1592 Clemson Dr?
• ' w '
`PERMIT # (1- ?
RECEIPT#
DATE 4-i
CITY OF EAGAN
MECHANICAL PERMIT
454-8100
MfNIMIfM RESIDENTIAL FEE - $10.00 } $.50
MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res P/ Comm Inst 2. New --5' Add
FEE &
5/C
TOTAL .; /d G U
Alter Repair
3. Tata{ Bid Psice ?l,'- ILJ ? 4. Job AddreSS 22-1t
1r
Lot?, ? Block ?._ Sec'?? ?- ?1 ?? ,5. Owner
GEO. ?EDGWlCK EA¢iP?a? & , ? r1L 6. Contractor Ep?r.p,
(Name) MSNNEAPOLIS, fV1N. S??Slre t) (Clty) (z[p)
7. Contractor Phone #
545-1611
RESIDENTIAL HEATING - 01-100,000 BTU's - S24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10,00 minimum fee
? HEATING VENTILATING HOT WATER STEAM v AIR COND.
?AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RCFRIG.
RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER
COMM./IND. RATE - 1"i6 OF TOTAL BID PRICE PLUS $•50 STATE SURCHARGE FOR EACFI $1,000 OF FEE.
Signed: r.d for
/!7^
Approved Inspections: Date Rough lnsp. Date Final Insp.
.?
f- ?0?•
•
,
BUILDING PERMIT
V' ? !
Receipt #
To w wrd fer Est. Volue Dote , 19
Site Addresa Erect ? Occupancy
Lot Block Remodel ?
SeclSub. 3tL.
? 2oning
Parcel No. Repair TypeofConst.
Additfon ? No. Stories
Move ? Length
Z Name Demolish ? Depth
t Address ? Int Impr. ?' Sq, Ft.
City Phone Install ?
t ; Name ,
? Address
u
? City Phone
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Phone
Assessment _
Water 6 Sew.
Police
Fire
Enp.
Planner
Council
I hereby otknowiedge that I hove reod this applitotion ond stote thot gldg. Off. the inlormation is correct ond ogree fo comply with all epplicoble APC
Srate of Minnesoto Stetutes and City of Eegon Ordinonces.
V D
Permit
Surcharge i
Plan Review ,
SAC
Water Conn. • ? ' .
Water Meter
Road Unit Tr. PI. I
5ipnature of Permittee ar, ete COpies
Total
? Bulldiny Pertnit Is isswd to: m fM express eonditlon ihas
dl work shall be dona in accordorxe with all opplicabla Stote of Minnesota Stotutes ond City of Eopan O?dinonces.
? Pwmit No. Pormk Holdw Ds" Telaphons #
Wrmbinq N
Q
Ff.VA.C. YVL
Ehmiric
6q-77q 1; CYL.
soft.mr
InWoction Dats Insp. Other
Footlngs I
Footings II
Foundation
Framiny -t-1-E ?",
Roofing S ?4 ? tl
Rouyh Pibg.
42
Rou
g ,/:
,,, ?? ? • ?
Insu
+
Firo ?
Ffnal Htg. 9
Final Plbg. %
4
Finel ,
Cert/Occ.
Water Dowibe Location:
Wsll
Sewer
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-198, Eagao, MN 55121
' PHONE: 454-8100 ,
eUL.DING PERMIT Re«ipt #
TO M w"d fw Est. Volur Date
Site Addresa ` Erect ? Occupancy n ,
Lot ak Block ? Sec/Sub. Remodel ? Zoning ,' jT
Percel No.
? Name CiF ' ZO',.- . ' •?
Address
? - . .. .
City Phone
Name _
tE
U§ Address
H r Ir.,
Phone
Name
Phone . i ri - 7 h:: '
Repair ? Type of Const.
Addition ? No. Stories
Move ? Length ?
Demolish ? Depth
Int Impr. ? $q. Ft. ?
Install ?
ApRrora N Foas
/lssessment _
Water & Sew.
Police
Fire
Eng.
Planner
Council
Permit k A_,
i
Suroharge
Plan Review
SAC ? % • ' '
Water Conn.
Water Meter
Road Unit
1 hereby acknowledpa thof I hcve reod this opplicafion ond sfote that gldg. Off. Tr. PI.
the information is oorrect ond ogree to comply with oll opplicable APC
State of Minnesoro Statutes ond City of Eogon Ordinonces. ParkB
Var. Date Copies
Sipnaturo of Permittea ,
Tot81
A Buildinp Permit Is issued to: on the exprcss tondition 1hal
all work shcll be done in atcordante with oll opplicoble Stote of Minnesofo Statutes ond City o! Eopan Ordinonces.
Pa mlt No. Pwmit Holdsr Dato TeIsphons #
Piumbinp
.?
,v
H.VA.C. {f(?
Ebetric ?S9 7 7 (,Y • °,j ? ? .'
SoftNNr
Inspaetion Dato Insp. Other
Foo:ing. 1 10)3 I?; D r?-
Footinys 11
Foundatlon ?
Frsminp c,l•?`-? 6 '? ? ?.
Rooting 6 .
Rougn wbg.
Rough Ht9. yiis/j4 t4e.,
Insul. y/?? f4 ?!l
Flroplace
o-
Flnal Hty.
g• -pb
a ? ^ ?
E ??ia Location:
Disp.
. ..
. r
PERMIT #
69 2,3 CITY OF EAGAN
• .
MECHANICAL PERMIT
RECEIPT # 454-8100
MINIMUM RESIDENTIAL FEE - $10.00 + $.50
DATE MINIMUM COMMERCIAL FEE - $20.00 + S-50
1. Bidg. Type: Res Comm Inst 2. New ? Add -
3. Total Bid Price `? ?I L) - 4, Job Address
'FEE cv'_y Sl.
s/ c - S?
TOTAL
Alter Repair
Lot S CDBlock Sv- -? ?? 5. Owner
GEO. R f,W1CK HE iNG & AN.
6. Contractor
(Name) MINNERPOUS, PdiN, (City) (Zip)
7. Contractor Phone #
E9-13-l(i .
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
?
HEATING ? VENTILATING HOT WATER STEAM AIR COND.
eIR PIPING PROCESSED PIPING AiR HAND. EQUIP. RtFRIG.
? RES. GAS PIPING OUTLETS -$1.50 TANKS: LP. UNDERGfiOUND OTHER
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
/ . i
Signed: for
Approved Inspections: Date Rough Insp. Date Final Insp.
PERMIT # 1 O 0?--
? ° MECHANICAL PERMIT
RECEIPT #
CITY OF EAGAN "
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE •.:. •?.? -f
CONTRACT PRICE: ? -• ?, ? PHONE: 454-8100 '
' fte Ad reSS ' •-
;^-? . '
'
, -.'?
BLDG. TYPE WORK DESCRIPTION
, LotBlock c/Sub
Res. New
Mult Add-on
m Name
-
- ,
Comm. Repalr
? Address v., ,
r Ajr:
c
?
City
Fli iv N;?J?bl? M P'
S:i42i;
??
. '•=1; `c.;?n
. FEES
? Name RES. HVAC 0-100 M BTU - $24.00
c Address ' ? ADDITIONAL 50 M BTU - 6.00 ,
p Ciry Phone ' -? (RES. HVAC IMCLUDES A/C ON NEW i
CONSTRUCTION)
Aln - 1
50 EA
tl
GAS OUTLETS
MINIMUM
1 PER PEki
.
-
i
.
(
TYPE OF WORK COMM/IND FEE - 196 OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLtES
TOWNHOUSE 8 CONDOS - RE5. RATE APPLJES - -
Boiler M BTU _ MINIMUM RESiGENTfAL FEE - ALL AdDbN 8
Unit Heater M BTU -It ' REMOQELS - 12.00
?
Air Cond. ? M BTU Q MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent
CFM
$ ?
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other
FEE:
c
.
+ s,_,
<-' t
r
-- '%
? S/C: SIGN RE P
TOTAL:
FOR: GITY OF EAGAN
'rt?svrar?.:,.::
. CITY OF EAGAN ' ;1 Q fj g
3830 Pilot Knob Road, P.O. Box 21-199, Eayan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt
T* bt rad fw !:.3i- 4 PL(;A Est. Value $61. 00,' p.,rP UCTOBE)< io :.
Lot 1,
Parcel No. _
W Neme '. ' ',7 ??i : • - r-
? Address ^ ?-?
City Phone •:? - J v
Name
Addre
F C:iw
Phone
W
PName ?_• • f
2?
? Address
pV[Z City Phone e? J J'750 2 .A
I hereby acknowledfle thct I hove read this application ond state that
the inlormotion is torrect ond ogree fo tomply with all npplicoble
State of Minnesoto Statutes and Ciry of Eagon O?dinonces.
Siynotum of Pertnittee
A Building Pertnit is issued to: 'R I ;..?
all worlc shall be done in occordonce with oll oppllmble State of Minr
Remodel ?
Repalr ?
Addition ?
Move ?
Demolish ?
Int Impr. ?
Install ?
Nssessment _
Water E Sew.
Police
Flre
Enp.
Plonner
Occupancy
Zoning
Type of Const. i
No. Stories
Length J
Depth ?. %
Sq. Ft.
Permit 00
Surcharge U
Plan Review Q
snC '- ` .00
Water Conn. 0
Water Meter F? 3 . ? n
Road Unit 0 , or
Bldg. Off, `? Tr. PI. 1. 32 . 0101
APC Perks
Var. Date Copies
Total Otj Y • •`) ?
on fhe sxprcss condition thoi
esota Statutes ond City of Eoqon Ordinonus.
" Pamit No. Pwmit Holdw Daft Telephons ?k
Plumbillo r,
HM.A.C.
EMcerie
Softww
Inspection Date Insp. Other
Foot,ng. l
Footinps 11
Foundation
Framinp
Rooflnp
Rough Plby. ay_ fb ? ?-
Rouyh Htg. y/is,/j Xf,?v
Insul.
Flreplace
`'
4/9 r 7c/?7
r
Fln
al Hty.
Final Plbg. ?o -SG
Final 42
Ckt/Occ.
Water DncriM Lpcation:
?
Wsll ?
•?a ??
Swver
Pr. Diap.
PERMIT # ?. ?S SU
CITY OF EAGAN FEE
MECHI?NICAL PERMIT
RECEIPT # ?s 454-8100 S/C
MtNIMUM RESIDENTIAL FEE - S10.00 + $.50 TOTAL
DATE MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res ?,? Comm Inst 2. New ""' Add Alter Repair
3. Total Bid Price ? G J v 4. Job Address / 1?41/ e /211-,
Lot ? Black Sec *??rt,? ?AY? 5. Owner
EzO. MGM h[ATiAG & AIR C`.'MNI' -''
6. Contractor
(Name) ?? (Crh') RiP)
7. Contractor Phone # rfINNEAPOLIS, MN. 55,d
545-I61?.
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
?G HEATING _LNENTILATING HOT WATER STEAM ? AIR CONO.
nIR PIPING PROCESSED PIPING AIR HAND. EQUIP. REFRIG.
RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER
COMM./IND. RATE - 1% OF T9TAL BID PRICE PLUS $•50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
?.?
Signed: for
!yit-I?
Approved ' Inspections: Date Rough Insp. Date Final Insp.
. . , - Jr ?1-;y -?
PEAMII' #0 CITY OF EAGAN `FEE
MECHANICAL PERMIT S
• G
RECEIPT #- ? 454-8100 S/C
, MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL U
DATE MINIMUM COMMERCIAL FEE - $20.00 + $•50
1. Bldg. Type: Res ? Comm Inst 2. New `-' Add Alter Repair
3. Total Bid Price 4. Job Address ?-
.k .,,.:ra n
Lot ?12- Block
,? .?;!??,r 5. Owner LU? . II1??U1:? ?, I. ,i.i .
6. Contractor 111o1 XENlA g.b'F ?O '
(Name) MINNEAPOLIS, MiIV. 5'?2? «'?`> (Z'P)
7. Contractor Phone #
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
? HEATING '-VENTILATING HOT WATER STEAM ? AIR COND.
AIR PIPING PROCESSED PIPING AIR HAND. EQUIP. RrFRIG.
_kG RES. GAS PIPING OUTLETS -$1.50 T,ANKS: L.P. UNDERGROUND OTHER
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $•50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
` - ? 3de???-
Signed: ?/Ig? for
App7oved Inspections: Date Rough Insp. - Date Final Insp.
, r- --- -?
BUILDiNG PERMIT
i% I0+j 11070
Receipt
Site Address Erect LJ Occupancy
lot ' " Block Sec/Sub. ' ,
: Remodel
air
Re ?
? Zonin
9
T
f C
t
Parcel No p ype o
ons
.
. Additlon ? No. Stories
Move ? Length
?
Z Name Demolish ? Depth
Address I
t I ?
? n
mpr. Sq, Ft.
City Phone Install ?
Name
Phone
Name 1% '
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH ON E : 454-8100
Phone ': 3 5
Assessment _
Water & Sew,
Police
Fire
Enp.
Planner
Council
I hereby atknowledgs thot I hove reod this opplication and sfote that gldg. Off. ' S
the information is Correct ond ogree to comply with oll applicable APC
State of Minnesota Statutes and City of Eoflen Ordinances.
F??s
Permit /
Surcharge
Plan Review
SAC
Water Conn. ?.r
Water Meter
Road Unit
Tr. PI.
Parks
Var. Date ? C?I?
5iyncture of Permittee
Total
A 8ulfdiny Pem?it Is isswd to: ' on the exprcss conditlon tha+
oll work shall be done in accordanca with oll applicoble State of Minnesotu Statutes ord City of Eopen O+dinoncea.
Buildirp Official
PWmk No. Pwmk Holda Daa Taisphone
PIumbinq iJ
l
H.VA.C. r "
ENetra
8oftemr
Impockion Dats Insp. Other
Footings 1 ») ? r
Footings 11
Foundation / i
Framing
Roofiny
Rouph Plbp.
Rouyh Hty. r6A& `
Inwl. Y?ya.? fui
Firoplace
S Y
6. ?<
Flnsl Hty. 264
Final Plby.
Final
Cert/Oca
Water Dascribe Location:
01 A/i,? y !r SG si e4,+.Sov* eaRI rff /k.F pr
Ws11 a ?• a ?+...'ts
Sewer
Pr. Disp.
-I
#
TOWNHOUSE
.
dUILDING PERMIT
Site Address _
Lot 5 0
Parcel Na _
CITY OF EAGAN N °_ 1 10 b 8
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ?
Receipt #
4 PLF.X U_1.._ 561.000 .,_._ OCTOBER 2 ,,.85
ra Name NEW HORISd]
= Address P• O. BOX 1.
? MPLS
City phone
p Remodel ?
Repair ?
Addition ?
Move ?
Demolish ?
Int Impr. ?
inarAu n
2oning PD
Type of Const. V
No. Stories
l.ength 4 4
Depth 2 7
$q, Ft.
? Name SAME wpprovais
u? Address Assessment
o- City Phone Woter & Sew.
Police
P! W Name D. GRI SWOLD Fin
!? Address Enq.
?W City Phone 435-7524 plonner
Council
I hereby ocknowledfle thct I have read ihis opplicotion ond state thaf gldg. Off. 9/18/85
the inlormofion is correct ond og?ee to comply with oll opplicable APC
State of Minnesota Statutrs_Qnd City of Ea9pn Ordinonces.
r ?? •- , ,• f/ . Var. Dete
5ipnature of Pemnitte?. ??---/ L
h Building Pertnit Is issucd to: NE
oll work sholl be done in accordante with
Buildinp Officiul
Permit $ 316.00
surcnarge 30.50
Plan Review 158.00
snc 525.00
Water Conn. 500-00
Water Meter 6 3_ 0 0
RoadUnit 280.•CU
Tr. PI. 132.00
....r....
iN S INC Total $2,004.-50 i,
on the exprcss condition thoi
Stote f eto Statutes ond City of Eagan Ordinancea.
Neme D. GRISWOLD
5lynoture of Permittee 41%.
A Building Pertnit is issued to:
all work shall he done in accordarxe
Buildinp pfficfal
ofion ond state that
with all upplicable
Ordi nonces.
OCTOBER ,,.
) Remodel ? Zoning PD
Repair ? Type of Const. V
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth 27
Int Impr. ? Sq, Ft.
Install ?
Approrals Feas
Assessmenf Permit 9 J1 v. u u
Woter 8 Sew. Surcharge 30.50
Police Plan Review 15$. 00
Fire SAC 525.00
Enfl. Water Conn. 500.00
Plonner Watef Meter 63-4 0
Council Road Unit 280.00
BIdg.Off. 9/ 18f SS Tr. PI. 132.00
APC Parks
Var. Date CoRies
INC $2,004.50
Tmel
on the express cmdition lhar
esota totures and City o+ Eugan Ordinonces.
TCWNIIi0i1SE CITY OF EAGAN N° 1 10 6 7
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721
PHONE: 454-8100
QUILDING PERMIT Receipt aqt
?..w w r,rr,v tcI nnn 2 85
TOWNHOUSE
CITY OF EAGAN N°_ 1 10 6 9
-' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?
BUILDING PERMIT PHONE: 454-8100 Receipt * (?LG S I
r,, t.. ..." s.,. 1 OF 4 PLEX c.. v.,i,,. $61, 000 .,-._ (3CTaBER 2 ,e85
SiteAddresa 1594B CLEMSON DR
Lot 51 Block 1 seclsub, THO
Parcel No.
W Name lv?rr nvtc?.av?v nvriza
; Address P• O• BOx 1367
b CitY MPLS Phone 420-?
? Name SAME
Ou
u Address
? City Phone
~W
D. GRISWOLD
FW Name
iZ Address
I hereby acknowledga thot I have rec
the informction is correct ond ogre
Stofa of Minnesoto Statu? t?d Ci
Sipnoture of Permittee
h Buliding Permit is issued to:
atl work sholf be dane in occordonca
Bufidinq Official
to
state thot
Erect EK Occupancy R3
? Remodel ? Zoning PD
Repair ? Type of Const. V
Addition ? No. Stories
Mave ? Length 44
Demolish ? Depth 27
Int Impr. ? Sq. Ft.
Assessment Permit _$ 316.00
Woter d, Sew. Surcharge 30.50
Police Plan Review 158.00
Fire SAC 525.00
Eny. WaterConn. 500,..00
Plonner Water Meter 63 _ 00
Council Road Unit 280.00
eid9. orf. 9/18/85 Tc PI. 132 . 00
APC Parks
Var. Date Copies
Total $2, 004.50
INC
on the Express condition thoi
mota Statutes and City of Eagnn Ordinances.
( TOWNHO9$E )
' CITY OF EAGAN N°_ 1 10 7 0
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 454-8100
6UILDING PERMIT rte«ior #
Ts ha Need ier 1 OF 4 PLEX FN vm„. $ 61 , 0 0 0 n„,e OCTOBER 2 10 8 5
Sita Addresa 1594 CLEMSQN DR Eract K1 Occupancy R3
THOM LK HT
ot 52 B1cek 1 seclsub
l S 2ND Remodel ? Zoning PD
.
.
Parcel No
. Repair ? Type of Const. V
Addition ? No.Stories
NEW HORIZON HOMES INC Move ? Len9th 44
? Name D
i ? '
?Z
P. O. BOX 13 67 emol
sh Dcpth 2
]
? Address
420-3900-
MPLS
i lnt lmpr. ? sq. Ft.
ty
phone
C Install ?
Name SAME Approvals Fees
g Address Asussment Permit --i 1 fi - Q Q
? City Phone Water b$ew: Surcharge 30 - 50
Police PlanReview 1.2.8 - 00
?W Name D. GRISWOLD Fire SAC 525.00
_? Addreu Enp 500.00
Water Conn
. .
tW City Phone 435-7524 plonner WaterMeter 63.00
Council Road Unit 280.00
I hereby ocknowladge thot I have reod this opplication and state that Bid9. Off. 9/18/85 T, pL 132 . 00
the inlormotion is correct ond ogree to comply with all opplicoble APC
5tote of Minnesota 5tatu and City of E n Ordinances.
.°° Parke
.
?( Var. Date
Coples
5lpnature of Permitt ? &,?
e?? rotal $ 2, 0 0 4. 5 0
A 8utlding Permit Is issued to: NEW HORI ZON HOMES INC on the expresy corbdition that
I
oll work shall be done in occordence with oll oppliy¢ola Stete ok'KiiThy ?esota Statutes ond City of Eoyan Ordinonces.
,
Buildiny Offitlol
CITY OF EAGAN _IRemarks zm 4?b 421
Addition• Lot Blk ? Percel #1?
Owner Screet 592 G1 emcon Dri ve Srate Eagan, NIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 8
STREET RESTOR. 981
GRADING
SAN 5EW TRUNK
* SEWER LATERAL 1 52 .0 2 -"8
_
WATERMAIN
+t WATER LATERAL
WATER AREA 13- 1981 136-51 77 40 5 4 5-5-83
STORM SEW TRK 249.91 AOZPZ P --B
* STORM SEW LAT 1981
CURB & GUTTER '
51DEWALK
STREET LIGHT
WATER CONN.
BUILDING PER, 11 67-11070
SAC
PARK
C1,7Y 0F EAGAN Remarks
Additiorr Thnmac t.ake HP9ghtSA di ti on Lot 10 -50 Bik ;? Parcel #10
Owner / st,eet 1592 B Clemson Drive State Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. S
STREET RESTOR.
GRADING
5AN SEW TRUNK 1973 44'QG
*SEWER LATERAL 1981 '..37..61 2 15.05 Q 2 - -8
WATERMAIN
* WATER LATERAL 1981
WATER AREA 54.61 2 - -8
STORM SEW TRK 249.91 A0121 2 --83
* STORM 5EW I.AT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN,
500-00
BUILDING PER. 1100-11070
SAC 00
PAR K
CITY OF EAGAN emarks
Additiorc Tbnmas i.akP HPi g Q ddi i Oti Lot ? 59?=Blk ? ? Parcel #20
Owner street 1594 Clemson Drive State Eagan, NIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, lj],, 8 A03212 --$
STREET RESTOR.
GRADING
SAN SEW TRUNK 9*73 a,4
*SEWERLATERAL 37.61 7
52 .p A 2112 - _8
` t
WATERMAIN
* WATER LATERAL
WATER AREA 4.()1 A0121 2 --8
STORM SEW TRK 312.37 20.82 15 24 . 1 A0121 2 - a
* S?ORM SEW LAT 1981
CURB & GUTTER
51DEWALK
STREET LIGHT
WATER CONN. 500.00
n
n
BUILOING PER. 7_
SAC 525.00
i
PARK
?
CITY OF EAGAN Remarks 1
Additiort' ThOll1aS Lake Height ddition Lot Pe?cel
Owner Street 1594 B Clemson Drive State Eagan, IyN 55122
Improvement Date Amount Annuai Years Payment ReceiQt Date
STREETSUflF. 279-71 .8
STREET RESTOR.
GRADING
SAN 5EW TRUNK /9 7
*SEWERLATERAL 1981 37.61 7.52 1.0 A012112 --8
WATERMAIN
* 1AfATEFi LATERAL 1981
WATER AREA 54.61 AO
STORM SEW TRK 24 . 1 A0121 2 -•.8
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road ni 56051 10 3 85
WATER CONN, 500.00
BUILDING PER. 1067-11070
SAC
PAR K
GEO. SEDGWICK HTG. & AIR COND. CO.
HOUSE HEATING TEST RECORD
J ? I
XDDRESS CITY
OCCUPANT 'Uew Vlor, &J+V OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY -' INSTALLED BY -? P-' w ?
Electrical Work Bv Gas Line By r''
TYPE OF HEAT GA_ FA?_ HW_ STEAM SPACE HTR. UNITiHTR. OTHER
{GAS DESIGN CONVERSION
MAKE n' MAKE OF BURNER _
Model u;,Q??, c_ 91., Model
Serial Max. BTU Rating
INPUT Su•GGY? MAKE OF FURNACE
Model
CONTROLS
THERPJIOSTAT Heat Pluo
Limit
Limit Setting
Fan Setting
Pilot Type ' ?1 r C ? t A•'
r
Pilot Make
Pilot Model Q'Q -
Pilot Timing _ ? ?'vS a N ?
L.W. Cut Off
Pressure Percent CO
?°
Input CFH b
Percent 02 1
Stack Temp. G' Percent CO ?
Vent Size - C7 / NC /(
KIND OF LINER SIZE NONE
Draft Hood ' I ? L ? Regulator <
Filters Size Number
Chimney Location Inside Outside
Chimney Construction
r
?
J J(
Smoke Bomb Wiring
Draft `-? Test Tag ? ?
Door Pressure Lighting Inst. 04C
Date Tested
Company Testing ? " wi '
Name of Tester , M iU ,'0<`•
f?S?.?, 13 l ? -
&
L HQUSE HEATING TEST RECORD L f-J /7
r , •
LCDDRESS f?? I C P?rl ';uA, I!K ` CITY
OCCUPANT_ i-lv,r- r?t1, pWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLEO BY ?~?•
Electrical Work Bv _ A/r Gas Line By
TYPE OF HEAT GA_ FA_,?_ HIN_ STEAM SPACE HTR. UNIT HTR.
I GAS DESIGN
MAKE "?r AIIJ f
Model 36L Lci ( f„-, ???i; SJ(l
Serial
INPUT 3?, CJ?iC?
CONTROLS
THERMOSTAT - Heat Plug
Valve ?.X -3C'?
Limit ?h r
Limit Setting 1 7Ci ° ?
Fan Setting /d U `r
Pilot Type
Oilot Make & _71-JA-1 ?
Pilot Model
Pilot Timing U4C? - ?/ ?
L,W. Cut Off
P ? /U
P
ressure ercent COZ
Input CFH `t Percent 0
Stack Temp. 2 2
`-???°?? Percent CO ?f?? Nt
MAKE DF BURNER _
Model
Max. BTU Rating -
MAICE OF FURNACE
Model
Vent Size
_ CDNVERSION
?
KIND OF LINER SIZE IVONE
Draft Hood l /1, '4tu i P , Reaulator
Filters Size Number ?
Chimney Location Inside Outside
Chimney Construction ? o < ; fY
Smoke Bomb Wiring
Draft Test Tag-\4' ?- ?
Door Pressure ,-?-- Lighting Inst. _' ?j.f Cf
Date Tested
Company Testing
Name of Tester
Form 235
Z 4 11t ?5. ?. dl, . GEO. SEDGWICK HTG. & AIR COND. C0.
HOUSE HEATING TEST RECORD
ADDRESS CITY
OCCUPANT vt ?U/l. OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTAI LFr) RY ?t°O ? E 4 L!J /C
Electrical Work By /' 1.1e- Gas Line By
TYPE OF HEAT GA_ FA ',_ HW_ STEAM SPACE HTR. UNIT
? G?1S DESIGN
MAKE ??t ti f MAKE OF R?JE??
Model Model f1
Serial Max. BTU hw?-
INPUT 1 C? oUO MAKE OF?
? Model '-
CONTROLS
THERMOSTAT??3 y Heat Plug
Valve 5?r j4 ,- 1'1/1CT= ?
?
Limit
Limit Setting - ) 2 b `
Fan Setting
Pilot Type 1- ?P di
Pilot Make ? ? ? ? •
Pilot Model'
Pilot Timing .t,
L.W. Cut Otf ? -
Pressure
Percent COZ o;.
?
InputCFH y 7 Percent O
2
Stack Temp. Percent C0 ?U1lL?
Vent Size ,0
K I N D O _
Draft Hood
Filters Size _
Chimney Location
Chimney Construction
CONVERSION
Smoke Bomb '--' Wiring F1 /(
Draft '?- Test Tag YC5
Door Pressure --r Lighting Inst. _r-).???
Date Tested
Company Testing T, CL?
.
NameofTester
Form 235
R*pipt PLUMBIN(3 PERMIT
CITY OF EAGAN
FiII in numbered spaces
Type or Prini 1egiQlY
1. Date 2. Installation Cost
-?
Permit No.
FN i
s/C 1
i
Tot ? i
3. Job Address Lot Blk. Tract
4. Owner
6. Contractor ; r Phone
8. Addross
7. City State Zip
8. Building Type: Residential ?
9. Work Description: New O
Commercial ? Institutional O
Add ? Alter O Repeir ?
10. Dacribe
11.
No. Fixtures
Water qoset No. Fixtures
Cess
ol/D
infi
ld
Bath tubs po
ra
e
Se
ti
T
k
Lavatory p
c
an
ft
S
Sttower ner
o
Well
Kitchen Sink
Urinal/Bidet Othe
laundry Tray r
Floor Drains
Drinkiny Ftn.
Slop Sink
Gas Piping Outlats
12. I hereby certify that the above information is true and correct, and I aQree to
comply with all ordinances and codes governing this type of work.
Siyned : for
Rouah Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 46"100
Receipt PLUMBING PEAMIT
CITY OF EAGAN
fill !n numberod t,paces
Type or Print lepibly
-?
Pennit No. , j
i
FM +
S/C ;
Tot
i
1. Date 2. I?utallation Cost
3. Job Address Lot Blk. Tract .?
4. Owner ;
5. Contractor Phone '
8. Address
7. City State Zip . '
8. Building Type: Residential E3 Commercial ? Institutional ?
9. Work Description: New ?
10. Describe
11.
Add O Alter ? Repair O
No, Fixtures
Water Closet No. Fix ures
Cesspool/Drainfield
Bath tuba $e
tic Tank
Lavatory p
Softner
Shower Wel I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Pipinp Outlets
12. I hereby csrtify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : ,
for
Rou9h Final
Inspectiona: Date Insp. Date Insp.
This is your permit when numbered and spproved.
Approverf CITY OF EAGAN 464-8100
Raaipt ?
PLUMBING PERM17
CITY OF EAGAN
Permft No. ?
Fa {
fill in numberod;qacea S/C ?
Type or Print /egiWy Tot
1. Date 2. Installation Cost
3. Job Addreu r, -L Lot Blk. Trect - r
4. Owner
5. Contractor ' Phone
6. Address
7. City State Zip
8. Building Type: Residential Q Commercial ? Institutional O
9. Work Desaiption: New ? Add ? Alter ? Repair O
10. Describe
11.
No, Fixtures
Water Closat No. Fixtures
l/D
i
fi
Co
ld
Bath tubs ra
mpoo
n
e
Se
ti
T
k
Lavatory p
c
an
S
f
Shower tner
o
l I
W
Kitchen 5ink e
Urinal/Bidet Other
Laundry Tray
Floor Drains
Orinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hsreby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
RoupA Finsl
Inspactions: Date Inap. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Rsaipt PLUMBING PERMIT Pe?mit No.
CITY OF EAGAN •
FN
f!!I in numberod r,pecea S/C
TYPe or Print lagibly Tot - ?
1. Date ,' 2. Installation Cost
3. Job Address Lot Blk. ' Tract ' a4. Owner S. Contractor Phone i6. Address' L. lv '
7. City State 2ip j
8. Buildiny Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New 0 Add O Alter O Repair O
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cess
oul/Drainfield
Bath tubs p
Septic Tank
Lavatory Softner
Shower Wel l
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby osrtify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this type of work.
Siynad . _ ' -- ' for
Rouyh F inal
Inspections: Date Insp. Date Inap.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 4544100
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: ?:'' I 1 r' f NA
3830 Pilot Knob Road Permit Number: i' 30 a 19
Eagan, Minnesota 55122-1897 Date Issued: i / 0 ' '') 7
(612) 681-4675
SITE ADDRESS: !'"9' 1 (' N 0 APPLICANT:
+. t? tr 1 ii ? ? ?
I`:.'N[l
PERMIT SUBTYPE:
TYPE OF WORK:
r+e u
«r:?;r.krt, rinN 14reurtn aEcM
INSPECTION .. . D.
?
J
???I
Permit No. Permlt Holder Date Telephona N
ELECTRIC
PLUMBING
HVAC
InapecNon Date Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
I
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG I
FINAL HTG
ORSAT
TEST
BLOG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG a ?'? . //VSP•
DECK FINAL
L .
?. CITY OF EAGAN WATER SER77? ?? 7
?3830 Pilat Knob Road PERMIT NO.: P. O. Box 2 1199 , _ ' ?
M Eagsn, MN 51 ? DNTE: _?, ex
R.. No. of Units:
Za+inp: - ew HoYizOn aomes
I3
Owrnr:
B oma a IF-7-ts-1-1-
B C e.mson Dri
;.Sia Mdress:Tilompson P um p -
PlLxnber:
.00
:Meter $ NO.- . Siza: rmi
Reoder No.:
I peM te 606VI1? wM6 NM ? Cahwo?
63 , ? Opc, metei
Total:
.
? & Date Paid:
pcih of WO
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pilot Knob Road
P. O. Box 21198 pE??T N?.:
,
Eagan, MN 55121, DATE-
• No. of Units:
O
M111e/:
/lddross:
Site Addi
Plumbsr. nMom-pson
1 MrM te eewl! w11b lM CUT of iMPO
OfJiMwoM.
ConrwcHa? O+orpe: ' -') - c)C" - -
ACaou?+t Deposit: 5 06.,
Permit Fes:
SurcFwrge:
Miac. Chorpm
Totol:
Dob Paid:
By
Date of Irnp.:
CITY QF EAGAN WATER SERVICE ,PERN??.IT
3830 Pilot Knob Rosd PERMIT NO.:
P?rO. Box 21,199 ? -? - " -- • ,
Eagan, MN 55121 DATE:
R$v R3 No. of Units: . 4-plex
Zonirg: .
OwMr: *?ew Horizon Homes
Mdross:
???;I594 Cle?:soa T?rive '- Thomas Ll: Hts 2
Plurrfber. T120rit AOn PlU ' .
c v SC?O.oOpd
AMter N=.: ? ?0 C ?t ? ? 15.900d
si?: y?o1 lo.oo a
Raoder No.: ?:`y?? .50 d
.9m to eoeo* wilh Hw ?t?? 1 1^? r? ? i )a '?'P
Miac. Chorges: .
?^ ?l!'n• •CtFI'
Total:
_BY pate Poid:
Dote of Insp.: Intp.:
¦¦ vr L/1%7m111 SEVNER SERVICE PERMR
Pilat Knob Road
0. Box 21199 PERMIT NO.:
igan, ;IAN 55121 DATE: ' ') • ': - ` ,
ninp: y? No. of Unita: ...'? -
Addross:
ft ooaiplp wN6 fw Gft of L"•
of Insp.:
Connoctton Qwrpr.
Acoounr aposit: _
Pemi1t Fee:
SurcF?ar+De:
Misc. Chorgm
Total:
Dah Paid:
?;siOf EAGAN
Pilot Knob Road
f1 WATER SERVICE PERMR •
O
B ox 2 1 t88
P U .:
PERMIT N
.
Esgan. MN 05121 DATE:
Zoninp: No. of Units:
Owrnr. _
to oa.oy vuh er.
OF EAGAN SEWER SERVICE PERMR
Pilot Knob Road
Box 21199 PERMIT NO.:
MN 55121 DATE:
p: No. of Units:
Fo oer*l-r wM eM ah? ef Vsen
? BY
? Doft of Irnp.:
?- Irop..
Connmwtlon Qwrps:
Account Deposit:
PeffMlh FN:
SllPCh0rge:
Misc. p+orom
Totcl:
Doh Paid:
?
OF EAGAN . WATER SERVICE P
'^tKr,)bRoad
21199 PERMIT NO.: ?
i 55121 DATE:
-n
No. of Units:
';t?w ?iorizon Homes '
, /lddress:
? Sitr /lddreas: 15`-'2 Clemsor Drive . :.:or,.as c i s
Plumber. 1-1'-ompeo-i P tsm ,??V ? - -
Meter 1?q.: 3 7,2 / 7 rv O ; 5 . p..
r f ec_lt Before digging I?b??
?/????1 w__?__ ?_ . n.Zd U7n(oTG1rD1af1NF• rFi lLLIIY.t 1c.
? 1 yliM to i0w1* N" !hN - r.
, o? E ,???, • F
53 . 7Upd nc: cr
Total:
? g Dots Poid:
Date of Irup.: Infp.:
CITY Or EAGAN
3830 Pilct Knob P.oad
P. O. Box 21199
Eagan, MN 55121
Zoning:
Ownsr:
Address:
SiTe Address:
Plumber:
SEWER SERVICE PERMIT
PERMIT NO.: - -
DNTE:
No. of Units: '' p1
HOERS
Isow h eeupil wllh tlM ?'Jhr of Eowa Connsttion Charqs:
OIdIM11OM. ACCOU11t DISpos(t. A
Pafrrit Fif: .. ,
Surcho?qe:
By Misc. Cl+orqes:
Dote of 1 nsp.: Towl:
Irtsp.: DaN Aaid:
RESIDENTIAL
f BUILDING PERMIT APPLICATION
CITY OF EACAN
??6 3 75 3830 PILOT KNOB RD - 55722
857-887-4675
Naw Conatruction ReaulremeMs
• 3 registered sik surveys showing sq. R of IoL sq. ft M iause; an?ll roofed areas
(20% maximum bl corerage albwed)
• 2 mqes of plan shaYing beam 8 window sizes; poured found design, etc.)
• 1 set W Energy Cakxtlations
• 3 capies of Tree Preservation plan B bl platted afler 7fl193
• Rim Jolst Detail Options seloction sheet (bldgs with 3 or less wifs)
DATE
JOB SITE ADDRE:
IP MULTI-FAMILY
PROPERTY OWN
TYPE OF WORK_
APPLICANT -G
ADDRESS 3Y:-:
PAGER #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Su6mitted
- Energy Envebpe CalcuVations Submitted
_ MINNE50TA RULES 7672
- New Energy Code Worksheet Su6mitted
Plum6ing Contractor. Phone #:
Plumbing System Includes: _ Water Softener _ I.awn Sprinkler Fee:
Water Heater No. of R.I. Baths
No. of Baths
Mechanfeal Confractor: ,
Mechazucal System Indudes:
Sewer/Water Confractor.
All above information must be submitted prior to processing of applicetion.
Phone
$90.00
I hereby acknowledge that I have read this application, state that the information is coRect, and agree to comply
with all applicable State of Minnesota Statutes and Ci1y of Eagan rdinances.
Signafure of Applican ?
Certff'icates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1/01
$70. o0
RemodellReoairReaWremenfs ? ???OE
r
. 2 coPies M plan ?
• t set of Energy Cakulatlons for heated additions
. lsitesurveyiorexterioradditions8decks 'r_
_
TRY1
VALURION
. Irdz? d irome sened by sePtic syslem for addRions
IUI¢DING, HOW MANYAUNITS? ?-? T
4l IIP CODE Ss68'
? ??- ? C
L FIREPLACE(S) _ 0_ 1_ 2
PHONE(a)31_-? -353-t-
CELL PHONE #
FAX #
Phone #
_ Air Conditioning
_ Heat Recovery System n ?? ?
IU1
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
? 07 OS-plex O 73 16-plex
? 08 06-plex 0 16 Fireplace
0 09 07-plex ? 17 Garage
? 10 08-plex V18 Deck
? 11 10-plex ? 19 LowerLevei
? 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
0. 30 Accessory Bldg
O 31 Ext. Alt - Multi
? 33 Ex[. Alt - SF
? 36 Multi
? 37 New ? 35 Int Improvement ? 38 Demolfsh (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolitlon (Entire Bldg only) - Give PCA handout to appiicant
Valuation
aooa m
o
Occupancy
MC/ES System
Census Code ? Zoning ? Ciry 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)
? Final/C.O.
Footings (deck)
_ Footings(addition)
Foundation
Drain Tile
Roof _ Ice & Water Final Otber
_ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
_ Insulation _ Windows (new/replacement)
Approved By (?z`{ , Building Inspector
Base Fee
Surcharge
Plan Review
MC1ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit License Search
Copies
Other
Total
?j Final/No C.O.
_ Plumbing
HVAC
?
F,9
SEDGWICK HEATING & AIR CONDITIONING CO. "EAriNG JOBNO.'-q6
8910 WENTWORTHAVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD S-?),673
ADDRESS?S
OCCUPANT ? ?-UrQ f ? ?/?V ?C
SOLD BV LA--) U 0 C C CJJn ?C1
MAKE"'-N/\n3
SERIAL NO.
THERMOSTATr] ?I 00
VALVE
LIMIT-_?S[?' .x
LIMIT SETTING =
fAN SETTING -
PILOT TVPE _J!
IGNITION MODEL
PILOT TIMING
W ? PERCENT COz
?
INPUTCFH lp(n PERCENTOz
STACK TEMP. G2:8 5_ PERCENT CC
FORM235(eEV 11/89)
CITY 2'- P'O\ lq rj
INSTALLED BY
MODEL
INPUT
iq 'C)70
??
VENT SIZE y
TYPE OF LINER j?-110V
i? .-----?
?..e
LWER SIZE .-
FlLTERS: 5IZE NUMBER p
WIRING ?L.!-taLC.?? ?+`?U % ?C'r,7
? ?
TEST TAG J ?
LIGHTING INS7. t?ck" ?-?- ?
DATE
COMPANV TESTING
NAME OF TESTER
FORMOISTFIBlITION: WHITECOPY - JOBFILE YELLOWCAW - CITV
rnis reauesi voie .,A(, n IG ?? Q 3
u 0h97800
Request Date Fire No. Fough-in Inspection
t??° q iretl? I E]Ready Now Will Notify InsPec-
? ?NO or When Ready
?Licensed Elecvical Convactor I hereby request inspaction of above '
n Owner electrical work installed at
r flovte No.
Street Atldr ss. oa
o C'tv
q
?
/
/ vG.l- v !
ecLOn o. Township Name or No. ATnpe Nn. Cov1?ry
n F
x_.
A
OccuOnmt (PHINT)
? Fhonc No.
Power SuD lier ?j? / AdA?ess ? L..J/y?Jh'7 tV ?
ElecVical Contrnc[or (Co pany Name) ontracIor's License No.
? V
Mailin A d ss I(. ?[ractor or Owr Maki ?p Instailati nl
?
Authorized ignal re-(o Nactor Owner ing Ins al ti ) Phone Number
. _: .:,3-2527
MINNESOTq STATE BOAXO OF ELECTRIGITY 1MIS irvsvecI iurv neuuest wILL rvui
Griggs-Midway Bldg. - Noom N•191 BE ACGEPTED 9Y TME STATE eOAND
1821 University Ava., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone 16121 Z97-211? E NC LOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-ooom-na
u
rySee instrutlions for comoletin9 ihis lorm on back of yellow copy.
ry
?i ! Q?11 "X" Be/ow Work Covered by This Request
v HeJ R.P. ryoe ot 8uileme Apoliancea wirad En.ipmeN Wired
Home Range Temporery Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Hezrtinc
Commercial 81dy. Furnace Silo Unloader
Industrial BIAy. Air Conditio er Bulk Milk Tank
Farm
OinA. oecTv
Othcr ISpacifvl
t er Suf?ify Othor Othcr
?
.,
N ,?.,..... .
F e . ..
Servica EnVanceSixe
p
Fee ;
Fentlins/5ubfeetlers
b
Fae
C?«???s
U to 200 qmps D to 30 Am s 0 to 30 Am>
A6ove 200 Amps, 31 to 100 Amps 31 to 1D0 A s
Swimming Pool Above 100-Amps Above 100-Am s
Transiormers Irtigytion Boorr?s Partial:'Other Fee
Signs SNecial Inspection $ ? ?
TOTAL F E
r
R¢m? rks ? UO
J.
RouOh-in
( Date
? z?
1•
I, tM1e E?e? heroh
??SPBC?OI, V
certily thet the above
Final
, ?'?t??_
? ??soeclion hes Ceen
mede
„ . . .
Tlkis ropuest void 18 monihs irom
, ,,4.ast vo;d _ a
Go ?3
3 months ,,om
i 09780
=.quest I]ate Fire No. NouPh-in InsUertion
?? ? R q ired? ? CReady Now Will Nnlify, Inspec-
J Yes ONO ?or When ReadY
Licensed ElecVical Contrec[or I hereby request inspaction ot above
? Owner elechical work installed ac
S[reetAddrea, oz or Foute No. City
I
ecuan Township Name or No. Ranye No. Cn mry
Or,cup [ I INT Phone
Nkwd 0 /ZDw
Pa r 5 pp ie
1 rr
/ A]e xJ?/
V V / V/ V
Elec[n I Co nctor ICOmpany Nam Contrarme's Licens !o.
Mail'np A dress ICo Vartm or O ner Makiny Instailati0nl ??
3
? %
Y
Authorizetl SiBnatu e
( nhactodOwn qking ns Il:itionl , Phone Number
mumrvesuiq STATE BOAND OF ELECTHIGITY
Grie9s-MiAway Bldg. - Poom N-791
1821 University Ave., St. Paul, MN 55100
Phone (612) 297.2111
ini5 INSPEGIION REQUEST WILL NOT
6E AGCEVTED BV THE STATE 6pqpp
UNLESS PNOPEN INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION d"Illi e/s-ouoovoa
' Sae instructions for completi`g this torm on back ot Yellow copy.
n 1 ""X" Below Work Covered by 7his Request
? HAd Nep: Type•of BuilOing APO?iancee Wired Equipmen[ Wired
- "Home Range Temporary Scrvice
DuplFx Water Heater Liyhtiny Fixtures
Apt. 8uilding Dryer Elec[rIc Heatin
Commerciai Bidg. Fumace y Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Fdfrtl ihxr . peci y Nxe (Speclfy)
t e UecRY Onher Other
p ' Fee ^ServiceEnlranceSize p Fae Fanders/5abtaetlers a Foe Circules
U ip 200 Am s 0 to 30 Am s 1 0 to 30 Am s
Above 200 qm ps 37 ta 100 qmps 31 to 100 q 5
Swinunin Pool Above 100-Amps Above 100_Amps
Transtormers - Irrigation 8oon-is Partial,'Dther Fee
Signs Speciai Inspection S
TOTAL FE
K
Nemarks -9?U6
nouemm I,theElecVical
I
? ? LiV?/?' ? Insp q
ecto hereby
ras
rtify that Ihe above
r
? r'nal
I ?
?j ..(?13 Date?/ ?l
?? jT ?„spection has been
da.
zo
mie reuuesc
This request void
18 nwnths from
E 0Q7799 0A --
I Rpques? Uaie?? Fire No. R fZough-in InsVection
3 ? eQu}reR? ?qeady Now Will No?ify Inspec-
, ? Ycs ?No «?r When Ready
Licensed ElecViwl Contrnc{or 1 herebV repoest inspaction ot above
? Owner - elechical work inatalled at
SVeei Address Boz r Route No. 0{tV-n ?-
l.d?..=
?• ? V
'^ 1 ?"" M
ecLOn o. Township Name or No. Range No. Count? .?-
'
/
f/
Occuodnt IPqINT Phone No.
Power Supplier Adtlress
? ? ?
Elec[ncal t
a
c[or (C mpany Neme) Co
1 r' Llcense No.
/
?
? v ?
C' X
Mail'n Address l nVacur or Owner zki g I
? tailation?
Authorized ignature 1 r ctor?Owne km Ins IJationl Phnne Number
r?
MINNESOTA STqTE BOAFD OF ELECTFICITY . TMIS INSPECTION REQUEST WILL NOT
Griggs-Mitlwey Bldg. - Noom N-191 BE ACCEPTED 6Y THE STATE BOAHD
1821 University Ave., St. Peul, MN 55104 UNLE55 PHOPEH INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-ooom-oa
E'?I1?7?7' SEe instructions for completing this torm on back of yellow copy. u??
L3 ?7 "'X" Below Work Covered by This Request ?? l
U J/!?? °O3
Adtl Pep. Type of 8uilding Appliances Wiree Equipment Wired
Home Ranye Temporary Service
Duplez Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial 81dg. FumaCe Si!o Unloader
Industrial Bldg. Air Conditioner BWk Milk Tank
Farm Other SDenfv Othar (SUOCIfyI
ther Suecifv Other Other
Pough-in Date
^7??{
? °? ????
I, the '
Inspector, hereby
Finai
Dale `j cartify thet the ahove
f?spBCtion has beBn
matle.
This reques[ voitl
18 rmnths fmm
E ' 42 P,?
I....?...;? ..n?e .. _. ? Fire
-/?,-?-?';? ?
? Li?ensed Elec?rical Con[ractor
] Owner
Street qddress, 9oe or Route No
5ec on o. 1 ?? ?67ZJr?i
ownship Na&e m No.
iPh- in I nsVection ?-_
?wred? ?Ready Now ? Will Notity Inspeo-
]1'es Nn [or When FeaAy
1 herehy re0uest^ection of ebavg
elecvical work i sf led at'
?- lCJ
?
k
'ow¢r Supplier
? Atlaress
?lectrical Coniractor ICOmpany Name.)
Harrison Electric Inc.
? Iine dtlress (Contrector r Ownar Making InstailaboN
36 0 Mor n . N Mpls,, MN 55412
utho ze Signat r 1 ra mr/Owne.
? Makiny Installatinnl
^+-nNtSpTp STqTE BOARD OF ELECTqICITY
Gr1e9s-Midway Bldg. - poom N491
1821 Univeorsitv Ave.. St Pau1, MN 55104
Phone (612) 642-0800
-/?p
ecmr-s Licanse
421867
SZ1-0SZ0
THIS INSPECTION qEQUEST WILL NOT
gE ACCEPTEO 6Y TME STqTE BOARD
UNLESS VHOPEN INSPECTIpN FEE IS
ENCLOSED.
:W/jL7 I$Y REQUEST FOR ELECTRICAL INSPECTlON ea-ooooi-os
Il, See inshuctions for comp1e11n9 this lorm on beck ol
yellow capy. /
???6g ._ "X" Below Wark Cnvered by 7his Request
c.dd Rap. Type oi euuaios ncoua.oa. wurae
Home Fange Temporary Scroice
Duplex Water Heater Liyhtiny Flztu?es
Apt BuilAin? Dryer Electric Heavn
Commercial Bldg. Fumace Silo Unloader
Industnal Bldg. Air Conditioner Bulk Milk Tank
Farm omer Soenfv Oine: IS,ao;tyl
t er Suecily. piher pihi,•,
M- Fea ServiceEnbenceSize 4 Fea Fyeders/5uEleeders 4 Fee Cir ults
U to 200 qm s 0 to 30 qm s J 0 tn 30 Amps
Above
O Amps?, 31 to 100 qmps 1 to 100 Am s
N
SwimmiPool A6ove 100_Amps Above 100_Amps
Transioers Irrigation Booms Pdrtial."Other Fee
SignS Special Inspection
Rem3r?w, ? TOT FEE
Rou9h-ln Onte
I, the ecvicai
_ Inspacto , y
Final ertity thxt ihe above
? U inspacti Aas been
e.
'woea' .o1. ?o 111 oiI U. . F .1i1
/ -.
?
This reques[ vaid Q?D ?
18 months trom
0- o 97798 4-
Re.queate _ I?? Fire No. Fouph-In InsVection '?f
q?5 ???'''qyyy ire,d? ?Aeady Nuw WWill Notify Inspec-
v?y ?JYes ?NO ? ??or When FeadY
,?Licensed Eleclrical Convactar . f ??ereby request inspaction of abova -
n Owner elecGical work inatalled aY
SUee Address, Box or Route No.
O
ecLOn . aship Name or No. 0.anye No. Coury?y
?
F-/
OccuDant ?P IN I Phone No.
/
V J
/Y
Y V J
Power SupUlier Addre
j r
y
Nam
e
l
vactm Compan
EIecV
2 C
? ?- C????traQtor's License No.
.,
?
/
,
,
}
ry
,
Q/?9l?S?/?
adin?g ?tlle6s C. [ractor or O ner fv7
? ak?ng Insiail tionl
Auffiorized ign u
ti ctoW wne k ng Inst lationl Phune Num
b
er
, . ' ?
"
p2
2
'?
1
MINNESOTq STqTE BOARD OF ELECT0.ICITY
Griggs-Mitlway Bldg. - Room N•191
1821 Universitv Ave., SL Peui, MN 55104
Phana 16121 297.2111
TMIS INSPECTION REQUEST WILL NOT
6E ACGEPTED BV THE STqTE 90APD
UNLESS PHOPEH INSPECTION FEE IS
ENCLOSEO.
REQUE5T FOR ELECTRICAL INSPECTION ee-oouoroo
?j See instrvc[ions for completin9 this torm on back ot Vallow cooV- /,1 7d?
1{ "'Y" Rnlnw Wnrk Covered bY lhis Aequest ?
LJ
AAd
Rep. J V
Type of Builtlin9
APPliaOCBS Wired -
Equipment Wl?ed
Home Range Temporary Service
Duplex Water Heater Llghting Fixtures
Apt. Building Dryer Electric. Heatin
Commercial Bldg. . Fumace Silo Unloader
Industrlal Bldg.
FBfm Air Conditioner
ther pecify Bulk Milk 7enk
Other ?SOecifyl
t er Su?cify Other Other '
Compute inspecaon ree verow - -
qf a Service EntrencaSixa p Fee Featlers/Subfeede1009?j
/D iAps 0 to 30 Am s 'f??ove 200 Amns?31 to 100 Amps 1
$ign5 apeciai insNecuon $? TOTAL F
flemarks ???
I Fough-in ? U?Le ?ry I I, the Elech?
Insoector,hereby
• ? ? cartity that the above
Final nspection has been
_
This repuest void ??_???
18 months from
I? n ? A. n; 9 ? u ?' ) (?, / T_,n Lt ? z io. oD
Requesi Dete
1 Fire No. Rouph-in Insper.tion
Requiredt
Ready Now?EgWi ll Notity osrae-
?
712ves ? N. mr Wnen Readv
3ULicensed Elecvical Convacmr I hereby requast inspection ol above
? Owner elecbical work insralled ai: .
StreetAddress, Box or Route No. . Gity
1592 Clemson Dr%ve Eagan
ecUOn o.
Township Name or Nu.
flanpe No.
County
I I Dakota
Occupeni IPflWTI Phone No,
New Horizons
Power Sopplier Address
Dakota Cty. Farmington
Elachlcal Gontracio, lCOmpany Nartie) ConVactor s License No. -
O.B. Thompson Electric Co. A40602
Mailin0.4dJress (COnVacmr or Owner Making Instailation)
12201 Mtka Blvd., Mtka 55343
tuue?ICoMractor/Owne! Makinp InstallaYion)
Authorized Siena Phone Number
,
:,i. ? ?
933-2521
MINNESOTp STATE80AHDOFELECTRICITY
Griggs-Midway 81tlg. - Foom N491
1821 4niversity Ave., SL Paul, MN 55104
Phone 16121 297-2111
THIS INSPECTION NEQUEST Wlll NOT
BE ACCEPTED 8Y THE STATE BOARD
UNLESS PFOPEH INSPECTION FEE IS
ENCLOSED.
?
nl'[Ci REQUEST FOR ELECTRICAL INSPECTlON ee-aoooi-oa
,,Jg7al.z? , Sea inslructions for com0leting this torm on hack oi vellow capy.
?: ? ?? ?
"X'" Below Work Coveted by This Request
v HAd Rep. Type oi Builtling Applinncee WireC Equiua,ent Wired
Home Range Temporary Service
Duplex water Heater Liyhtiny Fixtures
Apt. Bui{ding Dryer Electric Heatm
Commercial Bldg. Furnace Si!o Unloader
A Industrial Bidy. Air Conditioner gulk Milk Tank
i Farm Othei oem y nther (SPeclly)
? er ?Speclfy -
Other ,
01her
p Fee ServiceEntranceSize n Fea Feedere/Subleeders k Fee Circults
0 to 200 Amps 0 to 30 Am?s 0 to 30 Am s
A6ove 200 Amps 31 to 100 Amps 31 to 100 Am s
Swimming Poal Above 100_Amps Above 100-Amps
Transtormers Irngation Boorc?s .$0 PdrtiaLOther Fee
Signs SUecial Inspection S
r --??
TOTAL FEE
Rerriarks jQ
10 .
Nau h-in Date ? J a P
8 I, the Elecvo'cai
7 pector, hereby
e-lify lhat fhe above
Final insuection has been
?ae.
Thia reauest volC 18 months (rom
-..? 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
? S q Telephone # 651-675-5675 FAX # 651-675-5694
New Consiruction Reouirements RemodeVReoair Requiremen(s OfftGe Use Otdv
3 registered site surveys showing sq. fl, of loi, sq. fl. of house; and all roofed areas 2 copies of plan ceh66 $emxep Recd .,_.1' T M11,
(20%mscimum lot coverage allowed) 1 set of Energy Calculations for heated additions TC2eRresAfan RCCd Y N'.
2 copies of plan showing bwm & window sizes; poured found design, etc. 1 site survey for additions & decks TreB ProsRESiUUed
1 sel of Energy Calculations AddRion - indicate'rfons'rfesepticsysfem ?h-s?teSepNcSyslEth Y_N?..
3 copies of Tree Preservalion Plan if lot plafled afler 7/1193
Rim Joist Detaii Options seleclion sheet (bldgs with 3 or less units
j
Date?! / 2?(? {
Site Address IJIq C LI:(A9C
0 N-
ConstructionCost 66
c.a ) D2. Unit/Ste #
Deacription of Work 211LA.Ct: 10x 2f) -I)?Ck
Multi-Family Bldg ? Y _ N Fireplace(s) _ 0_ 1_ 2
Property Owner Telephone # (U ) y 9- 14C3C
Contractor ?-X74?00 ai uflacs
Address ?05 W, CG"ll
State St. Cit
y 1tiuEn&ur
Zip Telephone#(65) ) ?322-4crC4clr tAr jG3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDlNG
- Minnesota Rules 7670 Ca[egorv 1 Minnesota Rules 7672
Ellergy Code Category , Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone #(
N If sa, 25% plan review
I hereby apply for a Residential Building Permit and acknowledge that the information??^?--
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.
? 1 kE PvDi-I
Applicant's Printed Name Applicant's Signature
. ., Buila?ng s? ?2
^ ? ?S q35.5
• r? o?v x-
?935 ?
? (935,g?
?? ?y ? P S r93 - ?p
- 3 op 8'E 1 1
7.3j•0og ?
O 3
=2.;3
O ^' i- "; )
J S? 7, o 'D {
C936, oN
N N
\ Q 3
e (936
0
(936.5) .p ?O P 30 ? (N
O
? I
p, 7.
O'l ? L
22, '33 2_j(, N y?, l936. 5? -
d N77°3 3/.0
gyYa? ? ?FV 1c?'t??? ,.
?,kTc 1 ( (o • 8S
O Denotes Iron Monument
° Denotes Wood Stake
X000.0 Denotes Exi5ting Elevation Proposed Top of Foundation Elevation=
(000.0) Denotes Proposed Elevation Proposed Garage Fioor Elevation= 9 37. D
-*-- Qenotes Direcfion ot Surface Drainage Proposed Lowest Floor Elevation= 937.5
1 hereby certify that this is a true and correct representation of a survey of Me boundaries of.
Lots 49, 50, 51, and 52, Block 1, THOA",AS LAKE HEICATS 2ND ADDITION,
Dakota County, Minnesota.
And of the iocation ot all buildings, if any, thereon, and all visibfe encroachments, if AS any, sutrv yed
on said land. It also shows the location ot the stakes as set for a proposed buil$i59-
by me or under my direct supervision this 30th day of Auqust_ 19 ,
Paul A. John?q
10°,38
Land Surveyor, Minn. Reg. No.
40' TIFICATE QF SURVEY
CER
pppR rAGE fior
7
?+
McCOMBS-KNUTSON ASSOCIATES, INC. ?? ?? ?_y? ?9
[ONSULLIMG IRIM[[Ili N WO SuIIY[iDt3 B Zltk PWRNS qLF MO. ??jlylsL.
? WXMf??K rM MUTLMIN3pN,WNME[Oi11 7430
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
U
New Consiruclion Reouirements RemodeUReoair Reauirements
3 registered site surveys showing sq. ft, of loi, sq. fl. of house; and all roo(ed areas 2 copies of plan
(20°k maximum lot cwerage allowed) 1 set of Ewrgy Calculations for heated additions
2 copies of pian showing beam & window sizes; poured found design, etc. , 7 sile survey for addAions & decks
1 set of Energy Celalations Addifion - indicafe 'rf onsite septk system
3 copies of Tree Preserva6on Plan if bi p(aned afler 7l1193
Rim Joist Oetail Opiions seledion sheef (61dgs wtlh 3 or less units
.. ?
Ofkce:Use{3[i?
CEriaF?i.raeX:FieCd, „'Y ?I?
I[2dACCSPi9i?:R2?1 _? .??.
j?eeAraSRequi?ed ,,,,Y ., P7
Skt-s?{eSepilG?si?n ..:Y _N
Date v / 2?, /_2CoL4 Construction Cost
Site Address ? is,?`14S C Ltmso?J p12 Unit/Ste #
DescriptionofWork X6 oLc k nnIGbJ EQL}V-t-
Multi-Family Bldg ? Y _ N Fireplace(s) _ 0 _ 1 _ 2
Proper[y Owner i C
?...,
S
Telephoue #
Contractor ?? 1 E??EK ICU? MA1 N7 WAW
Address `TGK ?+?J (?GtH
?, ? /,?
City ''I(NkW'P`L1r
State N? 1U Zip Y)W`7 Telephone #((251 )`?Z z- ?Ici 6`7
?Xf' ?c3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Mumesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _
fee applies.
Licensed Plumber U T Telephone #(
Mechanical Contractor 11 ? AUG 2 6 2004 7elephone #(
Sewer/WaterConhactor l?,. I 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 NIN
Statutes; I understand this is not a pemut, but only an applicarion for a pettnit, 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 requ'ues a review and
approval of plans.
M i kt ?4r)
Applicant's Printed Name
Applicant's Signature
OFFICE USE ONLY
Sub Types 1. 1 1
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling O OS 06-plex ? 16 Fireplace ? 21 Porch (3sea.) ? 31 Ext. Alt- Multi
? 03 07 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn, (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex g 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-pleac ? 11 10-plex ? 19 Lower Leve( ? 24 Storm Damage
? OB 04-pleac ? 12 72-plex Plbg_vor_N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors
)X 34 Replacement ' •Demolitioa (Eotire Bldg) -Give PCA haadout to appt+eaat
v-
Valuation ? MCES 5ystem
Occupancy
Census Code Li? Zoning City Water
SAC Units Stories BoosfeP Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIIiED INSPECTIONS
_ Footings (new bldg) FinallC.O.
_ Footings (deck) , K;ST; ng ? FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Ice & Watu
Roof Final _ Pool _ Ftgs _ Air/Gas Tests Final
_
_ Framing _ _ Siding _ Stucco _ Stone _ Brick
Fireplace _ R.I. _ AirTest _ Final _ Windows
_
_ Insulation _ Retaining Wa11
Approved By: , Building inspector
---------- - - ---- - - - --- - --- - -----
---- - -- - - - - --- - --------- - -
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connedion Charge
S&W Permit & Sureharge
Treatment Plant
License Search
Copies
Other
Total
?ZS' 5
? 5 ? y (3
3y.5 cl
7k-
.. (936,5, -?
t ? ?936_p?p
M31.op 7-
38 E !
- ?_ ?93>oi'??IN ?
C /
? -i,?7•.
?
??.
N ^
N
O M
fN?
(93(, ?r1 ,0
J ?
? lo
^'q
d
Buildjn9 t$ 12
e-?5?? i?
?
-"01 yt'\
Z2.;, ?
N t7J,% ll?
? 0 0
3 4 ? ? F1
vt
J
a o 3 N ,.
a. ? .: . '
Z ss
<93?
b
(9g,F oJ
O Denotes Iron Monument
° Denotes Wood Stake
X000.0 Denotes Exis'ting Elevation
(000.0) Derrotes Proposed Elevation
-e-- Denotes Direction oi Surface Drainage
? y
t
C n n .y
L_ n L y i?a
REVf?SycD
,
.......
9Y ?
OATE ! • ? (o • Pj?
Pfoposed Top of Foundation Elevation°
Proposed Garage Floor Elevation= 9 37. o
Proposed Lowest Floor Elevation= 9 3 7, 5
1 Aereby ceNily ihat Mis is a true and correct representation of a survey of the boundaries ot
Lots 49, 50, 51, and 52, Block 1, THON,AS LAKE HEIGHTS 2ND ADDZTION,
Dakota County, Minnesota.
And of the location of all buildings, if any, thereon, and all visibie encroachments, it any, from or
on said land. It also shows the IoCation ot the stakes as set for a proposed buiiding. As surveyed
by me or under my direct supervision this 30th day of AuQUSt ?19 85 .
Paul A. John
Land Survevor. Minn. Reg. No. 10438
""` CERTIFICATE OF SURVEY
. ?ac
??- `?0 for
. ?? McCOMBS-KNUTSON A5SOCIATES, INC. ?? ?
'w?•) oeXsouui uonce0S 0 wo suMr[raS 0 im run[af . nu ?/a?
.lll.?:?'. WMMf?fOl1{rMMtITCNIWON,WIWE[OTA ?T3O
Buila?rr9 3t /2
?3y,ti
C? `c?so? ? 3s.5
O ??935.1
.. (935,5?
^53i.oo 38'E
. (937.03)/' 0014
? ?p
22.33
? O N ?' zZ ;3
f )
N 4 \ ^' ?
36, . ? 3 zo ? 1
l9 ?o V1 N 2 0. ? p tl' S? I
N ` m z9.
N W .c ti (936, o
1936. O? Q? rQj .. N
p7.oohr :?-
_ ? , c- -? •o• -
zz.a3 ZzC. ^' ?F l936.5?
? 41,3ipa3;.0 3 C !? n !y ?
N77e ?i.oqo ? ??i.:.1iN
d t
(q33o W r? -R £ V
9Y
?43g-,oJ
DRTE ? ' ( L? • ??
O Denotes Iron Monument
13 Denotes Wood Stake
X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation=
(000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 9 37. 0
f- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 9 3 7, 5
I hereby certify that Mis is a true and correct representation of a survey of Me boundaries ot
Lots 49, 50, 51, and 52, Block 1, THO*",AS LAKE HEICHTS 2ND ADDITZOT,
Dakota County, Minnesota.
And of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location ot the stakes as set for a proposed building. As surveyed
•
by me or under my direct supervision this 30th day of Auaust 19 85
??
Paul A. John
10°,38
Land Surveyor, Minn. Reg. No.
swow
- kCOMBS-KNUTSON ASSOCIATES, INC. ?
?)????? OgfYtllni IaNMlflli Iu11Y[Y0. { 0 iliF ?? ?? ??
"?"?
CERTIFICATE OF SURV
Tf r
IOI
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
9 3?_T 1 Telephone # 651-675-5675 FAX # 651-675-5694
New Constmclion Reauiremenl5 RemadeUReoair Reauiremenis 6ffice k3se OnN
3 registered site surveys showing sq. fl. of lot, sq. fl. of house; and all mofed areas 2 copies of pfan CC0FSwveyRecd" Y N
(20% mazimum bt coverage allowed) i set of Energy Calculations for heated additions TreeP[0g PIgnRCtX}
2 copies of plan showing beam 8 window sizes; poured found design, etc. i site survey for additions & decks tree Pres fi?Wir¢d -: Y ?N
1 set of Energy Calculalions Addition - indirafe if ons8e septic system f7tt-Ae Septic5yslem
3 wpies of Tree Preservation Plan if lot platled afler 711f93
Rim Joist Detail Options selection sheet (bldgs wilh 3 or less units
Date 8 / I / 20Gq ConstructionCost I?Zooaw
Site Address IrjM2 S C LL-MSG nJ Die1 UE UniUSte #
?escriptionofWork k'L PLqCE )0 X26 DEC)+'
Multi-Family Bldg ? Y _ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner bT L64c- Telephone # (7-3 ) t)2t- 1.I,C?3?_
Contractor IJ?? ExTE.CIoK MNInlC6NA N<6
Address L40 $ St, City MINUeiirrr.r
State Zip &&u 4 _ Telephoue #((o?j' ?) 322- a-?`t6°r E kT Ig
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(-V submissiontype) Submitted Submitted
• Energy Envelope Calculations Submifted
Have you previously constructed a building in Eagan with a similar plan2 _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Confractor
N If so, 25% plan review
Telephone #(
Telephone #( 1116?
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the informaigt-ES&fu=-'°`°aRd::agurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval ofplans.
PIK E rtm+
Applicant's Printed Name
42K i4 dK5--,
Applicant's Signature
q3y,ti
93y.5
l9355' _
r
? P r93?_o?p
0?h31,0p ??36'E J ;
r? ?937.o?.DDlr?
,
?..
10
0
?
1936 ? N ,^?
N
• t m
?
(936, 5? ?p
7
/
O
0
X D00.0
(000.0)
-E--
Denotes Iran Monument
Denotes Wood Stake
Denotes Existing Elevation
Denotes Proposed Elevation
Denotes Direction of Surface Drainage
0
0
N N
,o N (936.0>
rn o
i N
0 1
Buila'nq ? 14
9'? 5 .1
"y a._, ."7 3'V
ti
\ ok- WW, , , ?.
Proposed Top of Foundation Elevation=
Proposed Garage Floor Elevation= 937.0
Proposed Lowest Floor Elevation= 9 37, 5
f hereby certify that this is a true and correct representation of a survey of the boundaries of:
Lots 49, 50, 51, and 52, Block 1, THOMAS LAKE HEZCHTS 2ND ADDITIOh,
Dakota County, Minnesota.
And of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location o1 t kes as set tor a proposed 6uil8i5g. As surveyed
by me or under my direct supervision this 30th day of Aua St ,19 .
I ?
Paul A. John 10338
Land Surveyor, Minn. Reg. No.
? McCOMBS-KNUTSON ASSOCIATES, INC. I
[ONSVUIMC ItC1YfUi ? Wp SYI1YR0113 ? SrtF M?YEIIS
?J??....;? WMifAlOL?f W MUTCXIMZON.WMNELOT?
ERTIFICATE OF SURVEY
fiOf
??HOWONf Ne S
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
/ ?-
City Of Eagan
?O ?0 ?4? 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Consiruclion ReauiremenGs
3 registered site surveys showing sq. ft. of IW, sq. H. of house; and all mofed areas RemodeUReoair Reauiremenis
2 copies of plan f5$ce-fke0?v
Certaf SuNOy,:Reetl
N
(20%maximumlotcoverageallowed) 7setofEnergyCalculalions(orheatedadditions 3'teePtEePI?(IRectl ?Y _N
2 copies of plan showirg beam & window sizes; poured found design, etc. . 7 site survey fw additiom & decks Tt6¢i'3res Reqilual Y ,_..: 14
lsetofEnergyCakulations Pddlfron - indicate'rfon-sitesepticsyslem QtFSitB$ep??c?5y51eM -?•?:Y _..N'
3 copies of Tree Reservation Plan rf lol platted after 7l1193
Rim Jaisl DeWil Opfions selection sheet (bldgs with 3 ar less unils
/
Date 0 12- 6 / Q y oa?
-
Construction Cost 4 G,,
Site Address 1"94 / T S.L Q jf r 9 y
i? / S' 9 V Pi C/z m-V m dl-.. Unit/Ste #
Description of Work S-teI / r+
MuIH-Family Bldg X Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner /4 Sf-?,c i>?ia.., F/No nt.?/!?/6a/r Telephone #( 7?'? )??a s 6 y 3 6
Contractor A E..Z E7( Tt-r r•Y -ht'l 04-?
Addresa 9'O f 4/ - (O T4 ST City /yO?J
State MN . Zip S7(119 Telephone #( 611 )d6/-6.Z Y3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Caze¢orv 1 Minnesota Rules 7672
Energy Code Category , Residential Venfilation Category 1 Worksheet • New Energy Code Worksheet
(J submission Type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
Telephone #(
Telephone # (
Telephone #{
I hereby apply for a Residential Building Permit and acknowledge that the informat is coete and acc rate;
that the work will be in conformance with the ordinances and codes of the City o MN
5tatutes; I understattd this is not a pernvt, 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.
IIA V i?cT / ASo7A
Applicant's Printed Name
Applicant's lgignature
CCTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT PERMIT TYPE:
Permit Number:
Date Issued:
BIJILDING
030479
08J07/97
SITE ADDRESS:
P.I.N.: 10-75951-500-01
DESCRIPTION:
1592 CLEMSON DR
LOT: 50 BLOCK: 1
THOMAS LAKE HEIGHTS 2ND
REBUILD DECK
&uildtng,,,Permit Type DECK
<Suilding 4fiirk Type NEW
`Census Code
rv
i4
<' .a
zr`
t1 F rq
UNI7 B
434 ALT. RESIDENTIAL
? y
f- t"` a? ? x'=.?;,?'} i(_.. 3•r-?U! i?? r ?( t?? f tli
,:?n7.aL
t7L
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Subtotal
$50.00 COPIES
$.50 Total Fee
$50.50
$50.75
CONTRACTOR: - Applicant - OWNER:
NELSON, KEITH 14206550 COOK GEORGIA
18511 86TH PL N 1592 CLEMSON DR B
JAPLE GROVE MN 55311 EAGAN MN
('612) 420-6550
I herebyaeknowletlg6.that T have'? and:4,sCaGq?'rthaV`the=
informaYian 3s correct and agree to camply,;witM all applic'able State o# Mn`."'
Statutes and City ofi agan Ordinances.
APPLICANT/PE IT SIGNA URE IS EDB :51 ATU E V
?
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681 -4675
SO • ZS_'
? 3 rogiatered ske surveys ? 2 copies of plan
? 2 coples of piana (inGude beam & window elxes; poured fid. tleaign; eta) ? 2 ske surveys (exterior additione 8 dedcs)
• 1 energy plculationa ? 1 energy calwlations for heated addkions
? 3 eoples of tree presanation plen if lot platted after 711183
requfred: _ Yes _ No -
DATE: II- zz CONSTRUCTION COST
DESCRIPTION OF WORK:
STREET ADDRESS:
/
LOT S? BLOCK
S9-L
1 L--vt S a
? SUBD./P.I.D. #: o"'"'_'y`"''"' li,-? ?* 2-r-?
PROPERTY Nan'1e: Phone #:
OWNER
Street Address:
City: State: Zip:
CONTRACTOR
ARCHRECTI
ENGINEER
Company: ???NIlv?c.?dY? Phone#:
Street Address: License #:
CttY:1j"LYAL State: Al IL-1 Zip: 7 /
Company:
Name:
Phone #:
Registration #:
Street Address:
City:
Sewer & water cc3r.5ed plumber (new consWcdon only):
and lot change arc, equested once permit is issued.
Zip:
Penalty applies when address change
I hereby acknowledge that I have read this application and state that the iMortnation is co ct and agree to compiy with all appliqble
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECEIVED
Certificates of Survey Received _ Yes _ No JU ? 1997
Tree Preservation Plan Received - Yes _ No _ Not Required BY•
State:
; Bui/airn9
? - q3(7- ti ) y q Z 6
C? EMSON ? 3s.s C 1??Sd ? D(? .
(9355) 40'T r •
G
? Q S r93(
o - ?p
"h3/op 73
. 8 E 1 ?
. e"e3?.o?•OOr?
z2.33 =
0 ^I ?" ; Z ;3
% ?\ Q C ?T 7 k O
t)1 'D ? ^7e j Q \ ry O
\
<9?, N -. . o? ? 3 ?, 0
d?N '^ v °' ? o. e? S? I
f N`,? z?. ? V? N
N ? y m ti(936,0\ I
(936, 3 N N J
1F N-_ Cle
q 7.0 0?
? .. ,
zz?3; Zz??N ? (936.5 iX ?? p?Llc. EnS?
113/,p0(93 .O . RE?lp)LO IVLA 12 J"1l,Y
d N77 °3g, °
<9 ftfVIEWcD
3?.0) ?fR`S GeJ?? N ?
peRuY 9Y
?93¢ oJ
oATE 9 • ? c? . ?s
O Denotes Iron Monument
0 Denotes Wood Stake
X000.0 Denotes Ezisting Elevation Proposed Top of Foundation Elevation=
(000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 937.0
-*- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 9 3 7_ 5
I hereby certify that this is a true and correct reDresentation of a survey of the boundaries ot
Lots 49, 50, 51, and 52, Block 1, THO^SAS LAKE HEICHTS 2ND ADDITION,
Dakota County, Minnesota.
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 30 th day of P'u°u-t , 19 85 •
Paul A. John
Land Survevor. Minn. Reg. No. 10938
op-par
,McCOMBS-KNUTSON ASSOCIATES, INC.
?\
/?? )??J? CO?SUtiuf UCUt[?t ? U?G tu?Y[?O?S ? SI1E ?tA?tqS
?Rl.?. . wNMF/?OL1t w NUttNIMmM,Mllwf[OTA
A07iKT30 CERTIFICATE OF SURVEY
fior
V? ? ?S
?? ? ? ? ?'v
,
July, 1997
City of Eagan
Eagan, Minnesota
To Whom It May Concern:
Re: )S?'1 zg L' j CmS6 X/
The holder of this letter is hereby authorized to build a deck up to a total azea measuring l Ox20
on the property owned by Horizon Hills Home Owners Association. The holder of this letter
understands that because the deck is built on Association property, it becomes the property of the
Association, with the unit associated with the deck continuing to exercise their private use
exclusions.
The Association will ensure the deck is constructed and the cement footing is poured to meet the
City of Eagan building requirements and will order the final inspection of such when work is
completed.
Please feel free to contact me with any questions or concems.
Sincerely,
Horizon Hills Home Owners Association
13"-." I-10
Barbara Koob, CMCA
Property Manager, Member-At-Large
cc: File
P.O. BOX 21423, EAGAN, MN 55121
(612) 688-0695
HORIZON HILLS HOME OWNERS ASSOCIATION
z5t CITY USE ONLY
L BL RECEIPT #: I 1, 1 C? V
SUBD. RECEIPT DATE: 0- J ?j 7,q
PERMIT# 7 6aft
1999 PL[7M$IRe P£RMiT (ftESID£R77lkL)
crrYoPimeax
3830 Paor KNos ttu
£A8lIA.!!N 5518E
(651) 661-"75
Please complete for: ? single famiy dwellings
> townhortres and condos when permits are required for each unit
D backflow preventer for underground sprinkler system
FIXTlIRES
EACH III
TOTAL
R^frp fi ?I+ Q n?
? .. .. ::
_
-
T
r.
Floordiain 3.00 x R
Gas i in ouifat ' minlmum- t 3A0 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 - $
Private Dis osal S stem new/refurbished ' requires MPC iic. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x - $
RPZ new installatioNre air 30.00 x - $
Rou h o enin 1.50 X - $
Shower 3.00 x - $
Under round s rinkler 'rf dwellin is under consVuction 3.00 x = $
Unde rounds rinkler 'rfexistin dwellin 30.00 x - $
3.00 x = $
Water heate 3.00 x
-
$
softener r if awellin untler conswction 5.00 x = $
Water softener 'rf existin dwellin 30.00 x = $
Water tumaround 30.00 x $
State Surchar e .50 -? -> -> $ .50
TOtal _>
$ ?- . SZ'
... ..i ..Fto•jHnr?c, i n_ v!.?}p! Ftoa}GK. _ W=}Cr S!?9fIP.rS+. @}C.
.. ._. .... _. .?, ?.. . _. ._ ._.. __ . .
? herebY adnroxAadpe thsi i have read this appGCaNai. sfate Ciat tlie in(crmatiai is carecf, and aEpee to oomply wflh ali applkeEle (?y%of F.agen oidinances.
It Is the applipnYs responsibility to notify the property owner that the City of£agan assumes rw IWWIity fw any damages pused by tlie City during its
normal operstional and maintenance activitles to the faqlWes consWcled under ttils permit within Qlly praperty/rlghGOf-way/easement.
SITE ADDRESS: / ` 0
OWNER NAME: : TELEPHONE #: /Yi1 i
y ? CODE)
INSTALLER NAME:???- TELEPHONE #: 4? r'-
STREET ADDRESS: (?? CODE)
v
CITY: STATE:
l
ZIP: J S
PERMITTEE
CLAIM VOUCHER - REFUND REQUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO: KCJ Enterprises
ADDRESS: 2800 Campus Dr #40
Plymouth MN 55441
LOCATION: 1594 Clemson Dr P.I.DJLEGAL:- L5, Bl, T6omas Lk Hgts 2nd ?
RECEIPT #/DATE: 117535/09-28-99 VALUATION:'
REASON FOR REFUND: Duplicate permit PERMIT #: 38060
TYPE OF REFUND: t
9001 $
Electrical Permit -
321
Plumbing Permit 3212-9001 $30.00
- Mechanical Permit 3213-9001 $
Building Permit Fee 3210-9001 $
Plan Review Fee 3422-9001 $
SAC (MC/WS) 2275-9220 $
SAC (City) 3866-9379 $
SAC (Admin) 3446-9001 $
Water Connection 3865-9220 $
Sewer Permit 3743-9220 $
Water Permit 3713-9220 $
Account Deposit 2252-9220 $
Water Meter 3716-9220 $
Water Treatrnent 3868-9220 $
Surchazge 2155-9001 $
Utility Acct Overpayment 2250.9220 $
Curb Box Deposit Refund 2253-9220 $
Construction Meter Dep Refund 2254-9220 $
Water Usage Chazge 371 I-9220 $
Other $
TOTAL $30.00
I declaze under the penalties oF law that this account, claim, or demand is just and that no part of it has been paid.
November 22, 1999
I NATUREvN G7
/p DATE
?
?
? arr usE ONLY
L BL e
SUBD. a VIA
0- 7545 1-5l0-01
RECEIPT #:
RECEIPT DATE: /oCA ?
PERMIT # ? O?P D
30 ?
Please
1999 PLLTjdSINfi PERMiT (RESIDEiV77i4i)
crrYorEAem
36M PILOT KlqOB ftD
?euv.x?ssi? Q
" (651) se1-4e7s
for. D single famity dwellings
D townhomes and condos when permits are required for each unft
D backflow preventer for underground sprinkler system
FIXTURES
EACH
u
v TOTAL
Bath tub T z nn g
Floor drain '
-- ?-•
-- 3.00 x = s
Gas i in Outlat • mrnimum _ i
- 3.0 x = $
Hot tub/s a
.
00 x - $
Kitchen sink 3
.00 x - $
Laund Va 3.00 x - $
Lavato 3.00 x - $
Minimum fee alterations to exi n Uw n 30.00 x - $
Private Dis osal S stem new/refurbished ' r i MPC lic. 75.00 x - $
Private Dis sal S stem abandonment 30.00 x = $
RPZ new installation/r air 30.00 x = $
Rou h o enin 1.60 X = $
$hower 3.00 x - $
Under roun(Frinkler if dwel ' is under construction 3.00 x = $
Under roun(i s rinkler 'rf e' ting dwellin 30.00 x - $
Water closet .00 x = $
Water heater 3. x - $
Water softener if dweuin under consm,crion 5.00 x = $
Water softener 'rf existin dwellin 30.00 - $
Water turnaro d 30.00 x - $
State Surc e .50 $ .50
Total _> S
8'-`:.'.'?.j,+'.'Q? t.y. ?_•a`sc h^.??:e?, ?-e?4Ar Gui?snan, .?d?.
I herebY aclvwi?Aedge tfiat ? have iead Ihis applicatlonsfafe tfiat Ifie inforrnaUOn Is corted, aiid e?ee fo oomply wllli all applicalile ' uf Eagsnaidinances.
It is the appllcanPs responsibility to notly the propeAy oxmer yiat qre Cig• of Eagan assumes no Iiabflity for any dart?agas ca the City during ifs
rrormal operatlonal anC maintenance acMvitles to 1he fadlitles consWded under tlils permit wiMin City propertyhight-of-way/easement.
SITE ADDRESS:
OWNER NAME: : TELEPHONE #: lv 5/
(AREA CODE)
INSTALLER NAME: TELEPHONE #: ?
STREET ADORESS: (?A CODE)" -
CITY: STATE: ZIP:
?
SIGNATUR OF PERMITTEE
/
y ? 2/84
!
? ?
I
't
CITY Or EAGAN
?
?, ?
Il?n APPLICATIODI FOR PEM-SIT
SESJER AND/OR WATER CONNECTIODI
(PLEASE PRINT)
1) PF.OPx3rt"! ADDkESS:
TFr:%i. D°SC4IPTICN:
(Lo lock/Subdivisicn or Ta? Parcei I.D. N=mer7 /
IF F.:.'tTr '=i, ST?S:C'^IRE. DaTt.' OP Oi2T.GI`..M u;IT JI;:G B__•i: ZS
t . . ?:•:?..?r :.?...?ri
P?Z..L:P =Trr6;/??DPOST-J GS: 13 R-1 SitiGL:. ?r_•1?+V •
Q? R?-7: CUP=: ('!':'iJ . G^M:'S)
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Ph'ONE:
Pu7?? (PLEASE PRtNTy FOR C
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-
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PDDRESS: r.
r
PNQMP$GN !LUM$IAIG-
12201 MINNETONKA BLYD, PLl1?"RS LI?
• •.
'
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/
CITY, ST?.TE, ZIP: MINNETONKA, MIWN.
? E i
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PH
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? PLUrieEH LFGENSE #
. Q Rerd
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ADDRFSS:
C1'I'7, STATE, ZIP;
PHO:]E:
IPLEASE PR1f1iI
5) IIVDICF.TE '.4FFICH PER6IIT IS BEZh{; REQIIESTLM:
L!' C'Cy.^IEC.TZON 'IO CITY SETUE.R
Q/CONNF?tIG.?I ZO CZTY jdATE.''2
? 07=11 IPL.LA-CE DESCRIBEJ
6) I2,DICA.:: C2--- :
7} SIC.,,1L"RE;
El.P='?SE F?OID r1PPP,QVED pgZ-1IT Pp:2 PZCa-LP BY O.VE OF P5GVE
O PZE-,S :•AIL APP:tqVEb PM'•LIT TJ I. 23 4 AFav7E
(Ci.-c2e one)
D1T-1: ??-?7 ?
rc:i-t11' = 1JbUt?
F°ES: $ SJ
$ ,.
$
$
$ ?-
?S.Od
?
$
Soc? d-v
$
S
$ .
5=::cD niRMrT (I_`1CL.UDs SU?C?.?+?Gc)
W3TER PERNtT_: (IPICL'uDE SiiRC:iAc2G%)
WATER i7ETER/COPPE4HORN/OUTSIIIv- REe,D: R
Wr1TER TAP (ZNCL[7DF. COR?ORATIODI STOP)
S::vzR Tzk?
AC.^.OUNT D.F.POSIT - 4JATER
wac
sac . TRU>iK WATER ASSESS:?E:iT
TBtiJ1K SES•7ER ASS: SS:7A3iT
LAaE?..aL BE;iEFIT/TRUNK SE::TEit
LA:cRaL BENEFIT/TRUNK SJAT°R
WATER TREATMEIdT PLANT SiTRCHARGE
$ - OTHER:
$ TOT? L
$ ?l't tG AMAII::T PAID/RECEI?T
:
DOES UTILITY COti:7ECTION REQUIP.E EXC?.VATION IN PUBLIC RIGHT OF WAY?
?YES IF YES, TfiEN-'n "PEftMIT'.FOR=MOFt% WITHIN
PUBLIC ROADWAY" MUST'BE TSSUED BY TY.E
C? NO ENGINEERIDIG DIVISION. LIST AS A CONDI-
TION.
SliESECT TO THE FOLLOZQING CONDITIOi S:
ApPROVED BY:
TI;LE:
DAT° : 16 1210-
A??? ?rs w? r i? ?Fw 4t ??t +?r w? l? ???.?? wr? ?N? dtwi i! ?wi? wFA ?t+ rF ? fa ?.i?/ ?l.? /!? w! ?J? t? ?
1
t?
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CITY Or EAGAN
APPLICATION FOR PER:t1IT
SEWER AND/OR WATER CONNECTIODI
(PIEASE PR[NT)
PPOD= ADDRFSS: i.j-y? xj'
LEGIAL D:.SCRIPTzCN:
`
(Lo lock/Subcuv2.; on or Tae Barcel
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Z) A-P?TSC v'T (PLEASi PRttli
.
PIAiQE: j . .
ACD.TtESS:
CTTY, STATb', ZIP:
3) PLI;mmyl (PLEASE PR1Ni) FOA CITY USE O4LT
--ri18t9RS6N pLUrnRIN6 C9. lNC.
FDDRESS:
12201 MINNETONYA BUID. ,
PLUY.BEPS LICEYSE:
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' CITY, STATE, 2IP: MINNE:
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PLUHBER I.FCENSE H / ? oF Reterd
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4) CCCU?Pi?lT/G*.+'CtER LIP,ME:
ADDRESS:
CITY, STATE, ZIP:
PIiC1:lE:
(PIEASE PRLtIF)
5) INDIG;TE NiHZCH PER-IIT IS HEIhG, REQUESTID: ,?, ?C!L:wIE',CTSQN 'it? CITY SEY7FR
t? C??kVDL.`TIC:I 'iD CITY WATE4 -
• ? + ER (PLF•'11SE DESCftIBE) 6) U:DIG?:: C.:c.: .
• ? P*.E-)SE E'ALD r1PPP9Vm PER+tIT FOR PICK-L's SY 0,'VE OF ASG'VE
?:ALL 7770 77"T TJ I. . 3 4 RL(7vE
(Ci.2 e one?
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7) S IC7,T[,c'tc^.: DA•I•c: ?v - ?
rcr??tiT = ISSUED
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rrES:
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RQ?.TER. PERDtZ: (IilCii.iD: SliRC:iAcZGc,)
WATER ylETER/COPPE3HORN/OUTSID : REn7ER
$ WAT°R TAP (INCLUDE COR?ORATIODI STOP)
S sEWLR TA?
$ /Sou ACCOUNT D.F.POSIT - S7ATER
wac
S SaS, ?c? SAC
S TRliVK TdATER ASSESS:I::+T
S TRliNK SEIdER r155E5S:}AiiT
S Le`.TE?.aL BE:iEFIT/TDU*1K SE::TE:c
$ LATc.R•lL BE?IEFIT/TRU.:K S+TATED
- - ? ?? ' - - - - ----- -----=-- --- -
- SJATER TREATMEI`'T PLANT SIIRCHARGE
$ - OTHER:
S TOTAL
6la
S AD?OC;tiT PAID/REC°IPT R
DOES UTILITY C0N.IECTION REQUIP.E EXCAVATION IN PUSLIC RIGHT OF L3AY?
? YES IF YES, THE:7 A"PERMIT FOR 'r70RK WITHIN .
P[JBLIC ROApTvAY" MUST BE ISSUED BY TY.E
C? NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
. , ?
SliEJECT TO THE FOLLOWING CONDITIONS: •
:. .
..
APPROVED BY: ?
TI:LE:
DATE: : 7
? i?s? sr r? ? i+ ?s ?c r ra ??? w_+? w! ? w si4 Utr ?? ?tw? L! ?wi? wi? R+? rF r s?! ?.i? A!r ?eti i! ?lA ?+ a.
??
2/84
CITY OF EAGAN
7
' lUu APPLZCATIav FOR PERMIT
SESJER AND/OR WATER CONNECTIODi
(PLEdSE PRIHi)
1) PP.O?ERT^I ApDRESS:
LM;I. DESG2IPTIG?I:
(Lo lock/Su:aivlsicn or TaY Parcei Z.D. Ni..^:..^er) J
T'r t,,.,,dZS=:i. 5'T_'?.L'C^TRE, DAT`: 0F Cc2T_GMAL `ui=L`:G -EF-=1 25j?r`C:
• ---
P-°=SL:P =7Td:/??APOSJ LSE: O R-1 SiNGL:, P?MSL° .
? R-2 DUP=r (?'.:'O L^?I=)
. C]-R-3 TC)L`J1ilC{:CF (m:._nJ + L-a11TS) i WITS) •
? B-4 A2P.v?`r`,r?CC_7:,;.?rIIL3S ( ONI M)
? CG1?nfE?.CL3L/RF."??zil,/CF-'I?
Q ?1'CL'SI:2Z.3L
Q
2) APP*_SC-NT ?i (PLEASE PRIYT)
ADa?ss:
cri^r, M=-, zxP:
PhG1e :
3) Plumm _ (PLEASE PR1HI) FON L2iY?USE 08LY
??-
ADDRESS: TkOLAPSC:J PL:l????=•l?`? PLlIY.B 5 IICEYSE• '
? ??Ztlr.,,?. ? ri %rD. Attiv .
CSTY, $T?.TE, 2IP: nnlN\E' ONI:A, .'.^I:•?iJ. 55343 E: ' ed
--Awaicr
' p??: GI??ZSZ/ PLU"f8£R LICENSE N 176-flV
S
t of Retord
arr nicta
4) OCG(S?AD1T/CS'rl`IF.it NpMt:
ADDRESS:
CITY, STATE, ZIP:
PHC3?IE:
(PLEASE PBiNf)
CGa
/
5) INpICNTE :JHICH PERtiLiT IS BEIAG RFX<UESTED:
0--O;M..-4ECri0v zv ciTr sa,-gz
o MM%MTzOv ? ?? I-TATER
? C!'iTMR (PLI's'1SE DESCRIBE)
6) U.-DIG..:: C2s.:
? Pt.E-ME E?OID APPPGVID PER}tIT FO4 PICK?-L-?'s BY C:7E OF AEGZ,'E
Q?PLF? :•',,?2L APPROVID P?.:•IIT TJ l. 2?3?%4 AB,)fi7E
?,? /?, (Circ2e one)
7) SIG.:,TLRE:
DATE:
?---- ?
ISSUED
?
y •
F..°.ES C ?S /Ui S v S?'?.::L.D. PER\1T'y^ (INCLuLE JUP.C?:iRvL)
$ lU Su WATEc2 PERNtZT (INCL'uDE SuRC::AZG'n)
WATER METER/COPPERHORN/OUTSIDE REnDER
S- WATER TAP (INCLUDy CORPORATIO:I STOP)
$ S:.:vLR TA ?
CCOi::iT .._?OSI?
ACCOU\T DrPOSIT - WATER
wac
sac
S TRGVK NATE& ASSESS:!r:+T
S TRli3IK SES•7ER r1SSES5.?E:iT
5 Le`.TE?..,L BED;EFIT/TRU:1K Sz:--R
S L1Tc.Rt1L BENEFIT/TRU::K tIATE$
_.._---- - ---- _.$ __.. ?? e,U._. • -
WATER TREATMENT PLANT SURCHARGE
$ - OTHER:
S TOTAL
AMOL'ST PAID/BECEI?T
DOES UTILITY CON:IECTION REQUIP.E EXCAVATION IN PUSLIC RIGHT OF WAY?
? YES IF YES, THEN F+ "PE3b1IT FOR `AORK WITHIN .
PUBLIC ROADWAY" MUST BE ISSUED SY THE
C? NO ENGINEERZDIG DIVZSION. LIST AS A CONDI-
TION.
SUEJECT TO THE FOLLOWING CONDITIONS: •
APPROVED SY:
TI:LE: •
DAT°: AO 767? -
"! .FJo "FJm 1! r p1 i.'" M/a sFaomt w!t QNi" sqw P!m a% s?lo w r
ti- __3
1 ?.-..
ti " 2/U p
Q
lf CITY Or EAGAN
? APPLICATION FOR PER:?lIT
SEj4ER AND/OR WATER CONNECTIODi
(PLEASE PBIHi'?
1) PROPEf'2T° ADDRESS:
7Ff ai. DESC..'42PTIC:1: 51i % °.
4
6
(io loc.k/Su:csivisicn or TaY Parcei I. .'i..^:?r) ` 7777.
Tc ?i2v'=;G S'??S.CP*;2E . Q?T: 0° Cc2T_Gl^.AL `uiIL,DI.`:G :=Icr.NC.:
, .•_-- ..
' \ •y ?? ??I
P.°ESc-`.:? "-^;TI`ivZ'.'/?PDPOS=- uS: ? rZ-1 SM;(?'L?. :r"MSI.Y .
?
R-Z-??UPL?: (?:':O L^.' 'S)
? ?
. Lt" PZ-3 ZC7oRU-rcn (q':'z= i L':]I:'S) ( U,=--) •
Q B-4 A2.=P/==.trrllT.Zi ( [JNI TS)
13 Cpen1ERCZaL/RE.7:."- aI,/C'cF'Z=-
? "mCtiST'-2IAI,
L3 L%ISTTILTICtAI./Gv^C?'?:TM'`'T
2) A°PT_SCIN'r
NP3'1E: (PL ASc PRL'IT)
!
ADD_RESS : ?
CITY, = TE, ZIP:
z. DFON";
3) (PLEASE PRINT) FON CITY USE OYIY
UaItdG CO„
R
.
ADDRESS: Tvic"tP3a"
?,ppl MINNETONKA BL4D•
-
•+ P,L-U.°.BEBS lI nSE; "
'
CTTY,
STATE. ZIP: r3
MINNE`ONKA, 1 ? Ezpired
PHONE: ""cr.
PWHBER LFCENSE N /> /6J7141 / Not of Recor¢.
' arr nttia
4) OCCt,'?ANT/C*.v1`IE'.c2 NAC`:
ADDNESS:
CITY, STATE, ZIP:
PfiXIE:
(PLEASE PRltlf)
5) INpIQ".TE :VFlICH PER_,[.,•.LL?T IS BEIP. RF'?.UESTL•D:
,t,?_, /c;==ou zo ciz^r saiTR
t? ce:??rzcv TO cixY waxEz
MIE12 (PL2ASE DF_=BE)
b/ li:DiGf.: C.:::
1) SIG:,,'IL'2i c,:
? PI..°.,lSE frOLD r1PPP,(}VED pgt3tlT F17R PICK-L Y C:VE OF AEL'VE
?SC :ALL APPROVm PEN•lIT TJ 1. 2 3 4 AfiOVE
? (Ci.rc e one)
J••
D.axE:
_ '?l_-
ISSUED
?
FEEs : S /O g?v
$ (O, j U
S , .
5
$
$
$
$
S
$
S
5:.:':L.D. ?74RMrT (I`_IC.Ta::i.'. SLSP.C:l.:).vL)
WATE$ PET,2MZT (IiJCiuDE SliRC:i3RGL,)
W1TER METER/COPPERHOR:3/pUTSIDE RE:,DER
WATER TAP (INCLUDE CORPORATZ0:1 5TOP)-
S»:YLR TAP
ACCQUtT DFPOSIT - FlA:;::R
wac
sac TRU?1K S+lATER ASSzSS:?Z?iT
THli:JK SES•iER r155ES5:•?E2iT
L'nTEP.AL BE:iEFIT/1'nU:IK SF.::TBFc
LA:cRaL BENEFIT/TRUNK SdAT°a
- -- - -- --
TAATER TREATMEA^f PLANT SL'RCEiARGE
$ - OTHER: - _' - -
$ TOTAL
Ai??OL'J:T PAIDjREC°I?T s
DOES UTILITY CON:7ECTION REQUSRE EXC.aVATION IN PUSLIC RIGHT OF WrIY?
? YES IF YES, THEf1 n"PEZMIT FOR 'AOR:C WITHIN
PUBLIC ROADSvAY" MUST BE ISSUED BY TY.E
C? NO ENGINEERING DIVISION. LTST AS A CONDI-
TION.
SUEJECT TO THE FOLLOS4ING CONDITIONS:
..
APPROVED SY;
TI:LE: '
DATE :
,
w fr? ?.? w s s? .?? nc+. re ??+ ar?w w? w?? wrr vt+ ot.? w+n? ?.s? rt+ w?r nr ra r? wa? u+t.? wft
??
0 - .)643
PERMIT #:
? CITY USE ONLY
RECEIPT DATE:
2002 $ESIDEIVTIAL MECHANICAL P£RMTf APPLICATION
crrY oe EwsAN
3$30 PII.OT KNOB RD
L'AflAN MN 5512a
651-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: -Dd.
SITE ADDRESS: IsC1ol •
OWNER NAME: TELEPHONE #: ?47
INSTALLERNAME: SEuv,..,,,, .'.:::'-JCAI^CObDIY10io.,..,,T?€hFPHONE#: 14v_ JRr"
. J :Cn vorL7, A1IB. v0. _
Minneapoi;3, L?N 5542k1
STREET ADDRESS: iorm an4 onnn
CITY:
STATE: ZIP:
Place a check mark next to the perntit work type
? Add-on, modification or alteration t existina dwelling unit $ 30.00
• furnace replacement -p?,py?„? ?joGkl???bf?-d70
• air exchanger
• air conditioner
?` f2? n?j
N
D
??
• other ? ? ?s
I
r r?'?? ? ry???Z
Nature of work:
J
?
?
State Surchar e $ .50
TOtal $ jo •SD
<:::/-X
SIGNATURE OF PERMI TT
voz
aS
COMMERCIAL
? 2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4676
Foundation Onl New Construction Interior Im rovement
• Structural Plans (2) sets . ArchitecWral Plans (2) sets • Architedural Plans (2) sets
• Civil Plans (2) • Structural Plans (2) • Code Analysis (1) "
. Certifirate of Survey (1) . Civil Plans (2) • Project Specs (1)
• CodeAnalysis (1)" . LandscapingPlans (2) • KeyPlan (i)
• Project Specs (1) . Code Malysis (1) " • Master Exit Plan (1)
• Spec. Insp. & Testing Schedule . Certificate of Survey (1) • Energy Calculations (1) not always"
• Soils Report (1) • Spec. Insp. & Testing Schetlule (1) " • Elec. Power R Lighdng Form (1) not always"
• Meter size must be established . Meler size musl be est2blished • Meter size must be esizblished - if appiicable
+ ProjectSpece (7)
1 . EnergyCalculations (1) " l
1 • Electric Power & Lighting Form (7)
l • Master Exlt Plan (1) L
1 • Emergency Response Site Plan (1)
1 • SoilsReport (1)
1
• MClES SAC detertninaUOn letter • MGES SAC determina6on letter • MC1E5 SAC de[ertninatlon letter
call 651-602-1000 call 651b02-1000 call 651-802-1000
Food & beverage or lodging facilkies - submit plan to MN DepaAment of Heatth. Call 651-215-0700 for details.
" Contact Building Inspections for sample.
*'" Permit for new buildings or additions will not be processed without Emergency Response Site Plan. Ask Building Inspections for requirements.
DATE: ??/ Z WORK TYPE: _ NEW K REMODEL CONSTRUCTION COST: 7'?l ?
SITE ADDRESS: 0 r'?U c )
TENANT NAME: I7? f /tl?C' SUITE #:
FORMER TENANT NAME, IF APPLICABLE
DESCRIPTION OF WORK / o .C. /?
Name:
PROPERTY Last First
OWNER ?O
Street Address:
Phone #: L? 1 y? S / 6 3?
City: State: ? Zip:
Company: 8 ?? cLf Phone #:
CONTRACTOR 'J
Street Address: S 7-
City: LI-IQ l? State: Zip: ss 7/ /
ARCHITECT/
ENGINEER Company:
Name:
-- = ? -??
Phoae #:(2 C0 r
,
Registrarion#: -? 1 , orn')
i . . . , ...,. I?J ?
Street Address:
City:
Licensed plumber Installing new seweNwater
State:
_ Zip:----_'
Phone #: ()
I hereby acknowledge that I have read this application, state that the information is co and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: /?
.
THOMAS LAKE HEIGHTS 2ND 75951
PERMIT
DATE &
TYPE LOT BL ADDRESS
sisa 4-PLEX 290 01 1570/ CLEM50N DR
300 01 1570B/
310 01 1572B/
320 01 1572
9i85 4-PLEX 330 01 1574/ CLEMSON DR
340 01 1574B/
350 01 1576B/
360 01 ]576
9i85 a-rLSx 370 Ol 1578/ CLEMSON DR
380 01 1578B/
390 01 1580B/
400 01 1580
9i85 4-PLEX 410 Ol 1582/ CLEMSON DR
420 01 1582B/
430 01 1584B/
440 01 1584
viss a-rtex 450 01 1588/ CLEMSON DR
460 01 1588B/
470 01 1590B!
480 Ol 1590
_
?- ------ -... --- -- ----?_
-"-?`
?-
toias a-P[,sx 490 01 1592/ CLEMSONDR
500 01 1592B/
510 01 1594B/
toiss 4-PLEX 530 01 1596/ CLEMSON DR
540 01 1596B/
550 01 1598B/
560 01 1598
32
APPROVED 3/85
PAGE 2 OF 5
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3-CERTIFICATES-OF;?SUBYEY-
. . _ ,
' 7-'SET GF rNERGY CALCUI:ATIGRS '
: . . ; -
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:o Ee Used For; RESIOENCE ,Vaiuatiorr •.5{,7 D te: 9-?•
Site hddress : I ':-6FFICE USE ONLY ,.
Lot: Elock ? Sect/Sub TH0MR5 CK Erect:- ' Occupancy -' '
. ? . HEZGHTS R_r„odel Zoniag Farce? F,eyair.. Type of ConsL
,:?nlarge - ,: 0 tif;.Storie's
O??rner ' NEid.'HORIZON NOMES,rINC. -? '_rM;ove - ?Length `.,, _ . . .. ,.._ ._ .._ -.;. . ' . . ..
Demolish . Depth
Address . P.O. 807( 1367 Grade
.::.;. . . .._ . , . :. .. _ . , .
City/Zip_.COd' Mpls.. 17ino.- . 55440' - ' ----=- ---- - -.----------
: . • . . . - . - _ , - ^ .. --- - . _ -. . , . .. .
- Phone 420-3900 9PPROVALS -
. ?Contractor 5AI9E'
?
- ? :.?Assessments : ? ?Perinit
.
Fa.er./S aer '. Surcharge .
A ddress --? Po2iee Plan <Reviex
? Fire -''
_ ? "SAC-.
Cityl2ip Gode --
` Engn..
-: • Water Conn
- . - .. Y - - _
. Planner % lrater.l;eter
Phone ,-? . •
rpuncil Road Unit.
,
`
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Blag Offq Psrks
fi
rch /Engr. ? U. `GRISWOLD
APC
Treataae»t Pl
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73'TRAG3"ftRS ,74t1S??BE -L?CENSED kTITH 'i3fE' CITY,,OF'EAGA3i-:
° ItiCLUDE:Z,SEYS Or`FLANS
?. 3-CERiIFICATES-OF SURVEY
, "? • ,-`.'Y SET OF rNERGY CALCtJLfi7'IONS
? op
Tc Used For:- RESIDENCE Valu2G?on• cC?(? IIate:
Si±e Hd3ress • ?r?q?? (`Qa,,.n? ?jy, OFFICE USE ONLY ?
Lot: Sj -916ck.=L Sect/Sub THOmAS LK Ereet', Oceupancy
HEIGHTS'?Temodel- _ Zoning,
rarcel '
? P Type.oP Const
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En7 ar?e
of,' Storie5
C".:r,er NEId HORIZDN HOMES,..INCT,, "
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ol"ish - .
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hddress ?- P.O. ?.BOX 7367 _
Grade -- °'? 5q-`Ft
'City/Zip .Co3e_ Mpls:, IM1inri • 55440 .,. ? ,
, , _ --- - . --
-° -;--- ------ ---
.: Phone 420-3900 . . . . C APPRDVALS'--
? Contractor ? -SN19E -- Assess^ents - re:mit,. . -
? _ideter/Seuer Surcharge
.
:
,. • _
Address ? Police
- . „ . - - Plan F.eviex .' -
_ ; _ . ,
cAC ,
City/Zip,Code` Engr, , 1+'ater Conn .
' Planner- ' tiater Neter • ,
Pnone Couneilt -&oad Unit
- ? Bldg Af#' y? Psrks
Areh./Engr. D GRISWOLU, .. -_ .? , AFC, , Treat?sent Pl
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'Varianee • ?? - .
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'CiLyfZip :Code
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llOTE ALL :C?171TAACTORS'HUST BE LIC£RSED idITA 3'!1E' CI17OF,
uwir qq
I?? CLUDE, 2"SE3'S DPPLANS_ ,-,
3 C ERTIF'ILATES OF .SU{iV.EY :
SET -4 F tNERGY CALCULATIONS "
c0:3,003; . ,
To __ Gsed Fer:' "RESIDENGE V2lcation:.
?. Date: :Q-ck - gC;.
'
Site ::dir_ss: IAi (??o,rriMT? ?? .
f J -. • OFFICE
USE, ONLY
. .'
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Lot: Jff Elock ? Sect/Sub TH0I7p5 LK_ Erect'H x-- ? u . .' ... _ .
Occupaney ?
HEIGHTS ? heT,ovel 2oping
'
, FarceT 0
-
. r,epair.; Type of _Const }?
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- Uaner NEW'HOR3ZONHOmES,.INC.- ' Move Length
Denolish ` '-; D'epth -- : Z]=:
rddress p.0. BOX 1367. Grade.. Sq'Ft..- _
City/Zip Code : IApls.a Minn 55440. - - --- - ,--,-. -r-- ----
- Phone 420-3900 ? gPPR0Y9LS
Cor,;.ractor SAME Ass25smenLS Permit 3fto,
- . ' l,'aterlS=aer-
... Surcharge
'
: Add.^e§s ;
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Plan- Review .' 158
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' City/Zip Code`" _ Engr•: k'ater Conn '-130'o.
. ' Planner _ Wa£er Meter; '?-
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,
:IHCLUDE, 2->SoTS DF PLANS';:
3 CERTIFTGATES OF SURV£Y `. :
. 1 SET OF c.NERGY CnLCULAlIOtdS"'
70 3e Used For?- ' RESIOENCE?
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..l Valuation._.
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Site kddress:` ?SR2B' .CQQinrcn(s , .
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p ?1rUF? UFFICE USE ONLY
Lot: So =.,Block ..1= SectlSub Erect'
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THOIRAS LK Occupancy
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NEIGH7S ? Remo3el Zoning :
arcel.?{.- 2yge of Const ;
? ' ?nlarge ? ?7 oP:'Stories
-Ow7°r. . ? NEW flORIZOH HOMES; INC
Demoli`sh : Depth
Address P.O. BoX 7357. :" .. Grade = SqFt
. City/Zip_ Cod'e: Mpls.: .Plinn:. .."55 440-: -- -=- . ----- -------- -----
' Phone 420-3900: ' - Y APPROVALS
Cor,tractor S0.R1E Assessments Fermit
ldeter/Se;;er Snrcharge
Address ' Police Plan Peview -
; • - - . : iFire '% SAC .
City/Zip Gode.??- :- Engr '- 77
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k'ater Gonn _
Planner...
Water Yeter
? ^rnone Council . pead Unit
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? - B?dg` flfP ?sr'ks,
Arch:/Engr. _D
GRISWOlD -, , • ? : APC ??. _ ? ; ` Treatreqt Pl'
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Varianbe.,' _
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Address TOTAL :
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,-7F ?a?Tov?,+?11ZcivsE Cea. .Sedgcviek??c?-?Zv"?oN-`x 21,,754
HEAT LOSS CALCUlAT10N5 HEATING& AIR CONDITIONING CO. MiNNEAPOUS, MINN.
Weatherstrip5 A.S.H.V.E. Con6truction No. Insulation
IATindows Doors Guide
Reference Out. Wall Inl. Wall Ceillnp ROO( Floor Nind How Applied
Yes-No Yes-NO 19
Fl.?,?lu( a Room Length 'Z? Wid[h HeigM ? Fl• mASY- ?qRoom Length ?yp -WWH' (i Height
Wi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea
No. Witllh
ol ane He?pht
o( Oane No. 01
li hts Lineal ft.
of ceypk Area
ap• ft.
N.' WiE?h
ol ane Hmqht
oi
ana No, ot
li hts Lmeel IL
ol aack A?ea
54• ?L
2 eI 2 2. .?. 1 /
V 2 2 I ?7
R °J .2
2 L 1 IQ
Coef B tu Coef B tu
infil[retion InFiltration 2.? 1 3,91 7 J p
Glass 2q Glass 11
E.P. well ExP. wall lO X ??!
Net exp. wall Net ekp. wall 9• 25$
-t'nT• w81+ o0'r 1 117 a? Int. wall
Ceiling Ceiling ' 2.0 26 1
Floor Floor 00
,otel atu. 7 5-1 -Totel atu. 3
Required sq. ft. E.D.R. or sq, ins. W.A. leader area Aequired 6q. ft. E.D.R. or sq, ins. W.A. Leader area
FI. Itibny( Room Length ? Width Height FI. ?e 2+411?4om Length I 5 Width 10 Height
Windows and Doors-Crackage and Area Wi ndows a nd Ooors- Cracka ge and Ar ea
Na' Wi tlm
of ane Haiqht
o1 ene No. of
h h,g Lmeal h.
pf ?rack A?en
`+V• ft.
No' W?dth
ol ene Hi+?qM,
of Tnu No. uf
b hts Lmeal h.
o/ crack Aree
sa, f1.
,
o % R r ro .? Z$ 2 ? ?
Coef Btu Coef 8tu
Infiltration ZZ4 ? Infiltration
?
Glass Glass
Exp. wall
Exp. wall 1?,. ?,
Net exp. well Net ezp. wall
Int. wall Int. wAll M
CBilin9 M. Ceilinp
Fl Floor 1???-^
Tolel Btu. Total Btu. 32,
Required sq. ft. E.D.R. or sq. ins, W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
fl. '?t Ropn Length 12. Width ? Height ? FI, Hoan Length , Width Height
Windows and Doors-Crackage and Area Wi ndows a nd Doors -Cracka ge and Ar ea
N?' Width
of ane Heiqh[
of nne No. ot
li hIS Lmeal ll.
of crack Area
3C. ?1.
NO' y+?tlm
u? Hne IU;?pbt
ul ane Nn, ul
li hts l?neal 11.
ot crack A?ea
Bq, It.
Coef Btu Coef Btu
Inliltratipn Infiltrntian
Glass Glass
Exp. wali Exp. wall
Net exp. wall Net axp, wall
Int. wall Int. wall
Ceiling lZ.]C'1 Z-A 2C 10 Ceiling .Z.? 1'24S
Floor
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-'Floor r ?
Total Blu. Total Btu. -125
Requirecl sq. ft. E.D.R. or sq. in5. W.A. Leadei area 10 pequired Sq. ft. E.D.R. or sq. ins. W.A. LeBder area
HEAT LOSS CALCULATIONS
Cjc°•
HEATINGB AIR
.Se4yj49tel
CONDITIONING CO.
MINNEAPOLIS, MINN.
Weatharstrips A.S.H.V.E. . Construction No. Insulation
Wi;ndows Doors Guide
Reference IM, Wall CeiHog Roo( Floor Kind How Applied
Yes-No Yes-No ?y_ 5 .
QRoam Length Height
14<0)Width FI. Room Langth Width Height
Wi ndows a nd Doors- Cracka ge and Ar ea Windows and Dows-Crackage and Area
No. W,drh
ol ane HeipM
0 1 Pane No. of
li hIS Lineel h.
of Crack Area
sq. It.
No• WiArh
p} e? HaiOh[
of ane Nn. ol
li hls Lmeal 1t.
of cretk A,ea
%a• F,.
? ) Z
Coef Btu - Coef 8tu
Infiltratioo 760
Infiltration
Glass ?? Glass
EKp. wall ? A Exp. wall
Net exp. wall ? ,2 Q Nat exp. wel I
Int, wall Int. wall
Ceilin8 Cailing
Floor 10 74 (y-7 Floa
Total Btu. 3 Total Btu.
Flepuired aq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. ar sq. ins. W.A. Leader area
FI. {?ry? Room Lenpth y Width 11 Heieht FI, Room Length Width Haight
Wi ndows a nd Doors- Crecka ge and Ar ea Wi ndows a nd Ooors- Cracka ge and Ar ea
No. H'itlrh
of ane HeI,pht
ol ane No. of
h hls Uneal h.
of c.ack 4rea
sa. h•
No' W,??h
of ane Hxiqht;
nf flnn No, of
h Ms lineal h.
of c.eck Aree
s. 11. -
Coef Btu Coet Btu
Intiltration ' 11-7 2223 Inliltration
Gless ? mL QQQ Glass
Ezp. wall _ ExD. wall
Net exP. II 292 41 1 l Na+e.o. we
2 'TU 22.1 ri Im. wal I
ceiiina cauine
Floor Z-X I ?Z . ? 1 Floor
Totel Btw Total Btu. .
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. tt. E.D.R. ar sq. ins. W.A. Leader area
Length 13 Width Height FI, Room Length Width HeiBht
Windows a nd Ooors-Crackage and Area Wi ndows a nd Doors -Cracka ge and Ar ea
-
No. Width
of ane Haipb[
of nne Na. of
li hu Lmeal h.
of crack Area
sp. ft. NO' W?n?n
a} ane Me?qh?
of nna No. of
Iwh1s Lineel h.
of crack 4ren
eq. 11.
Coef Btu Coe( Btu
Infiltration Infiltration
Glass Glass
Exp. wall Exp. wnll
Net exp. wall 7 nh Net exp. wall
InT. wall tot. wail
Ceilmg Ceiling
Flaor Y,-r G? I ? l- Flo(x
Tutal Btu. Total Btu.
Required sq. It. E.D.R. or Sq, ins. W.A. Leadar araa Ruquired sq. /t. E.D.R. or Fq. in5. W.A. Leader area
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Use BLUE or BLACK Ink
For Office Use
CIV of Eapn j Permit
1 h 1
Permit Fee: -I V - 5 0
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: 3 I
Phone: (651) 675-5675 1 I
Fax: (651) 675-5694 I Staff. I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION #
Date: - I l - i 3-_- Site Address: WT 41 8 ) $nit
Name: C01L0S_-- Phone: 721- rQ 2_-
Residelnir
Owner Address / City / Zip:
Applicant is: Owner Contractor
Ype ofwof-k Description of work: Rei o i=- -
a--- - -
T.
Construction Cost: V i Zq Multi-Family Building: (Yes _ / No
Company: Ca Q5 BUG /0W__--_ Contact: c~
Address:-s~!SlsL~ I"1 t~i~PYIAYI City: Min Q nh's
Contractor
State: ! J ) A/ Zip: syd G - Phone: ~2-1
License SLA-~ 4 2- - Lead Certificate /V,a _7 -
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
-Yes --No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: _ Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
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 Call at (651) 454-W2 for protection against underground utility dames. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.oooherstateonecall.oro
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and cods of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
Applicants Printed Name Applica s Signature
Page 1 of 3
r For Office Use
(Ls
t � • a ::::ee'
:
Date Received: w
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 EDE rrik7
(651)675-5675 I TDD:(651)454-8535 I FAX: (651)675- I` ? Staff:
buildinginsaections(dcityofeagan.com J jN 10 ,. I
2019 RESIDENTIAL B G PER IT APPLICATION
Date: L / 7P/ Site Address: /OR vbQ.n'ry ,0./Wf'1 Unit#:
[ Name: 41VU if-1.460 /0704 1►D)$t Phone: F
R
owner Address/City/Zip:
Applicant is: Owner Contractor
Description of work: Avirre 4r,A4,/,#/e' t /1" 07si 4a- /At�2ou1-
Type ot
mak.
Construction Cost: Multi-Family Building: (Yes /No )
: Company:flair L rh"7784147T�b IWD /TDDC ontact: ,41 /*. "DV V j
Con Address: 14--//.2. 6f97 2t' � City: 4Lrf
State: V Zip: ;A-/.491 Phone: ci 24k Y'maii:/ rrlprv6rAt 'i`R'r,.y�C412
License#: RL 2Z 9f 2L Lead Certificate#:
If the project is exempt from lead certification, please explain why:
,% Augie4 itain 1471
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:
•
i N07) x = ea; maybe
. ._
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.comisubscribe.
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.aooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a pe ; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval lans.
x / , ILL A, [/r
Applicant's Printedtr� Applicant's Signature
DO NOT WRITE BELOW THIS LINE / ,_(.4? C. f erY1 O n bat /��6z-IS
SUB TYPES
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi C Deck — Porch(Screen/Gazebo/Pergola) Miscellaneous
D1 of A 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
ZO Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation L' 3, ace.— Occupancy .-C-3 MCES�ystem
Plan Review Code Edition ' 0,$- SAC nits
(25%_100%/0) Zoning P,i City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction VI3 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings (Addition) Ne Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
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 �(�/�Paan~ Other:
Mb Reviewed By: b X V\ r' ''\�I 4 R , Building Inspector
RESIDENTIAL FEES �
Base Fee K. X; S i%n, oo I i r!
Surcharge ,
Plan Review /D k 2 t? ' 2 00 59 • "df
MCES SAC ® / /57 D.) f9 • lT
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3