ICo ractor or Owner Makmg In ailaiion ?? . ? ? Y Authorized Sie?ature ICOnttaclor?Owner Making.lnstallali on) Ph ne Number ; ? ?' ? ? , : . .. _, • . - . .. ^'?_ ??/ ? . y Y y MINNESOTA STqTE eOAflD OFELECTNIGITY Griyye-Midway Bltlg. - Poom Nd91 1827 Univeraitv p.ve.. St. Paul, MN 66104 Phone 16121297Q111 TMIS INSPEGIION Xh(lUtSi WILL NUI BE AGCEPTED BY THE STATE BOAXD UNLESS PROPER INSPECTION FEE IS ENCLOSED. flEQUEST FOR ELECTRICAL INSPECTlON I0 See inatructions tar comoletinq this form on beck of vellow copY. EB-00007.04 ? *lf;ql q "X" Below Work Covered by lhis Request Ad Rep Type ol Builtling ApOlioncen Wired Equipmenl Wired Home Range Temporary Service Duplax Water Heater Lightinp Fixtures Apt. Buildinfl Dryer Electric HeaUn Commercial Bldg. Furnace Silo Unloader Industrial Bidg. Air Condrtioner Bulk Milk Tank Farm m.r nectv oiner ?snanfrl t er uecify Olher Oth¢r N Fee SarviceEn[raneeSize p Fee FenEers/Subieatlers k Fee Circults 0 to200qms 0 to30Ams 0 to30Ams Above 200 qm)s 31 to 700 Amps 31 to 100 A s Swinaning Pool Above 100_Am s Above 100_/>mVs Transiormers Irngation Booms PartiaLOther Fee Signs Specialinspection .I S) l TOTA E Memnrks " a ? L-E? ? I, tha EI?c4ie6r 3yv? i?sue?io., ne,ecv cartify that the ebove ? sDection hes been ? ?ae. 310 - 6 J 0 ? OFflCE U CE O LY This request void 18 monihs fmm valldo?ion dme pnnted in ihis 60? ?F ??'?7?J?'G ?P 7 P? / ?I PLEASE PRINT OR TYPE ?53o BO D ?/./" • (?' ?? ??v ? Requesyi?ale Rwgh-In Inspecnon reqWred ,? Yex .-9.41- inspecnon Other Than Rough.l?y Now ? Will Call (Yoa m?s? coll the inspecror when readrl Dme Ready?. / I_1?n d contmdor ? owner hereby request inspeciion of fhe a6ove eledri<al work at: lob Addresa (Slreep Box, or Rou1e No.? Tp Code Setlion No. Townahip Name or No. Ronge Na t t Occu m ? 7 ? Power Suppller Pddress Elen5onrc .(C anY N. CoMmcmr Gcense Na. 64190 / 0 Masror Lia No. IPlant Elecr. Onlyl MailinB s. IConrracror ar Owner PeR n Immllalion) Aulhonxed SignaN/re ?cror ar _Owyr PeAoimin9 InsblloNOn) /4. /?/ P? No. EB-OOOOIA-10 6/95 STATEBOARUCOVY-SEEIN5TRUCTIONSONBACKOFVELLOWCOPY RE?UEST FOR ELECTRICAL INSPECTION ?( 821 Une St. Paul, MN 55104 ?? ( II I?I II I? I IIII III I?IIII I?II I?? ?II 1rsity Avear Rmf SI1?8c s 0 3 1 C! 6 5 0 7* Phone (612) 842-0800 //96P l t Bld A Other New Addn Dup ex . g. p . d R Re air ercial Indusfrial Farm emo EAirCond. Equip. Water Hh. Laad Mgm}. Ran e Ele<. Heat Temp. $ervice "k' above the work covered by this requesG Enter remarks in this spoce and on fhe back of the white capy only. Calculafe Intpeclion Fee - This Inspeciion Requesf will nof be accepted withou} ihe correcf fee: Olher Fee # Service EMrance Size Fee af` Circuih/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps S}reet L}g./TraHic $ig. Transformer/Generabr Above 200_Amps 100_Amps CS'1 INSPECTOR'S USE ONLY TOTA J? f mt. $ign/Oufline Ltg. X Alarm/Remote Conirol Swimming Paol I hereb mnN ?hai I ?ns eckd ?he elern?ml ?ns?allauan descnbed he.ein on ihe dahs staud Irrigafion 8oom Rooyhm Dare Special Inspetlion Fral D. ??. Investigafive Fee m uucrwI I wrInu ?IO V GF l1R p yyITHIN 78 M N HS. fIFRFD OIS ECTED I . Thns rnVUest void 18 monlhs Irom . •.l ?? - `J ?' ?7+ IS-Licansed Elecvical Contractor I hereby request inspection of ebove f'1 n.....,., elwr.vicel work inetelleA ar. Stre ? s, Roule No. B C' ? ?i ?? a ection a. Townshi0 Name or No. RanBe o. Coty Occupa [ IPNINTI 1Pcv ??17011 Phone No. Power Supplier /+ddress EI C? CoQntracm? Namp??? _ p C??Mr r.tor's License No. Mailine Address 1 ntraccor or er Mabng Inst ilation ? n J ? Authorized ia awre IConuactor Owner Making Installatinnl p},?,( Phone Number MINNESOTp STATE BOARD OF ELECTNICITV Griyps-Midway Bldg. - poom N•191 1821 UnivereilV A.ye., St. Paul, MN 55104 Phona (612) 297-2111 " eE ACCEPTED BV THE STATE'BOARO UNLESS PNOVEP INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION Ee-00001-0' L - ? See instructions for comoletino this lorm on back o1 vellow coov. / 3691"8 "Jf" Be/ow Work Covered by 7his Request ?tli Nan. Twe ol BuilCing Applinncea WireA _ EquiVmenl Wiretl ? Duolex Water Heater _ IX Liyhtiny Fixtures i rnace Bulk Milk L.om p PUle n?s Fae pec??un ree aw,,w Service EntrenceSize fl Fee Feaders?5ubfeeders N Fee Glrcults U to 200 Am s Above 200 Amps 0 ro 30 Am s 31 to 100 Amps 0 co 30 Am s 31 to 100 Am s Swinvnin Pool Above 100-/amps Above 100_Am4s Transtormers Irrigation Booms Partial,"Other Fee oigns ??°°°• .. -'?° _ 5 TOTAL F Rou h-in ? I, t?e Ele nc I e Inspectoq ?ereby /? - IiIV that the nbove ection has been Final ?/, ?1g ?Oe. Thla reduest valtl 18 monthn irom ----------------- ? i FO a?e?e ? ? ? Pertnit#: ?39- I I Pertnit Fee: ? JV - k(?;t?[l" I ? DateReceived:6(0'ue?"-UCt v I ? Sfaff: c v? ? L_________________ 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Tenant: 5: I05631 rlo,wnn n?'. ? Suite #: RESIDENT / OWNER Name: ?4!1Phone: l11 J7 •/05-, '9152- Address / City / Zip: ? CONTRACTOR Name: License i Address: Champion City: 3670 Dodd Rd. #100 State: Zip: Eagan, MN 55123-1339 Phone: Contact Person: TYPE OF WORK _ New >? Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Descripfion of work: PERMIT TYPE RESIDENTIAL ? Water Heater _ Water Softener Lawn Irrigation Add Plumbing Fixtures ? RPZ PVB) ? Main _ Lower Level) SepticSystem _WaterTurnaround New Abandonment RES/DENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge) `Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace bumed out appliances, ductwork, etc.) (includes $.50 State Surcharge) v? TOTAL FEES $, I hereby acknowledge that this inforznation is complete and accurete; that the work will be in confortnance wttn tne oromances ano coaes or me Ciry oi Eagan; that I understand this Is not a permit, but only an application for a pertnit, and work is not to start without a permit; that the work will be in accordance witFi the approved plan in the case of work which requires a review and approval of plans. n?? ? 5---"" , x ??1 , ,?i{/?,fjL x I?? 0 ?, ApplicanYs Printed ame ? Applicant's nature 319w a'P a ? ?j SJ lq3 ? 1933 5? 1• /% I o ?. lqgy.p) ? O? N ?. lqgIbol ?j 5t6 S 00 3e E- _ _ C93io) 16'p0 g6 00 g6 w N 7j.3g, :00 ry9s ?? 0 Derates Iron Monument ° Denotes Woo¢Stake - - - • • `,E - I x000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation= (OW.O) Denotes Proposed Elevation Proposed Garage Floor Elevation= 9375 -*-- Denotes Direetion of Surface Drainage Proposed Lowest Floor Elevation= 93&0 I Aereby certity that this is a true and co ,ockrepresentation of a survey of the boundaries ot Lots 53, 54, 55 and Block 2, Tf:02;AS LAKE HEIGHTS 2ND ADDITIoN, Dakota County, 24innesota. - And of the location of all buildings, if any, thereon, and all visible encroachments, ii any, from or on said land. It also shows the location of the stakes as set for a proposed building. As surveyed by me or under my direct supervision this 24th day oi Anr_1 ,19 86, Paul A. Johnso Land Surveyor, Minn. Rep. No. 10938 IANEW CERTIFICATE OF SURVEY for ? CMC(OMBS-KNUTSON ASSOCIATES, INC. ? ?/?? LOYOITVilRlllpNi 3 WO iUIIY[T0113 0 SIT[ 14MMFR3 r? K?? ?ES r Y:j ? .'? ??V? • ? 000 PERMIT # 5 ( RECEIPT DATE: 8002 RUIDEPTL4L PLUM$IRfl PERbIIT APPLICATiON crrY og Eksm 3$30 fILOT ISAOB IiD $AHAA, !!tY 5518E e51-881-4678 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITEADDRESS: `_,l"1I l,cl t I%-Yl w' OWNERNAME:: TELEPHONE#: U'(fl-?U? ? C?(C (AREA CODE) INSTALLER NAME: TELEPHONE #: STREET ADDRESS: (AREA CODE) CITY: _ IQh-CkASTATE: I-M ZIP: J"-C/`t _ SEPTIC SYSTEM, new/refurbished (requires iwo sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water turnaround - existing dwelling unit (+ 5l8" meter'rf needed -$118) Other. _ RPZ: new installation/repair/rebuild $ 30.00 _ lawn irrigation system / Replacement/additional: 1/ water softener _ water heater $ 15.00 State Surcharge $ .50 Total $ I herebyacknowledge that I have read this applicalion, state that the information is correct, and ag `to complywith all Is the applicanYs responsibiliry lo notlry Ihe property owner that the Ciry of Eagan assumes no ' b r any damage operallonal and maintenance activlties to the fadlitles constructed under this permit wifhinr rtylrigKO??yA a City of Eagan ordinances. It by the Cily during ILS normal OF PEF3(9IfTTEE 1I02 COMMERCIAL 2002 BUILDING PERMIT APPLICATION CITY OF EAGAN 14 651-681-4675 '57 --l-C)?- il> 33 l. ? Foundation Onl New Construction Interior Im rovement • Struclural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Coda Anatysis (1) " • CertificateofSurvey (1) • CivilPlans (2) • ProjeclSpecs (1) • CodeAnalysis (1)" • IandsrapingPlans (2) • KeyPlan (1) • ProjectSpea (1) . CodeMalysis (1)" • MaslerExitPlan (1) • Spec. Insp. & Testing Schedule " . Certifcate of Survey (1) • Energy Calculations (1) not always" • Soils Report (1) . Spec. Insp. 8 Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always" . Meter size must be established • Meter size must be established • Meter size must be established - if applicable • ProjectSpecs (7) 1 • EnergyCalculations (1) ! • Electric Power & Lighting Form (1) 1 • Master Exit Plan (1) 1 1 • Fire Protection Plan (i)" b 1 • SoilSReport (1) 1 • MC/ES SAC determination letter . MC/ES SAC detertnination letter • MC/ES SAC determination letter call 651-602-1000 call 651-602-1000 ca11651-602-1000 Contact Building Inspections for sample Food & beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for details. a0 V U O ? DATE: S 6'0 Z WORKTYPE: _ NEW -X REMODEL SITEADDRESS: IS?9- 15g!?13 - 1,5-91, J$rJ3 TENANT NAME: ?DY12p.n X/1 //S A- D, '?/- FORMER TENANT NAME, IF APPLICABLE CONSTRUCTION COST: ao vr75 O't ITE #: DESCRIPTION OF WORK -? Nazne: /VnOiZD.t Phone#: ?( ?-?? PROPERTY Las[ First OWNER Sheet Address: Z,f/ ?'8 Ciry: /7'1/I CS . State: Zip:S"`SY Ze? Company: ?L T -lpYi 3r R/xkkf?, CO,P Phone#: ? ???' ?PZ y 3 CONTRACTOR Sheet Address: S ? ?0 2?- 5?• City: NQState: Zip: S? 711,,F ARCHITECT/ ENGINEER Company: Name: Sheet Address: CiTy: Licensed plum6er installing new s Phone #: fMAY 0 6 2002 State: p: ewer/water service: Phone #: y Registration #: I hereby acknowledge that I have read this application, state that the information is correct, and e to ply with all applicable State of i / Minnesota Statutes and Ciry of Eagan Ordinances. r S?6 d y Signature of Applicant: ? a^- D`?` Updated 1102 75950 THOMAS LAKE HTS 2ND 1582 10 75951410 01 (LOT 65) 1582B 10 75951 420 Ol (r.or 65) 1584 10 75951 440 Ol (LOT 65) 1584B 10 75951 430 01 (LOT 65) 1585 10 75951 500 02 (LoT71) 1585B 10 75951 490 02 (LOT 71) 1587 10 75951 510 02 (LOT 71) 1587B 10 75951 520 02 (LOT 71) 1588 10 75951 450 Ol (LOT 65) 1588B 10 75951 460 Ol (LOT 65) 1590 10 75951 480 01 (LOT 65) 1590B 10 75951 470 Ol (LOT 65) ?1589 10 75951 540 02 ([,or 71) 1589B 10 75951 530 00 (LOT 7i) 1591 10 75951 550 02 (LOT 71) 1593 10 75951 560 02 (LOT 71) 1592 10 75951 490 01 ? (LOT 65) 15928 ] 0 75951 50001 (LOT 65) 1594 10 75951 52001 (LOT 65) 1594B 10 75951 51001 (LOT 65) 1596 10 75951 53001 (LOT 65) 1596B 10 75951 54001 (LOT 65) 1598 10 75951 56001 (LOT 65) 1598B 10 75951 550 01 (LOT 65) 1597 10 75951 580 02 (LOT 71) 1597B 10 75951 570 02 (LOT 71) 1599 10 75951 590 02 ([,or 71) 1599B 10 75951 600 02 (LOT 71) 1600 10 75951 57001 (LOT65) 1600B 10 75951 580 01 ([,ar 65) 1602 10 75951 600 01 (LOT 65) 1602B 10 75951 590 Ol (LOT 65) 1601 10 75951 620 02 (LOT 71) 1601 B 10 75951 610 02 (LOT 71) 1603 10 75951 630 02 (LOT 71) 1603B 10 75951 640 02 (LOT 71) CLEMSON DRIVE 9 (PAGE 4 OF 5) ,. . 1986 BDII.dIIQG PEBIiTf APPLICa7ioll - CITi aF EsC,A9 . HOTEt Aid. COHiAACTOBS MQST BE LICFNSED YIiH THE CIiS OF EAGAH t ? 3INM.5 F1lIL2 DSiE[.LIHCB . - ? ., -:_• ? _?': f , .. z. ._..!•' . _..:' F .y' '_`_'..?.i. 3 ... r,.a_' . '-INCLITDE 2 S£TS OF PLANS? 3?CERTIFICATES, OF SQHOE?j!?-' 1 SEf OF. EN6RGY CALCALATIONS -:r° 'i'?". . : '.. . . -.. .s _: .•j p. ._' :`- - . '_'i_ ,,.. - E :?-. . .i lNLTIPLS nwEL-iIB'e -HE4IDE9S7&i. EEff'fEL`[lNITS t ? ".'F09SAL6 OHIiS. INCLODE 2 SETS OF PLANSO CEHrIFICAIS OE SUEYST - CHECK 1dlTH BLDG.D£Pi.9 . 1 SE.R OF BNERGY CALCULATIONS _ . ' C024MBCIAt _ . . , - INCLQDE 2 SETS OF ARCHITECTDRAL E STBOCTORAL PLANS, • ;'+ ? - 1 SST OF SPECIFZCATIONS AND 1 SET OF , ENERGY CALCIILATIONS, $2,000 LANDSC9PE.BOND To Be Osed For: RESIDENCE 4aluation: :!r ?' Date: p a4r9(o Site Address 1,5-& Lot ILZ Block ?- Parcel/Sub THOMAS LAKE HEIGHTS q_? Ouner NEW HORIZON HOMES. IN(;. 9ddress P. 0. BOX 1367 City/Zip Code MPLS. MINN. 55440 Phone 420-3900 ' Contractor SAME ' 9ddress C3ty/Zip Code Phone Arch./Engr. D. GRISWOLD 9ddress " CitplZip Code Phone # 435-7524 0) ?- ErecE ? Oecupancy Remodel Zoning Repair _ Type of Const Additioa # of Stories Hove - Length ?Cf Demolish _ Dept6 ,(i_ Int.Impr. _ Sq Ft Install 9PPB09AL3 FEES ." Assessments Permit 5iater/Sewer Surclaarge :g,?_ Police Rlan Reviev / Fire SAC 5 Engr Xater Conn ? Planner Aater Meter ro3 O Council Road IInit 2 d Bldg Off -J - Treatment Pl APC Parks 7ariance Copies _ iOiAi. HOTEs ADDflESSHS FDE CORAEB LOSS - CONiEACYOH/HOHEOTiHEH IiQSS DESIGH9TS WHICH ADDRESS I3 DESISED. HO CH9NG£S ifZLL BE 9LLOHED ONCE BUILDING PEHFIIi I3 ISSQED. . lik 1986 SIIII.DIHG PEBlRT dPPLICAYZON - QTr OF EsGAH , . ? , HOiBs AIL COHTRACfOffi !lAST HE LICEFSED YIiH iHE CTlZ OF EAGAIf 3IBCd.B F6lSI[.I i1fiELLIH(L4 r ..? ?.-- w . ' . • r .:. .? .? '? < " . . , . . .,,,; .; ? hu?+_-Y ?'' .. ? L ? .:?' _'. 't 4 _ t S' ; a..r?'E' S.- r ..?Y e ?,Y } - • : -. .;_-.;.;.•. . r . . .? ?,, INCLODE 2±SE'fS OF PLANS; 3?'CERTIFICATES OF SOHVEi1 SET,OF ENERCY CAI.COL9TIONS ."? .- MOLTIPLS DWELLI8G4 - :BESIDEBiIAL BFN2ELDgIT3 FOH'SALB OHI23 IBCLUDE 2 SETS OF PLANS, CERTIFICATS OF SOEYS! - CHECK YITH BLDG.DEPi., . 1 SET OF ENERGY CAS.COLATIONS INCLODE 2 SETS OF ARCHITECTORAL 8 STBOCTORAL PL9NS, a. - 7 SfiY OF SPECIFIC9TIONS AND 7 SET OF ' ENERGY CALCULATIONS, #2,000 LANDSC9PB BOND ?_ . To Be Dsed For: RESIDENCE Valuation: , Date: Site Address Lot !!LL Block o2. , Parcel/Sub THOMAS LAKE HEIGHTS oZ- Ownex' NEW HORIZON AOMES. INC. Address P. 0. BOX 1367 City/Zip Code MPLS. MINN. 55440 Phone 420-3900 Contractor SAME ' lddress Citq/Zip Code Phone ' Arch,/Engr, D. GRISWOLD Address ' City/Zip Code P6one # 435-7524 Erect r'I Occupaney _ Remodel 7.onin8 - Repair _ 1ype of Const -IZA-/ Addition # oY Stories Move Length t/C/ Demolish Depth T _ _ Int.Impr. _ Sq Ft Instali APPHOVAI.S £EES Assessments - Permlt Aater/Sewer Surcharge ? Police Plan Reviev Fire 59C ? Engr Siater Conn plaaner ilater Metier i a Council Aoad Qnit 91012> Bldg OfP 1`ceatmeat Pl ! APC Parks 9ariance Copies TOtAL NO'fE: ADDSESSES FOE CORNEB LOTS - CONTE9CIOE/HONEOiiHEB !lOSi DESIGHASB iTHICH ADDRESS IS DFSISED. HO CHANGFS 1iILL HE ALIAWED QNCE BQILDIHG PEffiiI2 ZS ISSIIED. 1986 BUII,DING PEBFIIT AppLICATioN - CIYf OF EAGAH , - H6'LE2 A!!. OOHiRACfOBS lifTST BE LICEBSED VI?H i'HS CIiS OF EAGAa SIHCd.6 FAlIILi . T • ' e1 ?r?"'-`a ? a ? ? ? .t ?? . . . •?t? .?y . ?.' ?s-g?+?'"i '.S ? -+f ? + .'?3 ? .'.y' ?.INCLTJDE 2 SEYS OF PL6NS? 3?CERTIFIC9TES OF SQHYETq _ i SEf OF,ENERGY CALCOLATIONS .:', ' M[RSIPLS DWELLIBGS EESIDE9TIAL $EZl?AL OeiIT3 FOg` SdI.S [JNR3 : ?? . ? . INCLODE 2 SETS OF PLAHS, CEHiIFZCATS OF.SUEVEi - CHECg SiI2H BLDG. DEPi.V . . 1 SET OF SNERGY CALCULATEONS (Ol1MEBC71L . , _ . -. , . • -. : INCLODE 2 SETS OF ARCHITECTORAL & STEUCTQR9L PLANS, ' - 1 SE2 OF SPECIFICATIONS AND t SET OF ' ENERGY CALCOLATIONS, 521000 S.ANASCAPS HOND ..:_ . ? To He IIsed For: RESIDENCE Site Address ?5&7/ &tC/YU0'AV .Q Lot ?a Slock o2. , Parcel/Sub THOMAS LARE HEIGHT o2- OKnea" NEW HORIZON HOMES, INC. Addresa P. 0. BO% 1367 City/Zip Code NPLS? MINN. 55440 Phone 420-3900 " Contractor SAME 9ddress City/Zip Code Phone el. Erect ? Remodel Repair _ Addition Move _ DemoZish Int.2mpr. _ Install _' APPEOYdLS Arch,/Engr, D. GRISWOLD 9ddress ' City/Zip Code Phone # 435-7524 i'Y) od,c,C - Gl 4- USH Occupaney 3 Zoning Type of Const # of Stories Length ? Depth S4 Ft Assessments -Permit 13P5 Nater/Sever Surcharge Police Rlan Reviev ? Fire S9C a2?-- Eav Siater Conn D Planner iiater Meter g?; ; SQ Council , Aoad Onit 2415 Bldg OffS - Treatment Yl 15eP 9PC Parks Varianee Copies T026L Valuation: ?j ??Q- Bate: ?`oZ?' S!o EIOTE: ADDSESSES FOH CORAEH LOiS - CONTEAC?OR/HOHEOi1HEB KOSi DESIGH9SB iIHICH ADDEESS IS DESZEEI). NO CHANGES WII,L BE ALLO'dED ONCE SDILDING PEffi4I! IS ISSIIID. ;?% - .- .1 . //, 6--), 3 1986 BOILDIAG YEBlQT APpLiCATIpa - CITi OF EAGAH , 80TBS aLL C09SRACfOffi !lQSi BE LICEF7SED liI7H ?HS CITZ OF EAGAII i ? . SIIiGl.B FAlMS DfiE[J.IH('S 4;:2? - "- ? "? t q' ? • . y'. ?.INCLQDE 2 SE'PS OF PI,ANS? 3 CERTIFICAYES. OF SDEYEI? • 1 SE[ :OF ?EIERGY CALCOLAiI0N3 }' ;._ ./?:. . .? . .. ? :'... . '"`.... . .. .e.s .. ..:.. _ i._ • '?_ ?" ? Y "•?? '.r . rioLTIPLS DjiELi.IBG4 - EFSrnWnrrsr HF1N'tEL 'DmIT3 :. • FOE SAI.S IIetliS ' . . ,/ •; - INCLQDE 2 SETS OF PLANS, CEFTIFICATB.OP SQEYES - CHECK YITH BLDG. DEPl., - .• . 1 SET OF ENERGY CALCULATIOHS _ COl4MEECIAL ? ' . . , - . INCLQDE 2 SETS OF 9RCHITECTORAL & ST@OCTDR9L PLANS, a- i- ' 1 SET OF SPECIFICATIONS 9ND t SET OF ENERGY CALCIILATIONS, ' #2,000 LANASCAPE BOND To Be Dsed For: RESIDENCE Valuation: ? Bate: Site Address Loti ?G Block ? Parcel/Sub THOMAS LARE HEIGHTS oZ Oc+nec' NEW HORIZON HOMES INC 9ddress P_ 0_ RnX lRfi7 .. Erect ? Occupaney Jr"3 Remodel Zoning .TF Repair _ Tgpe of Const Addition # of Stories Hove Length ? Demolish Depth ZG Int.Impr. Sq F't City/Zip Code MPLS. MINN. 55440 Phone 420-3900 ' Contractor SAME ? Address City/Zip Code Phone Arch./Engr. D. GRISWOLD 9ddress Citq/Zip Code Phone # 435-7524 y)? ovLc_? ' dq(r Install APPEOVALS FEES Assessmenta Permit iiater/Sexer Surcharge _T^_ Police Rlan Reviev ? Fire SAC !5ZS-- Engr Nater Conn Planner Rater Meter Council Hoad IInit 7-f0 ? Bldg Off S-F 7`reatment Pl APC Parks 9ariance Copies TO'iAL HOYE: ADDEESSES FOH CORNEB L02S - CONTHACIOH/HOHEOTiNEE lIUST DESIGAATS SiHICH ADDftES3 IS DESIBED. BO CHANGFS iTi[,L SE ALIAHID ONCB SQILDING PERMI2 LS ZSSUED. ?i4-..tL?S•1 . -rJ,u,-,,as /_c?, ,+?f-S ?j??' HEATLOSSCALCULATIONS HEqTONG&AIR COP9DlTIOMlNlG CO. MINNEAPOLIS, MINN. Weatherstrips A,S.H.V.E. Construction No. insula[ion Mindows Doors Refarence Guide p?. Wall Int, Wall Ceiling Roof Floor Kind How Applied Yes-No Yes-No 19_ F?•h?v1NG.G??QR? Length Z2- Width HeigM I FI• mAS1fR, U=.hROan Length 'Yp -N49th Haight Windows and Doors-Crackage and Area Windows a nd Doors- Cracka ge and Area No. wiAth at ann HBiDht ol ene No. ol li hIS Lineal h. ol crack Area e. IL No' WIath af ene Hoipht of ene No. of h hle Oneal h. af clack Area tq. ft• 1 e'1? 2 2 9. l 2 21 1-7 I°J .1 a ? ? ? ea Coef Btu Coel 8tu Infiltration Infiltration Glass 2-1-50 Glass Exp. wall X ?12 Exp. wal I !n 7!, Net exp. wall `?„i ?j, q• ? 31 Net exp. well (Cli 9• aS ? -hR"TvBti? 06r' 1 f t7 22,2 Int, wall Cailing :)--2, X 12 ?b Ceiling 1 Floor Floor O! Total Btu. 7 5^I Total Btu. Requirad sq. ft. E.D.R. or sq. lns. W.A. Leader area Required 6q. ft. E.D.R. or sq. ins. W.A. Leader area FL Room Length Wid[h Height FI. ?") ,2»Ul??om Length I5 Width I Q Heiyht Windows and Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and A rea No. Wid?h al a?e Meiq?l ol ane No. oi I. hta L?n eal 1L ol crack Aran +C??• No' WiNh ol one HxqM nl nne No. ul li hts L?neal ft, ol crack Area sp. It. , Coef B[u Caef Btu Intiltretion -roi 224() IntiltraUOn Glass Glass I? r W Exp. wall aC ? r",a?l Exp. wall Net exp. well ,. Net exp. wall Int. well Int. wAll .. Ceilin9 ? X? g ? ,'2•S Cailin¢ ??0 ?•?j ? Floor Floor G U U .A Totel Btu. S 7otal Blu, . e 3a?7 Fequired sq. ft. E.D.R. or sq. ins. W.A. Leader area' Required 6q. tt. E.D.R. or sq. ins. W.A. Leader area FI. Room Length '? a Width Neight ? FI. bl\nx Room 4angth 4. Width 5 Height T Windows and Doors-Crackage and Area W indows a nd Doors -Cracka ge and Ar ea No. Width of dne He,h1 ol DTna Na of li hts UnBal ft. ol creck Area s0. fL N?' W?nw uf xne M? qlq uf ane Na. nl h Pts l?neal 1i. of crack Aiafl s• H. ^ COBf 6[U COBi BSU' Iniiltration Infiltrntion ~ Glass Glass Exp. wall Exp. wnll Net exp. waN Net axp. wall Int, wall Int. wnll Ceihng 12.X.'1 .. Floor 210 Ceiling _? Floor Ct .?i•?,? I?`• Total BW. Total B[u. Aequired sq. ft. E.D.R. or sy. ins. W.A. Leader area ? O Rpquirecl sq. fL E.D.P. or sq. ins. W.A. Leader area ? Saqoied HEAT LOSSCALCULATIONS HEAYING& AiR CONDITIONING CO. MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E. Construction No. Insuletion IAiindows Doors Guide Reference Out. Wall Int. Wall Ceilinp Root Floor Kind Now Applied Ves-No Yes-No 19__ gFl. Q Room Length Width HBi8h1 FI. Room LenBth Width Height Ydi ndnws a nd Doors- Cracka ge and Ar ea Windows and Doors-Crackage and Area Na. ot ene Haipht of ane No. of li hts Lineel ry. ol c rack Area s9 . tt. No' WiC?h ol ene Haiph? af ene Nn. ol li hte l.neel fl. o, c?eck Area sQ. li. s ? / Coef 8eu Coef Btu Infiltretion 311 7(pQ In/iltration Glass Z(1) Glass ExP. wall }( Exp. wall Net exp. wall 2 Q Net exp. wall Int, wall Int. wall Ceiling Ceiling - Floor 10 ;'l (y?] Floor Total Btu. ? Total Btu. Requirad sq. ft. E.D.R. or sq. ins. W.A. Leader area Requir0d 6q. ft. E.D.R. or sq. ins. W.A. Leader area FI, ?m?+ Hoom Length ?,,. Width p' Heipht FI. ' Rppn len8th Width Height Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area No. Widob ol ena Me1qh1 af ene No. ol ii h(a Lineal iL o) creck Anen c4. fl. No. yy???h al uqa He?qht ol nnn No. ol h pts Lineal It. o1 creck Aree sq. h. 1 4aL Ip ` "' ? Coef Btu Coef Bw Intiltretion I 1117 2223 InfiltraUOn Glass ? QQD Glass Exp, well Exp. wall Net exp. II !tg2 01.1 ?, Net ezp. wall Lat?a4i ( Z -70 22 Int, wall 4 Ceiling Ceilinp Floor 2--X I QZ . ? 1 Floor Total Btw ?cb 9-j Total Btu. Required Sq. It. E.D.R. or sq. ins. W.A. Leader area Required 6q. ft. E.D.F. or Sq. ins. W.A. Leader area FI. r ? Length' l Width Height FI. Roan Leng[h Width HOight Wi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors -Cracka ge and Ar ea NO' WiEth ol dna Hai9M1[ of OnnO Na. nf li hte lmeal h. ol [reck A.ea s4. ft• No' W?nm uf nna !u pM1? uf ane Nn. nl h hts L?nenl 11. af erack 4rex ep. IL ? ? Coef Btu Coef 8tv InfilTration Infillrntlon I Glass Glass Exp, wall Exp. wnll Net exp, wall 7Xb 156 q,? Z-40 Net exp. wall - Int. wall Int. wnll ceir„g -- cBnine - f loor 7,-1 ?.? 1 7• s f lonr ---' 7otal Btu. Total Btu. Required sq, f1. E.D.R, or sq. ins. W.A. Leader area Roquirecl sy. ft. E.D.R. or sq. ins. W.A. Leader area PERMIT CITY-0F EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 PERMIT TYPE: Permit Number: B U L L D I N G 033915 Date Issued: 11/ 03 / 98 SITE ADDRESS: 1589 6- CLEMSON DR UNIT B LOT: , B I.IIGK; --r?i :)- THOMAS LAKE H75 2Np P.I<N.e 10-75951-S30-02 DESCRIPTION: rf'?.?..? C,flS ZNSERT/GAS LINE B.iildinj-P.,ermit 1-YPe FZREFtACt ?U11dlnQ Wo'r.k,, Type ALTERATION Census CQde 434 AL7. RESSDENTLHL t? \ t 1 ? REMARKS: CWZMNEY/FI.UF, IqUST 6E l_M5PCCTEQ BEFQftE CUNCEAL.INGe FEE SUMMARY: Base Fee $50.0e Surcharqe 50 TotaJ. Fee $50.5m CONTRACTOR: - flppli.cant - sT. t.zc, OWNER: FJRESIDE CbRNER INC 16331042 20090911 CALIGUIHE DAVE 2709 N FAIRVIEW flVE 1589 CLEMSON DR ROSEVILLC MN 55113 LAGAN MN 55123 (i612) 633-1042 rF???nF?-??o4 ? B I hereby aeknawledqe tMat S have read th`ss applieat.ian and sCate Chat the information is cnrrect an,d a9rea to complv with all appl.icable State uf Nln. StaCutes and Gity pf Eaqan Ordinances. APPLICANT/PERMITEE SIGNATURE I ED BY: SIGNATU I CITY OF EAGAN 3830 PIIAT KNOB RD - 55122 1998 FIREPLACE PERMIT APPLICATION 681-4675 DATE: /I - ) State: n? /?j Zip: ?la-,3 DESCRIPTlON OF WORK: nstruct new fireplace Alterations to existing _ lnstall eaa insert onlv "?sfall gas Iine oniv ' ? ? C? (-?r- Other JOBADDRESS: cm?SO n f--?" LOT: BLOCK: ? SUBD N/P.I. . #??'l?`?0.,? ?-?-e APPLICANT (circle one only): OWNER CONTRACTOR ? I hereby aclmawledge that I have read this apptication and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Nemr. rai/ rl..i )?4t vV P6one #: PROPERTY Last First OWNER Signamre: r_ Street Address: `-S-9 / City FIREPLACE INSTALLER GAS LINE INSTALLER City Street 1t-3- q ? PERMCT FEE: $50.50 Phone #: Wo-e?7? / ?License # U9G9 /f State: I/?N Zip:Z3 3,,l- ? Phone #: PERMIT -)0 CITY QF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 SITE ADDRESS: F'.T.N.: 10-75951-530-..02 DESCRIPTION: PERMIT TYPE: Permit Number: Date Issued: 15C3 rLFMtipIV Dft UNT'T [i 1-07:r>3 EII_QCK: ._ 7H(7P'Ir;S LAk.E NFTf3NTW ''Plfl -.` GAS INSE:fil`/GAS LINM Tyne =TREPI.ACE d?i1d.1nq Wo-?-tk T'ypp, ALTERATION zeerstts Cps1e A31 flLT. RESIOEiu.'rZ4iL ? ? B uxi.n rrdr, +fi34">_0 :; 1.?/:L1!9S t ( t 1 ._.. .J 11 . _. .._ ''v...ICJ ra4 0 S.? ? {.ii REMARKS: CHIIqNEY/Fi,.UE MU,T HE IiVR4?EC;7EfJ PFFOItE CpiVCG_F31.TNG. FEE SUMMARY: Bfsse Fee $60.00 Surchar?qe ?;.,5rp .. Tol.al 4=ee ,?,?'SB, S+A CONTRACTOR: - Aaw.l.zcaiic -- OWNER: WALTER COPI'1'RfdCTING 18618013 CAL16UTRE IlAVE 74-l'G) GOLUMBUS A1lE S 1359 C1.FhISON Cifi F I?:ftNFTL'I_D MN 55423 E61GA i'2 I+1N 55122 (8-92) 861-801:3 (651)451-7149 I hereby aeknawLecloa that :E have raad thi.5 ap;slicatiao and stato Lhat th2 information a.s ctrrrect and aaMoe td complv wat;h a11 apPli.Gattla ST:ate aF M1n. 5tatutes and f.4t;y Ofi £aAan OrcJinanees, I APPLICANT/PERMITEE SIGNATURE -(-ISSUED BV: SIGN TUR I CITY OF EAGAN ? 3830 PII,OT KNOB RD - 55122 1998 FIREPLACE PERMTf APPLICATION 681-4675 nATE: i2 -/v -- y'6' DESCRIPTION OF WORK: JOB ADDRESS: Construct new fireplace ? Insffill ¢as insert ontv Other LOT: BLOCK: I/: 3 v,5;"-- , ? PERMIT FEE: $50.50 _ Alterations to existing Install ass line onlv APPLICANT (circle one only): OWNER ON'I'RACTOR I hereby acknowledge that I have read this application and state that the information is coaect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY OWNER FIREPLACE INSTALLER GAS LINE INSTALLER CO.-?i C? ui Y`C? Name: I il?/? 4 t ? Phone Last / F"vsf'? Street Adc City _ Company: Signature:, Street Adc r ciri 1 Street State: SUBDIVISION/P.I.D. #- ? V\.OVY???, 1 a } -c /. Zip: Pdone #: ?? -,?d! 3 ?License # State: Zip: S S?f }? \--'?CtTY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (651) 681-4675 SITE P.I.h!.e 10-75951-540 -V2 PERMIT PERMIT TYPE: 8 u?11- D r iu c Permit Number: 03 45 q? Date Issued: 8 2/19J9S 18 9 i'LEirIi'd il?i L07e 59 CIOCi<t 2 7IiOMAS Li1KE HFICiHTS ?iVD DESCRIPTION: Eu,F't'1.d1ri9...;Permi.t, Tvpp a.clsr7a 4inrtf< r,;p F ,l:enstas Coeie ? 1 I \ . ? \`..L'4( /.. i ...?. i'113EirIEiV7 F TP:Iti A1_l.'tRAl"T(JN 437 HL'I'. RES:CftE iVT1f;L ?, ..? ...:-. . ?..: _ . , , . ; . ? i.._... REMA?KS: ?d eV 1EWF? e;Y WA vN F 111zi i.1_R. :;EF'FRATE PERM:Ll- `r2EQUTRED FOR ANY pLUP7f3.LPIG 6JCIRK. CfaLL 1F121 445-:_'.89V) h'fil7flfdC1:1:N6 E1.LCll?Ti:;AI, PrRWCT NNp 1i456'FCl"jUiVS, FEE SUMMARY: B,,se Fee ;ur,r,.t7arcI E 7(D tai Fe??? $ 6 0.0 0 . s E? --- - - ? -- 1;£i0.5t) CONTRACTOR: OWNER: - Rp p - st:riA r r eh _'tarc ? 1589 cLEr4sUN na E A 6 AN NIN 5 S.1 i 65 I.7 4 0 E-3 8 39 ? riervbv ,ackncawieeiqe that l hrive rearl tYii? applic:ation and state thaC 2.he ,n?brrnaT.iort is carreci ai7d aaree 'ia eamply wiLh a11 app:_ir.abla State cr-F Rfin. atatruY.'2: an.d Czty ot Faqa.n Gral.rnances.. kLY D BV: SIGNATUFE APPLICA NT/PERMITf IGNATURE IS ?? jc'l Ci ? 44-096-BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII,OT KNOB RD - 55122 ? 681-4675 1 ( '?' Q , S-6 New Construetion Requirements RemodeVReoair Reauirements ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (inGutle Deam 8 window s¢es; paured fid. design; etc.) -• 2 site surveys (eMerior edd'Rions & dedcs) ? 1 energy calculations ? 1 energy alculations for heated additions ? 3 copies of tree preservation plan ff lot platted after 7/1/93 required: _Yes _ No DATE: a IS/G}'g' CONSTRUCTION COST; DESCRIPTION OF WORK: ,ASP,a?r?P??' STREETADDRESS: ISS9' GI1?r.v1'?SD? I?i^. LOT: -541_ BLOCK: _ 2 SUBD./P.I.D. #: Thnmas LeAle, N&.i.A rS ;L-*Aa? PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER xame: C. Phone a: 65/- ?'/OS- 3 8 39 Last First StreetAddress: ???gC? ?/'- City ?Gtfwr's.r/? State: Zip: Phone #: Street Address: City Company:_ Name: Street Address: Ciry Sewer & water licensed plumber (new construction onty): and lot change is requested once permit is issued. Zip: Penalty applies when address chang I hereby acknowledge that I have read this application and state that the infortnation is cortect and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received State: License # State: Zip: Phone #: Registration #: _ _ Yes _ No Tree Preservation Plan Received - Yes - No - Not Required L "? `r! 1 BL CITY USE ONLY RECEIPT #: 14alq SUBD. I YA 0 M C1 /V ?a RECEIPT DATE: PERMIT# 1999 PLUlYI$tN6 PERM1T (ftESIDENTtAI-) crrYoFEAsAu 3830 Pu.oT Krros itn EA6AN, MN 55122 (651) 691-4695 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas i in outlet ' minimum -1 3.00 X = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ Laund tra 3.00 x = $ Lavato 3.00 x = $ Minimum fee alterations to existin dwellin 30.00 x = $ .39•00 Private Dis osal S stem new/refurbished * re uires MPC iic. 75.00 x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rou h o enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dwellin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener if dwellin under construction 5.00 x = $ Water softener if existin dwellin 30.00 x = $ Water turnaround 30.00 x $ State Surchar e .50 --> ---> ----> $ .50 Total --> --> ---> _.a $ 3a.5-,D Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. ----•--------------------------•--------------- -------- ---•------------------ -----•-------•-------------- . I hereby acknowledge that I have read this application, state that the inforrnaUon is correct, and agree lo comply with ail applicable City- of E-agan-ordina- nces--- It is the applicanYs responsibility to notify the property owner lhat fhe City of Eagan assumes no liability for any damages pused by the City during its normal operationai and maintenance activities to the Tacilities consfructed under this permit within City property/right-of-wayleasement. S1TE ADDRESS: Snn i?r'- OWNER NAME: :F//G SC.?tU?d2!' TELEPHONE #: f/ -1/05- 3 8'g9 (AREA CODE) INSTALLER NAME: TELEPHONE #: Q ?? - y?_F-~3 R3 ? STREET ADDRESS: I -SS ? C? ' .SV?l ,v.- , (AREA CoDe) CITY: ? c.?7 STATE: ZIP: ? SIGNATURE OF PERMI E 759371-530-00 L-0T -?/ L BL O? CITY USE ONLY RECEIPT #: _Q li SUBD. DATE: D / l? 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Piease complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit _ New construction ? Add-on furnace Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Qa±e: 0\ -aC; -CN k,:, ? Minimum Fee: Add-on/Remodel (existing residence on ? HVAC: 0-100 M BTU Additional 50 M BTU ? Gas Outlets (minimum of 1 required @$3.00 each) ? State 8urcharge TOTAL FEES $ 20.00 24.00 6.00 .50 C1120 ro S!?E ADDRESS: k S$ `? ? C-?eM So r-, e_ OWNER NAME: PHONE #: '-A Sa Z? INSTALLER NAME: STREET ADDRESS: ?1? o "? ? •--.? ???? ? ?t? ? ?- CITY: _ 1.-e.-?`sLv-.\\a- STATE: p'r? ZIP: ?c?"•'?T ?HONE #: ( (p\,)-) CITY OF EAGAN ... . • .?,e:, APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *ATS: PAYMFWOF FEE AT TSM OF APPISCATZON DOES L3JT amr= APPROVAL OF PERpIIT. T,SoECTIoN oF sEM rsm/oR Mm nOrnr.ramrCNS WII,L iVt7T BE SCHED- LJIkD UD7'1'Q, PE:E2MIT HAS MM r,rPxovID. ' lrlease rrinLl , • 1) PROPERTY ADDRESS: br• M •- .a LEGAL DESCRIPTION: Lot B oc Snb ivision or Tax Parce ID #) ? , ,_ ,: , . .??- b_ . , , , .._;,... , :.. , •- ' .:::: ` s F:-a=; :; - IF' EmSTTNG S7.RCCIL7RE. DATE OF ORIGINAL BvII,DING PERMIT ISSL'ANCE: ' -. (Man ear) - .,,.,. 1 PRESENP ZONING//c+?v?? POSID USE •.") ?? 7bZy,.v4', y.. ?}cZ2 ? n . .., iK,^k'? ! . :.:.... 'i y v ,TS- ?. 1ry ,'{???d.'.. f :k.wf? T94 ?4'1 K ' " P ? /OFFICE , Q R 1 SINGLE FANIILY i ? 4. . . . : .' .. :.. . . Q ?.sxxIAL _'c ? . a INSTI7L'TICm1AL/GOVERI?,'NT ?( R 3 1+OMIIi0L'SE (Three +-Uni?, - ts) ,. .. . R 4 PART(?TT/CQrIDO ID7It?1 ( : . _ _. . ?( .?A M _ Ututs) ,, _ , , .. . . ;, .:.. . .... .. .._ . ... Y ±;.. . •5) ? r• ? r• • ?• : o • na - a? CONDIDLTION TO CITY SEwE12 ? CmSIF1;.`PION RO CITY WATER [3 OTSm '. .• 6} n ••• r E3 PLEASE HOLD APPROVED PEEthIIT F?DR PICK- BY ONE OF A80VE '-- •--. .. ? PI?EASE MAIL APPRCJVED PERMIT TO I. 2.? 4. AHOVE . c (Ciscle one) » I,[WA ?'??nl` wn-,r, VU??? / I?. ?A?A., . ? s . .. _ :: . ? ` , . .. : 4 ... . _ r, . .. . ...1 , . ? , : FOR' CITY USE ONLY PERM IT # ISSL'ED s12 1Y 4 ? - 3 _ ' Pd w /Bldg. Permit FEES: ? ?h . ? 77 _ . ? ..?. . . f ?"..e .yy_•Y• . - .. . ?.,?R .?>A... _ I. ? i. ?f .. . . . ?.. *'"'1SEWER PERMIT' (INCLLDE ....r . RkN SURCHARGE) y . : ., .. .? ^ , , ,.. -' s..w.?. -._ ?,..u. _ . . ,. ... ?_ $ ?M..??.?'r.y . .[J._=? , , • WATER PERMIT ( INCLLDE - SC'RCHARGE ) ., . 777 77 777 5.wn 77 ? ? i7 ?-- - '• - $ -' ? `WATER METER/COPPERHOR N/OCTSIDE READER , yM$.,. ru'?mnID trnlrrrmF rnannunmTnN amnnI w.. ' ?'v f???'l'?•l ?er: /?>„-. $ ... ?;? i t? ?? _ - _ _ "?-C??` ^ ,_ ? e?• ' ?. $ , . _ 6',N1'._Tit:•f ' . . . ?E?'StiP'/TRCNK SEWER BENEF;T/TRONK WATER .'') , .. . 1"I..W. : RECEIPT DOES,FTILITY'CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OFFWAY? ? YES IF YES, -THEN'A "PERMIT FOR WORK WITHIN PUBLIC` i ° ROADWAY"MLTST BE ISSLTED BY THE ENGINEERING NO DIVISION_ LIST.AS A CONDITION Q . . . ? r ut ..,. ' ,e: . :. 51 SUBJECT TO THE FOLLOWING CbNDITIONS. . . . ., APPROVED BY: TITLE• ." • t - ?, . ?3,• .s? i DEPOSIT = "Sl DEPOSIT - Wi WAC 4 , t h'SAC ' ,TRLAI& WF4TER' ? • DA T$ .. . . : .' . ... , . ._ . . .....E... : ?,..ft . ? .. -_ . _:._:. _ .. .a ..... ^1 "_ "' : . -.... .. r ... . . ? , ...? . ..... .i..Y.... _ . . , ,..._ ? CITY OF EAGAN :..- ,. .: ..:... . „_?. APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *1OP3: PAYPff•Nf' QF FEE AT 7DZ OF aprLIcAazoN mEs Nom oxo.zmm pIpPROVAL OF PFltMIIT. . iNSrnc'riorr oF sEWx ArD/ox MM 7risrlv.raTipNS yiR.r. N7r gE Sam- UI.ID UNt'M PERMIT AAS BE'IN APPROVID. ' _ . . . . ? ..,. rlease Yrintl , PROPERTY ADDRESS- C,ftvrf?r? , . ?: • LEGAL DESCRIPTION S 2- ,... . ?,. Lot . ? ' B ockj Subdivision or Tax Parcel ID . . .<.1 ?. _. . a . ..., . ., . . ' : ... . _ ...,. . . , i? a . . • _. .. . -•--. . -.?,...... ....... . ' . -•^ ? . ._.?. . ' IF E7QSTING ST12L'Ctf)RE. DATE OF ORIGINAL BLIILDIN; PERMiT ISSCANCE: ' . Mon YearT .. ? PRESEDTP 7ADTING/PROPOSID LSE. y? ? A W KS rt n# $ ? C^t4'"n??Q?2? . ? Y ,ye h R 1 SINGLE FAMILY ;, y '1d !. ;. . - . . . .. TTIDL''1RIAL ; : . r . 1 R 2 ;D[.'PLEX (1t.a C?ni.ts) R 3 10WIUi0LSE (Three + Umts) IIn.its) . il> ? . ? R 4 ? ARTMENP/CObIDOMLNIL?Nl ( U[Ltits) }- ? '2) ?. . . .?: ADDRESS: CIT3C, SPATE. ZIP: - ?-? ' 3? ' u ?: ?• ' For City"Ve .. NAME Plumbers License: ' 14DDRF55: +?i? - ? EScpirecl QTY. S"fg'CE, ZIP: . _ Not recorded 4 . = __. . _? . .. ' PEHONE: • MASTER LICENSE# 1-7 St-- aff--Initxal •$) ? :? v? r• • ?• : a - a• ^ ?? . . ? GUNNCTION 1D CITY MM ? CONDIDL'PION M CITY WATER a (YTFIER ' .. 6) i? r• u• • r ? PIEASE HOLD APPROVFD PERMIT EY)R PICK- BY ONE OF P.BOVE -. --•- - ? PI?EASE MAIL APPROVID PERMIT Z?D 1. 2, ? 4. ABCR7E 1 c ??t (Circle one) . . . .- 7) ?f`71Gt ?'S??'Ia/A nll` s.w-.rm UI/???1 f7? . rA?A., :? . 5?Ii . ?.. . ' . .-.. . . . - ., . , . . . %?Y" - . . . .., ? ?S ' : . . ... - . • 3t !.. . . ,rt ..? ?: -'.. -.: " :.. .... :.; . . .2. .. . . ".' . . .. ' ' I . _' t ..? . _ J.... . FOR CI TY U S E ON LY ' &: - ,,? , : ... PERMIT # ISSCED 771 ?7 3 Pd w/Bldg Pezmit FEES: Rta . Y ?.. . '. .$ ? • : = SEWER PERMIT•(INCLLDE SLRCHARGE) "$ WATER PERMIT (INCLODE SURCHARGE)' ' ?s A.?d'?' r :• ,. ` ro i ,. t e..='s?.. , "y ?.W. .....,' `A y'.?.. `2 ?','TY mi"•':.4 z+. ?"` ?^t WATER METER%COPPERHORN/OL'TSIDE READER - WATER TAP ( INCLUDE CORpORATION STOP ) ?t, 'v° Ci.r. ? a e K v ?A ._ ?P^ S"rs?asw ? a "*6?- ?yM1A .t -S u ? ..?,e 5 -!^? n Szn a l t k .fr ?k ?m ? Yt???kia -. r a s u R 'S'§.?' T' ?tf$' '"' h?.. 1G[^Y, a !a-ry . L y e 6 Z ACCOLN2` DEPOSIT SEWERy,? ?^.? .?a ?4*v3 , L'gV $ ACCOLTNT? DEPOSIT 'C f `?? S z ?f { iY'?° ?f"? ? q s ? ? ) R ' ? ?a t3tia?."?X^ x T` r? ?A`Y 4 51`?'- • 4 ? ? _e? " •?r qs ? .uY WAC t is4? 7.' . u- . ._ v ; i 3 .?I'° a?r`.' ? y„dt ?-?,? • `SAC • •. •., ' "?r?.j` T ;c} ?Y-?v.y=;-s?-..2? i*?-,.??"r"3 .:y Fx-.aG1?+.?? ?,r S } $ c, ;(???; r ?Td2LAIK WATER P?tS?S?SSMENT aF ? ??'?_, ..??? ? "' ?a + ,?.? .+°?4 n'1dY __. '1tt1> ? S 1 (ZJ $ - $ ` i,,,'T$E'NI??SE YW?.F$? A?S?35MENT ? ;$ , ':- .>.. .,.: . .y::.x '. a.:,p'?..3.., .., ?,•.x;-- .1'i ' ' LATERAfi NEFfT/TRLTNR SEWER $ - TOTALi. WATER . RECEIPT RECEIPT?? ! 'F`" (,.,;?' ? ?ti`p' ??+ ?xy?'Ya??;`?'`;??' ` :e.. .i .. . .:.: .? .....-,..:..-. ..a .v..r.i........ .'e7M1us.a. DOES UTILITY CONNECTION REQOIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THENA "PERMIT FOR WORK WITHIN PLBLIC ? ROADWAY":M(!ST SE ISSL'ED BY THE 8NGINEERING NO DIVISION. LIST.AS A CONDITION. , s . . _ SUBJECT TO THE FOLLOWING L'bNDITIONS: APPROVED BY: TIT U . = , _ . a ? . ? . v'N . . ?... ? . . ' = ' A £ ? . . . ?--?Z '' • . ? C? _: p . ? p _ ? : ..J': . x ; .._ . , , ? D . T 3 . „ Kxrr?, - ? : ? . .. i . , `? . . . . . . . . , . . . .? . . . . . . .? . . .. . . . . . - ... . «? . . . . . ? ... ?'s? ?- R . . . . i , , -.,. APPLICATION FOR PERMIT CITY OF EAGAN SEWER AND/OR WATER CONNECTION ^T(Yln: PAYmRfSf OF FE6 AT TIME OF arrr.scATzoN mES NOr oorSTITUTE APPROVAL OF PFF44rP. niSPEMox oF sEWM Arro/oR kWTM a r.ramrONS yTII,L AK)T BE SCHD- UIED UN1ZI, PERMIT HAS BEQ9 APPROVID. 1) PROPERTY ADDRESS: lc??? LEGAL DESCRIPTION: _ ?,- Z` Lot Block75ubdivision or Tax Parcel ID ) IF EXISTING STRCCIL'RE, DATE OF ORIGINAL BL?ILDING PERMIT ISSL'ANCE: -~ i YRFSENr ZONING/pROPOSID L'SE: (obn ear} COMMERCIAL/RETAIL/OFFICE Q IfIDL'STRIAI, ? INSTITL'TIONAL/GOVII2pAg,'DpP ? R-1 SINGLE FAMILY R-2 DL'PLEX (Ttro Units) ? R-3 TOWNHOIISE (Three + Units) ( Onits) R-4 APARTMEDIT/CONIDOMINICTI ( Units) 2) ? -- NAME; ivew ytotj?dj Horizon Homes ADDRESS: 13805 86th . CITX. STATE, ZIP: S4inneapolis, MN 54440 PHONE: 42U-3900 3) N{ME; Thompson Plumbing For City Dse Plumbers License: ApDRESg; 1Y201 Minnetonka Blvd. Q Active ? CYTY, STATE, ZIP: Minnetonka; hiN 55343 ?ExPired Not recorded PHONE: 933-2521 MASTII2 LICENSE# 1763M Staff Irutial 4) ?•• • ? i?• NANiE: Same ae Ik"L ADDRESS: CITY, STATE, ZIP: PHONE: .5) ? r• •t a: ?• : o • s? . ?,? PCONNECi'ION 1C3 CITY SEWIIt ?6>ONNS(,TION M CITY WATER a prrHM '. . 6) PLEASE HOLD APPROVEO PERMIT FOR PICK-UP BY ONE OF ABpVE Cr'4F_ASE 1 / ,?. L APPROVID _?? ? ' PERMIT TO / 1. 2?4, ABOVE (Circle one) FOR CITY USE ONLY PERMIT # ISSUED 7 5S z & Pd w/Bldg. Permit FEES: $ $ /G SEWER PERMIT (INCLDDE SURCHARGE) $ $ ?G •• Sd WATER PERMIT ( INCLLDE SORCHARGE) .. $ !o ??-S? $ WATER METER/COPPERHORN/OCTSIDE READER $ $ WATER TAP (INCLC'DE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ SG? 4 r) $ ZJ WAC / $ CJ 27 $ O d SAC . $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ /5Z- $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ TOTAL ?- 217? RECEIPT RECEIPT DOES LTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN POBLIC Q ROADWAY" MLST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING tb[VDITIONS: APPROVED BY: TITLE: DATE: J/? a /t 4 , CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *IOTF: PAYM?LC OF M AT qIM pg ArPtscAMorr noFS Nom oorsrITUTE APPROVAL OF PE[tFIIT. INSPDCTION OF SETM AAID/OI2 P7F+,TER ZNS'I'ALLATIONS WII.I. NCYf BE SCHIID- UI,F.D ONI7L PfPIaT HAu BmV APPR(3S7ID. - .. 'r**i##*************!#*#*****#*fr****Y P ease Print) ? 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: rj Z •- . %LUciniocx/sunaivision or Tax Parcel ID-#) IF E7QSTING STRCCiS,R2E, DATE OF ORIGINAL BL'ILDING PERMIT ISSL'ANCE: . -- i PRFSE[JP ZONING/pROPOSID L'SE: (mbn Year [] COAME,RCIAL/RETAIL/OFfTCE IDIDCSTRIAL ? INSTIZL'TIONAL/GOVERbZ1ENT ? R-1 SINGLE FAMILY R-2 DL'PLEX (Z4,o Onits) R-3 10WNH0[7SE (Three + Units) ( Lnits) p R-4 APARTMENT/CONIDQiKiNIUM ( Units ) NFVVE: New Horizon Homes ADDRESS: 13805 86th Ave. No. . CIT'1'. SPATE, ZIP: Minneapolis, MN 55490 PH0NE: 420-3900 3) • u c ?• NAME: Thompson Plumbing i 2) ADDRESS: 12201 Minnetonka Blvd. aTl', STATE, ZIP: 24innetonka; MN 55343 PHONE: 933-2521 MASTER LICENSE# b 4) •a• a ? I?• - NAMg; Same as lf 2 . ADDRFSS: C221'. STATE, ZIP: PHONE: .5) ?CON[gCTION TO CITSC SEWIIt Plumbers License: Active FStpired Not recorded St IIl7.tid1 TION 2OCITY WATEEt Q pTfER 6) PLE75SE HOLD APPROVID PII2MIT EY?R PICK-OP SY ONE OF ABOVE PLFASE APPROVID PERMIT TO 1, 2 4. ABOVE ,? ? (Circ e one) 7) r r• u• - .. ' PERMIT # ISSL'ED 7Z/"'?l / ?):12.? IC 9 Pd w/Bldg. Permit $ $ S-D FOR CITY USE ONLY FEES: $/G-5-6 S /G-Sa S SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SORCHARGE) WATEF2 METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLODE CORPOBATION STOP) $ $ SEWER TAP $ $ $ / ACCOUNT DEPOSIT - SEWER $ ACCOONT DEPOSIT - WATER / v . $ Gr7l I WAC ? $ lr-a $ 166r-o SAC $ $ TRCNK WATER ASSESSMENT $ $ TRC'NK SEWER ASSESSMENT $ $ ' LATERAL BENEFIT/TR[!NK SEWER $ $ LATERAL BENEFIT/TRL'NK WATER $ WATER TREATMENT PLANT SURCIiARGE $ $ OTHER: $ S J-4 U 7i TOTAL 29'6- 3 ? zi 72-- RECEIPT R ECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SOBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE: ?ru RESIDENTIAL ? 13?e?zy? C)" BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EACAN MN 55122 651-681-4675 g/lo? New ConsVUClion Reouirements RamodeUReoair Requirements ? • 3 regisfered site surveys shovring sq. ft. of lol, sq. ft. of house; and all roofed areas • 2 coDies of plan (20% maximum lot coverage allowed) . 1 set of Energy Calculatbns tor heated adtliGons • 2 copies of plan showing 6eam 8 window sizes; pou2d tound design, 7 sde survey for eztedor additions & decks • 1 set M Energy Calculations . Indicate i( hane served by septic system for additions . 3 copies of Tree PreseNation Plan'rf bt platted aker 7f1193 • Rim Joist Detail Options seledion sheet (61dgs with 3 or less unils) DATE SITE ADDRESS TYPE OF e al..rm ., MULTI-FAMILY BLDG `----"Y _ N FIREPLACE(5) _ 0 _ 1 _ 2 APPLICANT PtIC C+rt!'??..?-??^ STREEf ADDRESS P? a• OeX ?10( CITY TY/S?r/ STATE h? ZIP TELEPHONE #o? CELL PHONE #!( ff ? 33r- 3s3,A FAX # G rc -15t _S?S'ov PROPERTY OWNER TELEPHONE# COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNL,SOTA RULES 7670 CATEGORY 1 MINNI:SOTA RUI.ES 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calcuiations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor: Mcchanical system includes: Sewer/Water Contractor: _ Air Conditioning _ Hea[ Recovery System Phone # Fce: $90.00 M6Y ll I hereby acknowledge that I have read this application, state that the informatiorris correct, and agr_eq to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant "?- OP'I+ICl: USE ONLY _ Watcr Softener _ Watcr Hcater _ No. of Baths ? VALUATION '?1&0001 Phone # Lawn Sprinkler No. of R.I. Batlis Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex )c 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or_ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn.(4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ex[. Alt - Multi ? 33 E)ct. Alt - SF ? 36 Multi ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Oemolish (Bidg)* ? 43 Reroof ? 46 Windows/Doors 1? 34 Replacement 'Demolition (Entire B ldg only) - Give PCA handout to applicant V e'? ; ? aluation - Occupancy ?MGES System Census Code ? Zoning City Water SAC Units ? Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const ??? Width ' REQUIRED INSPECTIONS Footings (new bldg) FinallC.O. ? Footings (deck) ? FinallNo C.O. Footings (addifion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacemant) _ Insulation _ Retaining Wall Approved By 2, , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ..?-- 046'?_ c?-u RESIDENTIAL ? BUILDING PERMIT APPLICATION ?i39_c?c? CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 5 122 659-68'1-4675 ???-9- ? Zs New Construction Reauirements Remodel(Reoair ReauiremeMs . 3 regislered site surveys showirg sq. ft. of IoL sq. ft. of Muse; and all roofed areas • 2 copies of plan I?'/J? ? (20%mazimum lol coverage allowed) . 7 selof Energy Calculations for heated addTons -S- • 2 copies of plan showing beam &window sizes; poured found design, etc.) . 1 sfte survey forenterior additians & decks . 1 set of Energy Calculations . Indirate H home served by septic system for additions • 3 copies of Tiee Presenalion Plan H bt plafled a8er 711193 r, ? fl (? „^ __' • Rim Joist Delail Options selection sheet (hldgs wiM 3 or less units) 0 a-DATE S-r'I -'DX VALUATION SITE ADDRESS MULTI-FAMILY BLDG LY? _ N TYPE OF WORK I?v c.Ic 4Q??Ia?e .a+. ?.? FIREPLACE(S) _ 0_ 1_ 2 APPLICANT STREET ADDRESS ,• b? l3?.t ?Q6 CITYTyIe.r r*,I(i STATE Jk""ZIP -SXa Y TELEPHONE # 65?_ ye? ?D-P CELL PHONE # 6Sl " 335- 3t 3A FAX # Z r`c ?,??dc? PROPERTY OWNER TELEPHONE # ----------------------------- --------------- ---------- --------- -------------- ------------------ COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNI:SOTA RULES 7670 CA"1'liGORY 1 MiNNCSOTA RUI,ES 7672 (J submission type) • Residential Ventilation Category 7 Worksheel Submitted • New Energy Code Worksheet Su6mitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing systcm includcs: Mechanical Contractor: Mcchanical system includcs: Sewer/ W ater Contractor: Air Conditioning Heat Recovcry Systcm P'ee: $90.00 % r_ c _'J1 ,# 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 Ordi s. _ Signature of Applicant «lT ? OFFICI', iJSE ONI.Y _ Waccr Soflener Wacer Healer No. of I3alhs _ Phone # Lawn Sprinkler No. of R.I. Ba[hs Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated al02 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 31 New b 32 Addition O 33 Alteration ?L 34 Replacement ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 Ext. Att - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 WindowslDoors `Demolitfon (EnHre Bldg only) - Give PCA handout to applicant Valuation 2('a Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const ? ??? ) --b?-I-'?L Occupancy Zoning Stories Sq. Ft. Length W idth MC/ES System City Water Booster Pump PRV Fire Sprinklered REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. Foorings(deck) V FinaUNo C.O. ? i Footings (addirion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Au Test _ Final _ Windows (newlreplacement) _ Insularion _ Retaining Wall Approved By T2, , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage 5&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ? 07 OSplex ? 13 16-plex ? OS 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex X18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N ?? ?a? ? 70_ sbaU RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55722 651-681-4675 ??`'? ??w.,?-(o New Conffiruclbn Reauirements RemodeUReoair eouirem is " ? I ,? • 3 registered sde surveys showirg sq. ft of lot, sq. tL of house; and all roofed areas • 2 copies oF plan (20%maximum lot coverage allowed) . 1 set af Energy Calculatbiu for heated additions , • 2 copies oi plan showing beam & window sizes; poured fourM design, etc.) • 1 site survey for e#enor addNOns 8 decks • 1 set of Energy Calculations • Indicate it home served by septic system for additions • 3 copies of Tree Preservation Plan if lol platted affer 711193 . Rim Joist Datail Oplions selection sheet (61dgs with 3 or less units) DATE > ? `t ' VALUATION SITE ADDRESS 1S?( CIc S-f.. Qn MULTI-FAMILY BLDGt,2Y _ N TYPE OF WORK ??<I teeD/tce ^`w I_ FIREPLACE(S) _ 0_ 1_ 2 APPUCANT doi/C (?cwP?rt. c k. -, STREETADDRESS Pr0 . 0mx 9rld CITY 't ?'' `d% STATE A'"'ZIP --<r0-:FY TELEPHONE #&' F$`l' d?6C CELL PHONE #4*SI^ 3 3S- 3372A FAX # Z-d`c '7F0 O PROPERTY OWNER TELEPHONE # COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CA`I'LGORY 1 MINNESOTA RLII.LS 7672 (d submission lype) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Su6mitted . Energy Envelopa Calculations Submittad Plumbing Contractor: PlumUing syslem includes: Mechanical Contractor: Mcchanical systcm includcs: Sewer/Water Contractor: Air Conditioning Hcat Rccovcry SysCem Phone # Pee: $90.00 Fee: $70.00 k ? m T 0 U T KAY-0 q 2002 ---------------- - is correct, and agree to comply -------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the infom with all applicable State of Minnesota Statutes and City of Eogan Ord?inya?nc Signature of Applicant -------- -------- ---------___-_------------------------------ ----------------- - -----°------- OrTICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Water Softener _ Water Heater _ No. of Baths Phone # Lawn Sprinkler No. of R.I. BaChs Not Required _ Updated 4102 OFFICE USE ONLY ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 04 02-plex ? 10 08-plex 1$ 18 Deck ? 23 Porch(screened) ? 05 03-plex ? 11 10-plex O 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation ?Ln Census Code SAC Units Nbr. of Units Nbr: of Bidgs Type of Const ? ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bltlg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bidg)` ? 43 Reroof ? 46 WindowslDoors •Demolition (Entire Bldg only) • Give PCA handout to applicant Occupancy Zoning Stories Sq. Ft. Length Width ' 9- -3 -c'1A MC/ES System City Water Booster Pump PRV Fire Sprinklered REQUIRED INSPECTIONS _ Footings (new bldg) Final/C.O. _ Footings (deck) FinallNo C.O. ? _ Footings (addition) Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing Siding Stucco Stone _ Fueplace _ R.I. _ Air Test _ _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By T7 , Building Inspector Base Fee Surcharge ^/ .?^Plan Review fj MGES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ?o?5g RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 %7 0--d New ConsWdion Reouirements RemodeliReuair Reauirements Office Use Onlv 3 registered site surveys showing sq. tt. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y_ N (20%mazimum lot coverage allowed) i setof Energy Calwlafions forheated additions Tree Pres Plan Recd _Y _ N 2 copies of plan showing beam & window sizes; poured found des'yn, etc. 1 site survey for addi6ons 8 decks Tree Pres Not Reqd _Y _ N isetofEnergyCalculafions AddiTion- indiceteifarsitesepticsystem On-site5eptic5ystem _Y _N 3 copies of Tree P2senalion Plan if lot plaHed after 711/93 Rim Joist Detail Options selec6on shcet (bldgs with 3 or less units Date 9? / e_ /C:1),3 SiteAddress jsq7 C/P?S=? d//` Construction Cost d t ° -0D, °" UnidSte # Deseription of Work Multl-Family Bldg A, Y _ N Fireplace(s) _ 0 _ 1 _ 2 Property Owner Telephone # ( ) Contractor C 7r °' ??0-7-v Address State Z"7 Zip 0 P`( City Telephone #(6)-f COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Cateeorv 1 . Residential Ventilation Category 1 Worksheet (4 submission type) Submitted • Energy Envelope Calculations Submitted Have you previously constructed a fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING Minnesota Rules 7672 • New Energy Code Worksheet 5ubmitted Telephone #( Telephone #( 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 of plans. ApplicanYs Printed Name Applicant's Signature in Eagan with a similar plan? OFFICE USE ONLY Sub Types 0 01 Founda6on ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 PorchfAddn.(4-sea.) ? 33 Ext.Alt - SF ? 04 02-plex ? 10 OS-plex Pl. 78 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Yor_ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/DOOrs x 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applieant Valuation Occupancy ?Z m3 MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const ? Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Au/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test Final Windows (new/replacement) Insulation _ _ Retauvng 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 Total 2004 RESIDENTIAL MECHAPIFCAL PERMIT APPLICATION ? rj53(o City Of Eagan 3830 Pilot Kuob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete £or: single family dwellings & townhomes/condos when permits are required for each unit Date -;L- / s2? / (,/ 4/ Site Address Unit # Property Owner Telephone # ( ?6/) 4J 4L ' z/02 Contractor - AIR COR?Dt7r^^?.. _ . 'i 0 ai Mrth Ave. Sa. Street Address Cit Y ? 881-9000 State Zip Telephone # ( ) Bond Expires: The Applicant is ? Owner 1/ Contractor _ Other Add-on or aiteration to existing dwelling unit $ 30.00 ? furnace _Additional -"Replacement air exchanger airconditioner _New _Replacement other - Q? State Surcharge $ 50 l T t 3 ? Onq?, ?/ ? o a • I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complate and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes, that I understand this is not a permit, but only an application for? permit, and work is not to start without a pemut; that the work will be ' ccordance with the approved plan in the case of work hich requues a review and approval oFplans. , Applicant s Printed ame ApphcanYs Signature Saw=' ? & AR ",.__— ..(- ,., Y a ___,-------1-- - ----,. if 13-?? ; .....t -- 0 Use BLUE or BLACK Ink For Office Use 1 j "Permit # - 01 i City of Eagn I I Permit Fee:. 44A ov 1 3830 Pilot Knob Road Eagan MN 55122 Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675.5694 I Staff: _ - I 2013 RESIDENTIAL BUILDING (PERMIT APPLICATION # Date: site Address: l6t~,1 ~ j5_°1)pl acj4 ry t~`#!~L_ ~ ~~yy -T- Unit Name: ~ ~,l i IS- M,[ h , e s__ Phone: Rosidentl ,Owner Address / City / Zip: Applicant is: Owner Contractor Type of+WOrk Description of work: mO e- * ~ _ Construction Cot_Z& 1 5 O p Multi-Family Building: (Yes No--) Company: _aR ~ _67/7~T UG7'/dam----- Contact: -2 _&2g2 en Contractor Address: O l " Ii a/')P.i'l Aha, city: Minn, -Aal ZS State: -tLLt=~ Zip: Phone: 6Zc2L. - ?2-1-5506 License _Sir - 197,092- - Lead Certificate #:2s~ ' f If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan? -Yes -_No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: _ Sewer & Water Contractor: Phone: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of the.information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 4540002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. Mm.oonherstateonecali m I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit abeA issuance. 6/ Applicant's Printed Name V Applies s Signature Page 1 of 3