1604 Clemson DrWCT.
,' .f.-. -<:, . ' +. ti . .s . ..... . . . 7.-
PERMIT#
MECHANICAL PERMIT RECEIPT #
ClTY OF EAGAN a3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE -?'CONTRACT PRICE: PHONE: 454-8100
Site Address " r) r• BLDG. TYPE WORK DESCRIPTION
? Lot_;..! Block i Sec/Sub - ?
I Res. x New x
Name
MAddress' ` i n, ^ r? v ^ . • uR Add-on
?
? ; ,' c?+^ 342 - V s_ Comm. Repair
c City • Phone Other
?
r
? Name
c Addre
O CitY -
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other ' f . , r, _
FEE
S/C:
TOTAL•
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RE5IDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
! . I SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
.? - ?.
QUILDING PERMIT
?' gz7QQ
Receiat #
To be wd for Est. Volue Date , 19
Sita Address Erect Occupancy
Lot Block Sec/Sub. r Remodel ? Zoning
Repair ? Type of Const.
Parcel No.
Addition ? No. Stories
W Name
? Addresa `
City Phone ?
A Name
u
dd
8
3
? A
ress
Citv
Phone
Gix
? W Name
i? Address
u
"i W City Phone
Move ? Length
Demolish ? Depth
Int Impr. ? Sq. Ft.
Install ?
Approvals f.•s
Assessment
Water 3 Sew.
Police
Fire
Enq.
Plonner
Coun[il
I hereby ocknowledQs thot I hova reod this opplitation ond stote that gldg. Off. fhe iniormotion is correct and ogree to comply with oll applicoble APC
Stote of Minnesoto Statutes und City of Eagan Ordinonces.
V D
Permit
Surcharge
Plan Review ?
SAC
Water Conn.
Water Meter
Roed Unit
Tr. PI.
Parks
I ?
Sipnatum of Permittee ar. ate Cpples
Total ?
N Buildin Pertnit Is issued to• .on tha e ss condition tho1
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Ea?n, MN 55121
PHONE: 4548100
9 • xD*-
all work sholt be done in accordance with oll opplicoble State of Mfnnesoto Statutes ond City of Eoflon Ordinonces. ?
n..:uc..., nsso-:..I
, Pwmit No. Pwmk Holdw DIb TNephons ?
Rlumbinp (p 0' / V ` ?-?
H.VA.C.
c, r '
17
Elacbic t R• 3 I? ?a` r-
Softener
Inspeetion Dah Insp. Othsr
Footlnqs 1 ?o? LCJ ?
Footinps II
Foundation
Frsminy ' _ ? fll4
Roofing
Rough Plby. A - -
Rough Htg. 44
Insul. s3 ?? v ,QjZ .
Flreplace
Final Htg.
Flnal Plbp.
Finsl
J?
911 Fg14?
Cere/Occ.
Water Describe Location:
WaU
Sswer
Pr. Dlsp.
I/ J40 PERMIT # CD 7 '? ?
• ' ' ?,,. . . --S? MECHANICAL PERMIT RECEIPT # ?(L Q-
.- CITY OF EAGAN
. 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
CONTRACT PRICE: PHONE: 454-8100
Site A dress BLDG. TYPE WORK DESCRIPTION
Lot Block ? Sec/ ub ?
r. i
, . Res. ? New
? Name 1oo1 XE.p??AV& Mult Add-on
?n Address Comm. Repair
c City 545.16111hone Other
?
a?
c
$
O
City
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outiets #
Other
Phone
' J M BTU
M BTU
M BTU
M BTU
CFM
/
FEE
S/C:
TOTAL:
FEES
RES. HVAC 0-100 M BTU - $24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYON D $1,000.00)
i.
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
f ?
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagao, MN 55121
PHONE• 454-8100
& Fr)
lii0i
QUILDING PERMlT Receipt #
Te M wmd fer - Est. Vaiue Dcte , 19 -'
Site Address ` - Erect ? Occupancy
Lot Block SeclSub.
' t Remodel ? Zoning
Parcel No. Repair ? Type of Const.
Addition ? No. Stories
W Name Move ?
li
h ?
D l.ength
?
? Address emo
s
Int Im
r
? Depth
F
p
. Sq,
t.
City Phone Install ?
? Name Approvols Fe•.
6u q?? Assessment Permit
City Phone Woter b Sew. Surcherye
' Police Plan Review
t
a
?W
Ne^'ie .
Fire
SAC
Address Eny. WeterConR
? W City Phone 43 ? Plonner Water Meter
I hereby acknowledge thot I have reod this opplication ond stote thot
fhe (nlormation is correct nnd ogree to comply with oll applicoble
State of Minnesoto Sfetutea ond City of Eagan Ordinonces.
Bldg. Off. ' •
APC
\fa' O
Sipnature of Permittes
A Buildinfl Permit Is Issued ro:
all work sholl be done in ocoordonce with all npplicoble Stote of Minnesota
Road Unit -
Tr. PL - ' ,
ate I Copies
Total y `
a+ the exprcss cw+dition ihol ?
$tatutes or?d City of Eopcn Ordirantes. ?
Bufldinp pificial
° Pamk No. Pwmk Holdsr Dats TNephone #
???ifig 6
Pt.VA.C.
Ehctrfc ? ?. S. S lp ?6 s y?
Softener
Irapection Date Insp. Other
FooUnysl d ?
Footlngsll
Foundatlon
Framing -
Roofin9
Rouyh Plby. ? - ?? -
.
Rough Htg.
Insul. S/j3/? lT.?r/ 643 44. QY l41
Flroplsce 4
r ?
Final Hty. ?
Final Plb¢
Flnal
Cmt/Occ.
?? Deseribe Loeation:
ell
I
w*r
Disp.
F".
.;
. ?
CONTRACT PRICE:
Site Address Lot Block
? Name li
"a Address
c Ciry -
_ Name _
c Address
O CitY -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
FEE
S/C:
TOTAL•
PERMIT #
? . ' • MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
? PHONE 454-8100
Phone
-? u M BTU
M BTU
M BTU
- `r M BTU
CFM
r
BLDG. TYPE
Res.
Mult
Comm.
Other
WORK DESCRIPTION
New
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU
-$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
?
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
--??
Site Address ' •J"''
Lot Block
Name ?
a?
Addr"s
c City p ?
v
Name K• r1uEp1147
?
c
Address
"¢m 5 o n .
o c?, a ?e n Phone-
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets # '
Other I n s t. ' r y¢ r, Pa? C¢
FEE
S/C:
r TOTAL
PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: -
PHANFr d5d_A1f1A
•
Sec/Sub
_ _1% I _
BLDG. TYPE
Res. x
Mult
Comm.
Other
WORK DESCRIPTION
New x
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
45011
ZO ;.%O I ?GNATURE OF PERMITTEE
FOR: CITY OF EAGAN
PERMIT #
. ' . • • M ECHANICAL PERMIT RECEIPT #
?
3830 PILOT KNOB OAD, EAGAN, MN 55121 DATE
CONTRACT PRICE: ? PHONE: 454-8100
Site Address BLDG
TYPE WORK DESCRIP110N
Lot Block ? Sec/Sub .
- R
N
?
Name N . R c
,4i M r, _ :..a . U . .'. '' ew
es.
?
Address 1001 XENI?? AV;=. = Mult Add-on
R
i
C
c
City. MINNERPGLI?P?b?e ?- r
epa
omm.
Other
- 545-1611
Name ? FEES
?
c Address ? RES. HVAC 0-100 M BTU - $24.00
p City Phone ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
TYPE OF WORK GAS OUTLETS - 1.50 EA.
Forced Air ?
M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. '
" y M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S1C IF PERMIT PRICE GOES
Vent CFM gEyOND $1,000.00)
Gas Piping Outlets #
Other
l
FEE ?C?r .
S/C: ?
SIGNATURE OF PERMfTTEE
TOTAL•
FOR: CITY OF EAGAN
h ? . •
4 ? L
CITY OF EAGAN ` ' ` ." `' 0 ` '
. ? a l; ,.
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
1 OF 4 PT_, Est_Vnlue ,?b1l0Ur, n..0. OCTVEER '4 1e ;5
Site Address f u I Erect ? Occupancy
Lot Block - SeclSub. N Remodel ? 2oning
Parcel No. Repalr ? Type of Const.
Addition ? No. Stories
Move ? Length
? Name
W
? Addreas F 'A
City Phone
.9
g?
u
F
Name
W
13 Address
tW City Phone
Name
Phone
I hercby acknowledye thot 1 have reod this epplicotion ond state thet
fhe informotion is correct ond agree to comply with oll applicoble
Stats of Minnesoto Stotutes ond City of Eagon Ordinonces.
Slpnoturc of Pern+ittae
h Building Permit Is issued to:
otl work sholt be done in occordance with oll appliwble State of Min
Demolish ? Depth ,
Int Impr. ? Sq. Ft.
Install O
Aporovols F•es
Assessment
Woter 8 5ew.
Police
Fire
Enp.
Planner
Councll
Bldg. Off,
APC
V D
Permit +
Surcharye ,
Plan Revlew , .?
5AC ?? I
Water Conn. ,,
Water Meter - J • V L) !,
Road Unif --7rt'? ' 0 0'
Tr. PL 7- l' f "
ar. ate ,
I copies .; U
, Total ?
on the express cadiNon that
sota Statutes and City of Eaqan Ordinonces.
Buildinp Officiol --
Permit No. Psrmk No1dK Date Tslephone it
Ploni,ing
H.V A.C.
'ENetrie 7 . b • g • ? il'? S ? r ` ? y ?
Sohwwr
(nfpection Den Insp. O ther
Footinps 1
Footinqs 11
Foundatlon
Framiny
•Y?p
40
r?,(
RooNng
Rouyh Plbq.
Rouyh Htp. .`'
InwL .S 'f?s3
Finplsce
Flnal Htg.
Final Plbg. Jc yl- ' Gf/ f1 / cCIT t
Final • ,.?t ?
CNt/Occ.
??? Daacribs Location:
WNI
Ssw*r
Pr. DIsP.
-----.a..w.?--•?y'd!?
CONTRACT PRICE
Site Address 1'I.GG
Lot (r? Block
? Narr? ? -M
? Address 1001
c City MIVfJ
L Name
c Address
p City
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
M BTU
M BTU
M BTU
M BTU
CFM
1
FEE
S/C:
TOTAL:
PERMIT # _
? . ' • MECHANICAL PERMIT RECEIPT # -
? CITY OF EAGAN
, 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:'??
Phone
BLDG. TYPE
Res. v
Mult
Comm.
Other
WORK DESCRIPTION
New
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
, ?.
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
,
! 7'??'u•,. , .
:
BUILDING PERMIT
"'" 17'!43
Receivt #
Te M wftd ier ? Est. Value Date , 19
SiteAddreas Erect ? dccupancy
Lot = Biock ? Sec/Sub. Remodel ? Zoni
ng
Parcel No. Repair ? Type of Const.
Addition ? No. Stories
?
Name Move ?
lf
h ?
D Length
Addreu '-' emo
s
Int Im
r
? Depth
F
City Phone •
p
Instail ? Sq.
t.
Approvals Faes
? Neme
?. Address Assessment
City Phone Woter 8 Sew.
uW
Name Police
Fire
?
?? Addrass En
t W
City
Phone y,
Plcnner
Counci I
I hereby acknowiedga thot 1 hove reod this opplication and stote thct eldg. Off. ' -L
fhe intormotion is torrect and ngree to tomply with all applicoble APC
State of Minr?ewto Statutes and City of Eagon Ordinances.
V D
Permit
Surcharge
Plen Review
5AC
Weter Conn.
Water Meter - G U
Road Unit J• 0 G `
Tr. PL 0
P8?Ics ?
I
Sipnature of Pem+ittee ar. ate Cppies
_ .? . Q
. , • - Totel
h Bufldiny Permit is issued to• on tM ex ss condition tlwl
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
. pre
oll work sholl be done in otcordance with oll epplicoble Stote of Mlnnesoto Statutes und City o4 Eoqon Ordinances.
9ulldine Offfeiol
Pwmit No. Permit Ho1dK Dam Telaphone it
Plumbinq ?079 70 141? 33idSa1.I
H.VA.C.
?
EleeMc 71 U•• s n, 3 Y r '
soft«»?
Iruaetion Dste Insp. Othar
Footinys 1
Footln9s il
Foundation
Frsminy , t
Rooting
Rou9h Plby. •2,(-Ye ? - ` . ( -
Rough Hty.
Insul. l3 y U ?y •
Flroplace
Finel Hty. ? 31/
Final Pltty.
Final
Cwt/Occ.
Watsr Desaibe Location:
WlII
S?w?r
Pr. Disp.
Lot
.. :? . , . .
" r PERMIT #
? PLUMBING PERMIT ? ? ? rt`V?
CITY OF EAGAN RECEIPT # •
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE;
'CE PHONE: 454-8100
11
m Name 7?:?2?,
y Address
c City r Phone
? Name _
? Address
p C'tY -
FEES
D FEE - 196 OF CONTRACT FEE
iS - COMM RATE APPLIES
JSE & CONDO - RES. RATE APPLIES
- RESIOENTIAL FEE - $12.00
- COMM/IND FEE - $20.00
RCHARGE PER PERMIT - .50
S/C IF PERMIT PRICE GOES
OF
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Fepair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Ki?chen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - S1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn ?
-7?-Softener - $5.00 J
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE: •.? ' u v
STATE S/C: V r ?
..
GRAND TOTAL•
' -- -
- i
BUILDIob PERMIT
To he u§ed for DECK
3830 Pilot Knob Rc
Block 1 Sec/Sub.
Y OF EAGAN ;. 53
P.O. Box 21-199, Eagan, MN 55121 '?•
ONE: 454-8100
Receipt #
f1000 naio .1mm 26
W Name ?G ??SOl1
o Address s?
City Phone 454-7173
,o Name SAM 454-3900 (W)
Address
? City Phone
0 W
W Name
W
Address
< W City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagikn Ordinances. ?
Signature ot Permitee j•'r ?-s ? ,s'; ?/ ??
A Building Permit is issued to: D= MATTE$Qb
on the express Conditi0n that dll work shall be done in acr.nrciance wirh all
I applicable State of Minnesota
Building Official ?
?_ _ _ .. --_- _ - - -- - - .
?
????7
.11
?
OFFICE USE ONLY
Occupancy - FEES ?
Zoning _
?
(Actual) Const •
- Bidg. Permit •25.00 ?
(Allowable) - Surcharge 050
A? oi Stories
Length iQj Plan Review ;
Depth ?Q! SAG City
S.F. Total - SAC, MCWCC
S.F. Footprints
On Site Sewage _ Water Conn
on ste wen - weter Mecer '
MWCC System
City Water -
Acct. Deposit
PAV Required _
_ 51W Permit !
Booster Pump _ ?
S/W Surcharge i
Treatment PI ;
APPROVALS Road Unit
Planner - Park Ded.
Council
BIdg.011. _ Copies
?
VarianCe - TOTAL
Permit No. Permit Holde? Date Tekphona #
WATER
SEWER
PLUMBING
H.VA.C.
ELECTAIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg.
Isul.
FMeplace
Final Htg.
Orstat Test
Final Plbg. Plbg. Inspectw - Nolify Plumber
Const. Meter
Engr./Plan
Bidg. Fnal
Dedc Ftg.
Dedc Final 7 f,
Wetl
Pr. Disp.
CITY OF EAGAN
Addition -?ema!
Owner
.ddition Lot 0 /-/ Blk A/ Parcel #10
Street 1604 Clemson Drive st8ce Eagan, NRV 55122
Improvement Date A Annual Years Payment Receipt Date
STREE75URF.
1921
6594 Zu. A0121 2 5-5-83
STREET RESTOR. ' 5
GRADING
SAN SEW TRUNK 19 73
*SEWER IATERAL 37.61 7. 52 1.0 A0121 2 --83
,.. .
WATERMAIN
*WATER LATERAL
WATER AfiEA y 136
51 5 4.61 A01212 --8
.
STORM SEW TRK ^ 249.91 A012172 5-5-83
*STOFM SEW LAT 981
CURB & GUTTER
SIDEWALK
STREET LIGHT
PCad UI1lt
WATER CONN, 500.40 "
RUILDING PER.
SAC 525.00
PARIC
?
CITY OF EAGAN
Addition TbnMIl
Owcer
?ddition i.ot # la'-Rik A I Peroel #10
Street 1604 B Clemson Drive StatB Eagan, Mn 55122
Improvement Date Amount Annual Years Payment RecEipt Date
STREET SURF. 5594 111.89 A0121 2 - 83
STREE7 RESTOR.
GRADING
5AN SEW TRUNK
*SEWER LATERAL 19$1 „ 37.-61 Z. SZ 1.0 AOZPZ Z
WATERMAIN
*WATER LATERAL 1981
WATER AREA #15- 1981 30 54.61 A012172 -- 3
STpRM SEW TRK ? 249.91 /?Q],?TQ 5-5- 3
*STORM SEW LAT 1981
CURB & GUTTEfi
SIDEWAIK
STREET LlGHT
WATER CONN.
500-00
BUILDING PER. 11100-11103
, 525.00
PARK ,
, ?
CITY OF EAGAN Remarks
Addition nnm2s La k6HQights Lot = G481k iff 45.1-Parcel #10
ovine. street - 1606 Clemson Drive state Eagan. NA1 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, 111.8 AOln 2 --8
STREEY RESTOR.
GRADING
SAN SEW TRUNK /9,9 I
*'SEWER LATERAL ?;Z 1981 .37,61 7.52 $ 1.0 A0121 2 5-5-83
WATERMAIN
*WATERLATERAL 1981
WATER AREA h ?t ?
. - - - . l _ -
STORM SEW TRK 249.91 A012172 S- 8
*STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET IIGHT
WATER CONN.
BUILDING PER. 11100-11103
sac 525.00
PARK
CITY OF EAGAN Remarks 75RS/ /..30 O/
Additian T}4oma,g j,a,jfP He ighte Lot Rlk ? Parcel #lQ
o,,,,i1er street 1606 B Clemson Drive state Eagan, MN 55222
Improvement Date Amount Annual Years Payment Receipt Oate
STREET SURF. 1$ AO 72 --8
STREET RESTOR.
GRADING
SAN SEW TRUNK 9 73
*SEWER LATERAL -37.61 7.52 1 .O A01212 - -8
WATERMAIN
*WATER LATERAL
WATER AREA !{.61 A 2 5-5-83
STORM SEW TRK 249.91 A0121 2 5-5-83
*STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500.00
BUILDING PER. 11 3
SAC 525-00
PAR K
GEO. SEDGWiCK HTG. & AI R COND. CO. Q
HOUSE HEATING TEST RECORD
ADDRtSS. ' IG Qc.?r? c jPrnSdAl 0 r CITY
OCCUPANT 2c .4j OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY - INSTALLED BY
Electrical Work By Gas Line By ?
TYPE OF HEAT GA_ FA x HW_ STEAM SPACE HTR. UNIT HTR. OTHER_
1) GAS DESIGN CONVERSION
? _?--
MAiCE ? - ?•
Model VG 5 U
Serial 1/964 Iq ?-L!?z
INPUT 17U Z'OC)
THERMOSTAT Neai PJu
/U
Valve -? ^ J T 7
Limit 4 wC
Limit Setting 170 0
Fan Setting '` U ° ?
Pilot Type - ` < / C
Pilot A4ake a ti G ?
Pilot Model qqn
- /
Pilot Timing xit. ? f d R/
L.W. Cut Off "------- -
Pressure ?u{- G/
Percent COZ 5 J?-
Input CFH
Stack Temp. ? s.??'
????-
Percent O2
Percent C0
?
??3 ? /CONTROLS
MAKE OF BURNER _
Model
Max. BTU Rating -
MAKE OF FURNACE
Model
Vent Size _ ? / &4 ?
KtND OF LWER - SIZE NONE
Draft Hood , N cI (,'cf Reeulator ? S
Filters Size Number
Chimney Lacation Inside Outside
Chimney Construction C 7-5.S S
Smoke Bomb Wiring ?
Draft Test Taa _ ? S
Door Pressure Lighting Inst.
Date Tested ? -
Company Testing ' <
Name of Tester
GEO. SEDGWICK HTG. & AIR COND. CO.
L??' B I HOUSE HEATING TEST RECORD
` 1 J r ?' J ??l P ?Q ?t C4 ?Li b V
ADDRESS ? CITY
OCCUPANT PLi' C? 20 ?v nwNER HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY ?F
Electrical Wnrk By Gas Line By _ (S,C
TYPE OF HEAT GA_ FA-` HW_STEAM SPACE HTR. UNIT HTR
GAS DESIGIV
MAKE bf -q A olt f
Model 3 L u ti j
Serial 64 i 9`{ 31
INPUT 5(J, iA 0
T-? ? y CONTROLS Y
THERMOSTAT Heat Pfug
Valve _ ? •? 3 ?? ? JL'Sv? ?
Limit
Limit Setting
Fan Setting /Cl U G ? ?
Pilot Type ??e C?r,?,< <?u•?
Pilot A4ake ?'?
Pilot Model
Pilot Timing - ?1L S a?t ?
L.W. Cut Off ?
Pressure Percent C02
Input CFH Percent OZ
Stack Temp. Percent CO ??-
MAKE OF BURNER
Max. BTU Rating -
MAKE OF FURNACE
Vent Size
KIND OF LINER
fdONE
Draft Hood R*lator ? -'
Filters Size Number
Chimney Location Inside Outside
Chimney Construction ? `? ? • ??
Smoke Bomb
?
f) r?fi
Door Pressure ?r-
- -?
Wiring t
Test Tag
Lighting Inst. ? L
Date Tested
Company Testing l
Name of Tester C v
Receipt '
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Prini legibly
Permit No.
Fes
S/C
Tot .
1. Date 2. Installation Cost ?
i
3. Job Address Lot Blk. Tra`ct
,
,
4. Owner ?
i
i
5. Contractor • Phone
I
6. Address i
7. City State 2ip 1
?
8. Building Type: Residential ? Commercial ? Institutional ? j
9. Work Description: New ? Add O Alter O Repair ?
10. Describe
11.
No. Fixtures
Water ClaSet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas PiPing Outlets
12. I hereby 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
Rouyb Final
Inspections: Date Insp. _ Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
RecBipt
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Prrnt legibly
Parmit No. i?
F ee
S/C
_..-?.
Tot.
1. Date 2. Installation Cost
3. Job Address Lot Blk. ' Tract _
r k
1
4. Owner
5. Contractor Phone
6. Address
7. City
8. Building Type: Residential ?
9. Work Description: New 0
10. Describe
State Zip
Commercial ? Institutional O
Add ? Alter ? Repair 0
11.
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory $oftner
5hower Wel I
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop 5ink
Gas Piping Outlets
12. I hereby 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
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
ReceiPt .3
PLUMBING PERMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Print /egibly
Permit No. ?
Fss
S/C
Tot.
1. Date 2. Installation Cost
3. Job Address • •Lot ` Blk. Tract
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ?
9. Work Description: New O
10. Describe
11.
Commercial ? Institutionai ?
Add O Alter ? Repair ?
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs $eptic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
? Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : t ` . for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt
PLUMBING PERIMIT
CITY OF EAGAN
Fill in numbered spaces
Type or Prini /egib/y
Permit No. J
Fea
S/C
Tot. '
1. Date 2. Installation Cost
3. Job Address r Lot Blk. Tract
s. /t
4. Owner
5. Contractor ? Phone
.
6. Address
7. City r' State Zip
8. Building Type: Residential 0
9. Work Description: New, d
10. Descri6e
11_
Commercial ? Institutional ?
Add O Atter ? Repair O
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Saftner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
51op Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : ' for
Rough Final
Inspections: Date Insp. _ Date Insp.
This is yaur permit when numbered and approved.
Approved C1TY OF EAGAN 454-8100
cirY oF FA?aN WATER SERVICE PERMIT
3830 Pilot Knob Road - 2
P. G. BOx 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
,
Zoninp: No. of Units: 4-1
pwr,sr. *?ew i:crizou :10r,..es_
llddross: ?
Sih Nddrem 1606B Clemsoi waWM1 Lk !its 2
}O OON* wkb 1he
Misc. Chorpes: a -7` . "•• F••
Total: 63.00pd ,n-at:
Dot* Paid:
Date of
CITY OF EAGAN
3830 Pilot' no6 Rosd
P. O. Box 21199
Eagan, MN 55121
Zonirq:
Owner. ., Address:
,$Ite Address: Plumber. as ;:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. ot Unita:
1elm b ee?/If vrkb d. CMl of iho¦ Connmtion Chome:
OeriM?eN. AtOOUnt Dsposif: _
Pe"nit Foe:
' SurcharQe:
' gy Mi.c. Charqa: -
Dote of Irnp.: Total:
;
Insp Date Pald:
,
U'T" UF EAaAN ' . WATER SERVICE P
3830 Pilo^ , nob Rnad " 7 14 ? I
P. OrBox 21199 PERMIT NO.: 1
Eagan, MN 55121 p3 DATE: -
Zonirq: _ No. of Units: P e?
??. New :.or on ?io:aes
/1dd?ess: _
Sits Addreas:
Plumber. -
Metar No.
Siu: 5 ?"
eodsr No.: U-? /" `'f /U/ Q l
qrM to oowply wilb !M Cih I
............ y.. _ `
Misc. Charpes: . p
Total: . . ( 7 pc rneG er
Dats Poid:
CITY OF EAGAN SEINER SERVICE PERMR
3830 Pilot Krrob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zonirg: `A No. of Units: Plex
Owner, N ew }tarizon :ioses
Address:
p, SIM Address:
' Plumber:
1 yme ts ee?lf wN` /lr Ghr oF dNs
OrdiwnaM.
By
Date of Insp.:
Ca+rnctton aorpe: k 2 5. 0
Acoount Depostt: 1
Pennit Fee:
SUKh0Ige:
Misc. Chorpss:
Totol:
Dab Pald:
? CITY OF EACAN WATER SERVICE P
; 3830 Piioi {nob Rosd ERM
; r9s IT
I P. a•St,X 21199 PERMIT NO.:
i Eagan, MN 55121 0^?: ?r?'' ^
?
? Zoni
^g: -
No. of Units:
? pM,Mr. tvew Horizon omes
Addresr.
; Sta Addreas: 16043 Clemson I1r. L62 :! :uL:as L : Cs
plun?r Tl:omnson P um r
AAster N.os.. -500
M. ? . 0
0pd
Si?: • P
Rwder No. • p
1 Nw? te oow??r wifi? !h- Ci?[#A i?P1Mi1' ?urrl,arn.? ? A VY • 5 '
Total• 63.00pd meter
Date Paid:
'--- -
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Krwb Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: .
'
Zoninp: No. of Units:
Owrwr. ;aew
/lddross: ?.:,,??? ;.•s -- ?;,:i :`r. T .' t?1 ;lx?:r., :3 f_?, !' - ?
Site Addross:
Plumbar.
-,7-
1 MrM hI -ph? w11h 118 Cihr of iowa
Adi"wcw
Cannsction Ci+arps: -
AcoourM Deposit:
Permif Fee:
Surchor0o:
Miec. Chaross:
Total:
Date Pold:
By
Date of Insp..
f cITY OF EAC.aN , WATER SERVICE PERMIT p,
3830 Pilt anob Rowf 7`0 z} ?f 1
P. C. Box I1199 PERMIT NO.: ?i
Eagan, MN 55121n ? D11TE: -r
ZO^i"o: . No. of UNts: - -
?r: ew or zon i omes
Mdress:
?Site Addrem 160 4 Clemson B omas ts ?
Plumb.r. • ompaon •' .CS
VMTJROO-
Meftr wo.: 3 p
?a ? ` • : } ??
' Size: ' 5/9 „ R o -,f(. -RAotm
Rsodar No.: a 4 gist p
I Mm Iv esw?Pllr wMh IM ?
Misc. Chorpas: 1 Z. TP
Totol: - 61. 00 pd meter
. B Dota Pnid:
f Date of Msp.: Insp.:
CITY OF EAGAN SEVI?pt SERVICE PERMR
3830 Pilot Keob Road
'
P. O. Box 27199 PERMIT NO.:
Eagan, MN 55121 DI1TE: -
Zonin0: ? No. of Untts: ?. .'S l s•?a
J ?'oZ'_znn
Owrnr: .
° . ,
llddress:
Site Address:
Plumber:
1agrse fo oeiwply wNh NN Clyr ef aM¦
Ordlwengp.
Connectton Charys: + 2 5. i? .ri
-?t
Acaotjnt Deposit: • .
Parmk Fu:
Surcharpo:
Misc. CFarges:
Totai:
Date Paid:
ew
Dob of Irup.:
(TOWNHOUSE)
tBUILDING PERMIT
Te be wad hr 1
CITY OF EAGAN N° 1110$
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-5100 G?
Receipt ?j
OF 4 PLEX Ev, yalue $61, 000
SlteAddress 1606 CLEMSON DR
Lot 64 eiock 1 cec/sub. THOM LK HTS 2N0
Parcel No.
? IN... NEW HORIZON HOMES INC
= Address P.O. BOX 1367
? city MPLS Pnone 420-3900
s
G
0
u?
Name SAME
Erect EX Occupancy R3
Remadel ? Zoning Pi1
Repeir ? Type of Const. V
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth z.?
Int Impr. ? Sq. Ft.
Install ?
Apprerelf Feea
Address Assessment Permit $ 316.00
Water 8 Sew Surcherge 30. 50
Clty Phone .
Police PlanReviaw 158, 0
Nama D. GRISWOLD Fire SAC 525.00
Address Enq. WaterConn. 500-?0
City Phone 435-7524 Planner waterMeter 63_?0
Council RoedUnit 280.00
I hereby acknowledge thot I have read this opPlicotion ond state that Bldg. Off. 9/16/$5 7r. pl. 132 . 00
fhe informolion is Wrrect ond ogree to comply wilh oll applicable AP? Parks
Stote of Minne:ota Stotutesy,r?d City of Eagnn rdirances.
Var. Date Co ies
Sipnoture of Pertnittee 7?/?---? p
NEW HORIZON HOMES INC 7otal $2r044.50
A Building Pertnit Is issued to: on the expreu condifion thol
all work shall be done in accordance with qN opplitable(SfuF@'o(Minnesoto Starutes ond City o! Eogan Ordinonces.
Buildinp Officiol
( TOWNHOUSE ) CITY OF EAGAN N°_ 11102
3830 Pilot Knob Road, P.O. Box 21-199 Eagan MN 55121
PHONE:454-8100 C (
?
?
BUILDING PERMIT Receipr # J o
?
Te M wad fer 1 OF 4 PLEX Est. Volue $61.000 Date OCTOBER 9 19 85
SiteAddress 1606B CLEMSON DR Erect [Z Occupancy R
Lot 63 elock 1 Sec/Sub. THOM LK HTS 2ND Remodel ? Zoning PD
Percel No.
Repair ?
Type of Conat.
V
AddNion ? No.Stories
c
Nama
NEW HORIZON HOMES INC
Move ?
D
li
h ?
Lenyth
44
'
;
Addreas
P.O.
SOX 1367 emo
s
I
l
?
t Depth z
]
b
City
MPLS
pnone 420-3900 n
mpr.
.
Install ? Sq.Ft.
Apororals Fees
g
r
Name SAMR
Address
City _
Phone
Axsessmenf
Woter 8 Sew.
Police
Fl.o
Erp.
Plonner
Council
BIdg.Off, 9 16/85
APC
v__ r....
Neme D. GRISWOLD
Address
City -
Phone 435-7524
I hereby acknowledge that I have read ihis opplicntion and stote ihat
the informotion iz correct and ogree to comply with all opplicable
$toto of Minnewto $tatufes and Ciry o/f EofgO?rd-irwnces.
Siynature of Pertnittea
A euilding Fermit Is issued to: NEW HORIZON HOMES
oll work sholl be done in occordante with oll oovFimble Stafe,e"hMit
INC
PBfml1 a i1 O. V V
Surcherea 30.50
Plen Revlew 158. O O
SAC 525. 0
Weter Cann. 500. 0 0
WaterMeter 63.00
RoadUnit 280•?0
Tr. vi. 132.00
Parka
I uopies O
TOtel ?
on the express conditlon thai
Statutes ard Ciry of Eoyon Ordinonces.
Bulldiny Offlclol
BUILDING PERMIT
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 454-8100
1 OF 4 PLEX
,000
Receipt #
N_ 11100
54_-yS?
,BER 9 „ 85 d
SiteAddress 1604 CLEMSON DR Erect Ki Occupancy R3
Lot 61 Block 1 cec/Sub. THOM LK HTS 2ND Remodel ? Zoning pp
Parcel No. Repair ? Type of Const. V
Addl[ion ? No. Stories
Neme NEW HORIZON HOMES INC
qddrysy P.O. BOX 1367
City MPLS Phone 420-3900
o
Zu
°uS?
f
Name SAME
Address
City Phone
?I nlame D. GRISWOLD
?w
? Address
?W City Phone 435-7524
Move ? Lengtn 44
Demolish ? Depth 27
Int. Impr. ? Sq. Ft.
Ins[all ?
AoVrevab Fees
Assessmenf -
Water 8 Sew.
Police -
Fi.e
Eng.
Planner _
I hereby ackrwwledge thnf 1 heve read fhis apDlicofion ond stote that
fhe informotion is mrrect and ogree to wmpfy with oll opplicable
Stota of Minnesoto Stofutes ?ond} C-ity of Eagan i%ces.
Sipnature of PermiMee a?R -_ ?
A Building Permit Is issued to: NEW HORIZON HOME$
ali work shall be dorre in accordante with all aooli[able 4 a?te o}`Minru
Council
Bldg. Ofi. 9/16/85
APC
Var. Oate
Sfatutes ond
Permit $r?0 0
Suroharge 30 _ 50
Plan Review 158.00
_ SAC 525.00
_ WaterConn. 500.00
WaterMeter 63s00
RoedUnit 280-00
Tr.PI. 132.00
Parks
- I Copies
raai $2,004.50
_ on tha express condition 1hat
City of Eayon Ordinonces.
Bu7ldiny Officicl
(TOW'NHOU9C) CITYOFEAGAN N°_ 11101
? '` 3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721
BUILDING PERMIT PHONE: 454-8100 Receipt # //
? L?7 S
T. M wsd fer 1 OF 4 PLEX Est. Volue $61,000 pote OCTOBER 9 1085
SiteAddress 1604B CLEMSON DR
Lot 62 Block 1 sec/Sub. THOM LK HTS 2ND
Parcel No.
W Name NEW HORIZON HOMES INC
? Add,nS P. O. BOX 1367
city MF'LS Pnane 420-3900
g Name SAME
0? Address
?- City Phone _
u?
Name D. GRISWOLD
Address
ZW City phone 435-7524
Erect ? Occupancy R3
Remodel ? Zoning pn
Repair ? Type of Const. V
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth .
Int Impc
?
Sq. Ft. Z
?
Instafl ?
Avverob Fea.
Auessmenl Permlt 4i?-3rM o
Water A Sew. Surcharge 30.50
Police PlanReview 158.00
Fire SAC 525.60
Eny, WaterConn 500.00
Plonner Water Meter 63_? O
Council Road Unit 280. ?0
I hereby ocknowtedge that 1 have read this apDtication ond sfate thot gldg. Off. 916 B5 Tc PI. 112_ 0 0
fhe informotion is correct and agree to wmply with oll opplicoble
State of Minnesota $totutes and Ciry oF Eag Okdinonces. p`PC Parks
Sipnoturc of Pertnittee Var. Date Coptes 0
- a--?
?
A Building Permit Is issued fo: NEW HORIZON HOMES INC rotai
on fhe express cordition Ihat
oll work sholl be dorre in atcordonce with all applicoble $tat o ' ewta Stafutes and City of Eaqon Ordirwnces.
/"1
Bufldinp Ofticial .R I C-/ r? -
., ,
BUILDING PERMIT
To be used for "E?K
Est
$1000
Site Address 1606 CLEMSON DRIVE
Lot 64 Block 1 Sec/Sub. THOMAS LAKE HTS
Parcel No. 2ND
w Name DOUG MATTESON
o Address SAME
CityPhone 454-7173
o Name SAIC 454-3900 (W)
?¢ Address
? City Phone
ww Name
???-, Address
gw City Phone
I hereby ackrwwlege that I h. ve read ihis applicalion and state that tha
information is corcecl and ? ree to comply with all applicable State of
Minnesota SlaWtes and Cil f Eac n Ordi ances.
Signature ol Permilee ?
A Building Pertnit is issued lo: 11Q1I(; MATTRSpp]
on Me express contlilion that all work shall be done in accordance with all
applicable State of Minnesota utes and Ciry f Eagap. Ordinances.
ll
8uilding-OHicial
il S'
CITY OF EAGAN
3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
N° 19337
Receipt # `J I 7 l / -?
Dale JUNE 26 19 91
OFFICE USE ONLY
Occupancy
Zoning
(Attual) Const
(Allowabla)
a ol Stories
Lengih
Depih
S.F. Total
S.F. Footprints
On Sile Sewage
On Site Well
MWCC System
Ciry Water
PRV Required
Booster Pump
APPROVALS
Planrrer
Council
Bldg. OH.
variance
lOr
7n,.
Bldg. Permit
Sumharge
Plan Review
SAQ City
SAC,MCWCC
Water Conn
Waler Meter
AccL Deposit
S/W Permit
SNJ Surcharge
Treatment PI
Road Unit
Park Ded.
Copias
TOTAL
FEES
$25.00
S!1
?
This requesl void 3,2-8 44 ? 0 7tli.
18 months from
S oq7`79t1 L1,3, $1. 114s AN9 gS&,ro
Ren??est Date
^
C
?? Fire No. Rough-in Insuer.lian
flep iretl ' .
?Reatly Now Will No[ify, Inspec-
?
?
r ?yes ?No 'or When Peatly
KLicensed Electrical ConVaclor . f I h
i
f
'
ereby requast inspect
on o
above
? Owner
l
i
i
e
ech
cal work
nstallad at
Sireet Address, 6ox or Ro?ut?e No.
?
?
/
? Ciry
??
?'
...(
.V
I /
ection o.
Township?Name or No.
Range o.
County
_
I y
OccupantlPRINTI Phone Ne.
?
Power Sup0lier Atldress
Elac[rical ConVactor Wom0any Name) Cnntractor's Licens-e No.
G n/ ? , <•, ? e (I
Mailine AAJress (Co vactoTbr Owner Makinp Instailxtinn)
Authorized Signnturc IConvactor Ownor MaKng nslallat bn) ? Phonc Numbcr
? ?33-_521
MINNESOTA STATE BOARD OF ELECTHICITY , TMIS INSPECTION flEQUEST WILI NOT
Griggs-Midwav Bldg. - floom N-197 BE ACCEPTED 9Y THE STqTE BOAHD
1821 University Ava., St. Paul, MN 55104 UNLESS PROPEfl INSPECTION FEE IS
Phone (812) 297_2111 ENCLOSED.
,,,,,?a0•Jj REQUEST FOR ELECTRICAL INSPECTION EB-00007:04
F771) [''? ('? See instructions for comDlecing this form on beck o/ yetlow copy. ?0?? ?
LJ l 1 q 7 7 q 1 i "'X" Below Work Covered by This Request
FAtl Hep. TyOe oi Builtling Appliancas Wiretl Equipment Wired
Hame Range - Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tank
Pafrtl Other 'pec Y .ihor ISpru(yl
t ar Uecify Othm r ? ?? Other
l.om{1!/ie !/15peCllOn heB U@lOW " '
N Fea
I ServiceEnhenceSi¢e'
H
? Pe
feaJers
M
Fee
Circuits
/ 0 to 200 Am 5 LYUW 0 to 30 Am o
p; Above 200 Amps ps 31 to 100 Am s
Swinming Pool Amps
MAbovel Above 100_Am s
Transformers ms Partial."Oth er Fee
ction
ftem?rks
V
s TOTAI PF,? ?p'
,?r •aJ
3
Roueh-in Data I,the Electricel
Inspector, hereby
certiiV the1 the above
Final inspection has been
myde.
Tfiis raouast voia 18 monttvs from •
I
2 A C s??? ?
J 0 ???NLY ihis requesl void IB moNhs fmm validanon dote pnnted i? bpi, _?
/_ /. ?
y y
d
PLEASE PRINT OR TYPE ?v
Request Dore
?- ? Raogh-In'mspection reqoiredt ? Yes
?Y
i
ll Ih
t
h Inspedlon qher Thon Raogh-ln: ? Reody Now 0 WAI Call
o? mvs
ca
e
n speaor w
en reody) Dorc Neady: ,
I, licen=ed contrac}or ? owner hereby requesf inspedion of the above elecfricol work ot h.
1o Pddress (Stree1, Bae, o Roate Na )
QK Ciry
d iip Code
s 1 a
. ,
Secnon No. Townshtp Name or No. Range No. Fife No. Counp
OCOPO"? Phone No.
r?c14 c.-) C
-97-1
PovrerSup lier Pddrexs
?
Elecrci I Connacbr Compony N. ) Convanor License No. Moarer Lia No. (Plont Elect Only)
o
O
Mai/ling? AEdrms (Conimdor ar qpar? i?p InsbllaM1On
5
? " 1
? n
?"/
F /Vw'
f ` /?
Aut rieed SignoNre ?Ca Iq rO?pr or Owner Pedortning Insbllatian)
NAk ? Phone No.
3a-4'??
0 6/95 STATEBOARDCOW- 5EEINSTRUCTIONSONBACKOFYELLOWCOPY
V
IIII IIIII III ?II1?I?II?II REQUEST FOR ELECTRICAL INSPECTIONIOGt?
MinnesMa State Board W Electricity
1821 University Ave., Rm. 5-128, St. Paul, MN 55104 z
0 2 9 6`-?u-= 4* phone (612) 642-0800 A7„?
Home Dup ex Apt. Bldg. Other New Addn
ommerciol Indusfrial Form Remod Re oir
Air Cond. H}g. Equip. Water Hfr. Load Mgmt. Other:
er Ran e Elec Heot Tem $ervice
"X" above the work mvered by this requesf. Enter remodcs in this spvice and on the bock of the white copy only.
Calmlafe Inspection Fee - This Inspeclion Request will not 6e occepted withouf the correct fee:
Ofher Fee # $ervice Enfronce Size Fee # Circuih/Feeders Fce
Mobile Home Park $tall 0 fo 200 Amps o 100 Amps
Street Ltg./TraHic $ig. Above 200 Amps Abov 100 Amps
Tronsformer/Generafor INSPECTON'SUSEONLY TOTAL
$ign/Outline L}g. Xfmr.
_
Al
orm/Remote Control ?
Swimming Poal
I
i
ti
B ereb en ed herein on the daleoemlad
rr
go
on
oom pere
$pecial Inspedion k
TH Invesfigafive Fee
IS INSTALLATION MAY
BE OH .1
l
DE ONNEC IF NOT COMPLETED WITHIN 1 MONTHS.
This ru0u°st void ?,?. 86 (p v 7?/
18 nwn?hs fwm
f?- f-, rs -7 -7 n n J J .1 10. `W .` J b 111. 3 J?P le c. -
U V J 1 1 O J /i /"" 'v."-' R i" - - t
FequeS[ Dat¢ ' fire No. RouPh-in Insp¢ction
Aeq rted?
?Aeaay Now Will Notity. InsOer.-
, -J??? ?j ?yes ?NO «?r When ReadV
?c
L icensed Electricxl ConLactor 1 hereby request inspection ot ebove
? Ownar electricel work instelled al:
Sireet Atldress, Bo/x 'o'rl flome No. ?J .
/VW C?.IS- VUJY ?//?, City
er.von o. Township Name or No. ange No. Cnunty
.D4 0
Occu?pan?t/l'V?(/lL-l/PNINTI^ -?^ '
/ ?'-.yN Phone No.
Power Supplier Address
,
ElecVical Cnn[rac[or ?Company Namel unttactor's License No,
Q o?s'G ?2-?c- I GO, ?l J
MailinA AtlJres (CO ractor or Own/?/.{ ?ylak
ing Instailation)
?
/
/? ./ . M CJ vV ;
Authorized Signamrei(Cant ctor/Owner np Installati N Phone Number
?3:.'•_c52 I
MINNESOTA STATE eOAPD OF ELECTflICITY
GriBas•Midwey eldg. - Room N-191
1821 University Ave., St Paul. MN 55104
Phone (6121 2972111
TMIS INSPECTION NEQUEST WILL NOT
BE ACCEPTED BY THE STATE BOAHD
UNLESS PflOPEN INSPECTION FEE IS
ENCLOSEO.
- REQUEST POR ELECTRICAL INSPECTION ee-ouoot.oa
See ins(ructions for completing Mis form on back ef yellow copy.
"X'" Be/ow Work Covered by 7his Request
? AdJ Pep. Type ol Builtling Appliantee Wiretl EquiDment Wired
Home Range Temporary Service
Duplex Water Heater Liyhting Fixtures
Apt. 8uildinc? Dryer El2ctriC Heatin
Furnace Silo Unloader
t dustrial Bldg. Air Conditioner Buik Milk Tenk
rm rnnv. oNO7v _mF? isnoouvl
t.r peciFy Ot c, ,.- Olher
p Fea ServiceEntrenceSize p Fee feeders/Subieeders b Fee ul?s
0 to 200 Am s 0 to 30 Am s 0 tn 30 Am s
Above 200 Amps 31 to l0U Amps 31 to 100 Am s
Swinming Pool Above 100-Amps Ahove 10G-Am 5
Transiormers Irrigation Booms Partial%Other Fee
Signs Special Inspection 5 r f TOTAL F
Remarks -I /
11. P
?
Rough-in D1fe I, the cal
1 3" Insoector, hereby
certity that the above
Final inspection hea been
mede.
Thia recuest voitl 18 monlhs Irom j
/
Th-s requesl void W 07A l
jB-Qdths ??U9?7788 L?sz?Bl/ 5k., kk?.?1?s2'?? $Sc,//
Request Da?e Fire No. Rovgh-In Inspcr.[ion Will Notif InsOec-
? ?- eup??cd? Dpeady Nuw or WhFn Ready
.? -r Y = N?
?Licenseci Elecvicul Convac[or 1 hereby reques< inspection of abova
elactricel work installed at
Owner
z or ou No.
5[reec Address, Bo ie
, GC?iy,;a/tI
•
????
?
ecUOn o. Townshio Name or No. Range Nn. Countv /
Or.cuDant (PRINT) -
/*-A/ ?'ax'/zavj Phone No.
Pow/e?r?SjupPlier
Url' V?i' 1 ?-l ? ?---?-Y?Y ,?V
Ad s
'
Etect ic 1 Cmnractoi ICompa v Namel,
?{Gri D/11 z??azd?Qi"o s License Nn.
Conlractor
G?J1 ---
Mailing AdJress 1 or or wner Making Instailation)
Jj . 1
d
/4?
(
,
i
-
Authorized SienaID e (CoMractor MakinB lostallaoionl
• . Phone Numbcr
-
g33-2521
?
MINNESOTA STATE BOAPD OF ELEGTNICITY
Griggs•Midway BIAg. - Room N•791
1821 UnivemitV Ave.. Sc Peul, MN 56104
Phone 16121 297-2111
BE ACCEPTED 9V THE STATE BOAPD
UNLESS PNOPEN INSPECTION FEE IS
ENCLOSED.
^3-l0 -4 G REQUEST FOR ELECTRICAL INSPECTION Eg-o°°m"°'
See instructions for comDleting this lorm on baCk ot Yellow Copy.
p " X" Below Work Covered by lhis Request
97788 ? . V
Hdd Nep. Type ot Builtling? APPlianCes Wired . EquiUmant Wired
ial 8
EleCtriC
77-1 Industrial Bldo. Air Conditioner? l? ? BLIIk Milk Tank ._ ?
R Fea- ServiceEntranceSiza p Fex Fentlers/SUhfeeders ? Fxe Cirwits
0 to 200 Am s 0 to 30 Am s 0 to 30 Am s
Ahove 200 qm?s 31 to 700 Amps 31 to 700 Am ;
Swimminy Pool Above 100-Amps Above 100_Amps
Transiormers Irtigation Booms Partial%Other Fee
algn5 aPeciai insyecuun 5?// ill l
TOTAL E
Hemarks y /
Rough-in
? ???yL?.r? ?/
3.-/ 7 I,theElecVical _
Insoectoq hareby
certify that Ne above
Final W. IP
-13 -k- inspection has been
,Ci) , dvae.
Thit reQuast voltl 18 monUS Irom
This request voitl
i months trom L L? p/ 74roi, LIC 94s L#n 6 0 7?/
2097787 fle<piest Datp Fire No. Rouph-in Insuection
?/ ?j/ Required? ?Ae?dY Now Will Notily. Insoec-
_? ?Y %1 h ?6XYPZ rl N. I Ior When Featly
K Licensed Electrical ConVactnr I hereby request inspection of ebove
? Owner elecVical work installed et
Street Atldress, Box or Noute No. C -I? ?
ecuon o. Township Name or No. Range No. Counry
Or,cupenllPflINT1 Phone o.
Power Sup0lier ' Address
Elecvical Contractor ICompany Na?mel ? Cnnirar,mr's License No.
??
Mailinq AA
ress ICOntractor or Owner Making I stallationl
^
Aothorized Sipnatuoe Convacmr/Owne aking In ta Intionl
. Phone Number
?'3-i521
MINNESOTq STATE BOA0.D OF ELECTRICITY
Grie9s-Midway Bldg. - Noom N-191
1821 University.AVa., 51. Paul, MN 56104
Phone (612) 297-2711
1!l IJ IIYJYL? 11 V IY M1LLL V CJ 1 nl LL IV V 1
BE ACCEPTEO BV THE STATE 80AND
UNLESS PflOPEH INSPECTION FEE IS
ENCLOSED.
3-11110 -Q(,REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi-oa
_ See instructions tor comvletin9 this form on back of Vellow caOV.
"X" Be/ow Work Covered by This Request
? 097781 - --
i ivalAddl Neo. Tvoe ol euildinpI Aooliances Wbed Eyaioment Wireo ?
Duulex I J Water Heater D(I_ Lit?htiny Fixtures I
Rida. - I I Air ConAitioner I I Bulk Mi Ik Tank I
p Fee Service EnbaneeSizer !1 Pee Fexdefs/Subleeders N Fne Circuits
(i 0 to 200 Am s 0 io 30 Am s :Uon 0 tn 30 Am
Above 200 qmps 31 to 100 Amps 31 to 100 Am s
Swimming Poal Above 100_Am s A6ove 100_AmPs
Transiormers Irrigation Booms Pdrtia6'Other Fee
/
Signs ppeciai inspeccwn 5119
Remarks
Tnisfepueetvoid
,
x
?
_ ?? _
CLEMSON
BUilding zi"' /5
n ^
I }
D,e / V E
?
(936,0
X? 9586°/3'20 "Eq
?°,43J.00 31.04 N
,
/e2.33 ? 22.33
M
p.rv
p l539:0)
? ol
' i
'
N 41
? .3 9
m
/ ?
2
?933
5) Q
O O
N ?
zo
i O \ m
o
? ? O
O M
.
e} o?
?" 4 ?
.?' N - ?
? (933.5? " •-•
N
.4D
e,-
3r,oo 31.ob
dsg(93F. }Eb?
?
?
0 Denotes Iron Monument
° Denotes Wood Stake
X000.0 Denotes Existing Elevation
(000.0) Denotes Proposed Elevation
f- Denotes Direction of Surface Drainage '
i(o ocG ?ms?
Proposed Top of Foundation Elevation=
Proposed Garage Floor Elevation= 935.5
Proposed Lowest Floor Elevation= 9 3(?, O
I hereby certi kthat this is a true and correct representation of a survey of Me boundaries ot
Lots62, 63 and eb Block 1, THOTfAS LAKE HEIGHTS 2ND ADDITION,
\J\
Dakota County, Minnesota.
And of the location of all buildings, ii any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 30rh day of Aueust 119 85 ,
L=/ ?CT7o,?
Paul A. .lohnson elll
_ Land Surveyor, Minn. Reg. No. 10938
CERTIFICATE OF SURVEY
BOOK GE
MASSOCIATES, INC. fO?'
YG [NLIMEfRt 0 lM0 SOIIYEYOIp 0 iRE PIAMN[RS
? . WNNENOLIi up MUTCMINtON,MIMNFiOiA NM HOWON FOWS
7430
6R I-+°
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when permits are required for each unit
.030 . sa
Ck.,,u .39?7Z
D
ate
Site AddressL ( ' /(- /rf ?Ql) D/ / U C, Unit #
Property Owner Telephone # (651) 7??1 ??? ([J
- D ? T
A
Contrscror /
2
Street Address 404(o //1/!,0 A Y-?1(.? ? / "!l} 741/ D?ity //W / 7YJf7/ e,
State ? Zip 4 ? Telephone It ( 7163 ?:3
Bond Expires:
The Applicant is _ Owner Contractor _ Other
Add-on or alteration to existing dwelling unit
f
Addi
i
l ?R
l $ 30.00
urnace t
ona
acement
ep
air exchanger
1( air conditioner
_New ?Replacement
other
6 .n?
ar? ?
c l5ll'
G ?
State Surcharge $ .50
Tota? $ 30.5
i hereby appty for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will
be in conformance with Ihe ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but onty an application for a permit, and work is not to start without a permit that the work will be in accordance with the
appr ved plan in the case of work which requires a review and approval of pl s.
?ari
Applicant's Printed Name Applicant's Signature
, ? -? • Mo5
?
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Kno6 Road, Eagau MN 55122
Telephone # 651-675-5675
Pleasc complete for. wmmercial/industrial buildings
mul[i-family buildings when separate permits are not required for each dwelling unit
Date
Site Stteet Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "*see below
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
**When insfalling/removing underground fank, call for inspection by Fire Marshal and Plumbing Inspector
Permit FOes: $70.50 IJnderground tank installation/removal
$50.50 Mittimum (includes $ta[c Surchargc)
or
ContractValue $ x 1% _ $ PermitFee
• If pe rmit fee is $1,000 or less, add $.50 ? $ State Surcharge
If ep rmit fee is over $1,000, add $.50 for
every $1,000 ep rmitfee $ Total Fee
I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work
will be in conformance with the ordinances and codes oFthe City of Eagan and with the Mechanical Codes; 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.
ApplicanCs Printed Name
ApplicanYs Signamre
ApproVed By: , Inspector Date:
'F . .. ? . . ? .. .
? ,?r. . . . . ? . _ ' ' ? ? _ . . . .
..t?`e`t Aa' ..'S .r a y ''3 f kr 5-? ? e??^`? .s?t' ' ye r ! t?r F.r`?. a SSx'3 s'. a ,?Y y
?
?Qt C? i?Ty?-Y.?s/.a
79Lj BUS'L'?i[ iYS{Fl1A nF??}?S1??Vl\ ?????AS ?C --L:.2i4TY1Hy"' {y? -!'1 ? C p .??f
.?-°"a..df?.5
H01`E ALL' COHTRAGTOR$ P4UST BE. L3GENSED _LwITH,?'iE? CITY•?OF? £AG!lTi- -r -` ?
. ?
.I,NCLU'?
E '2 SETS OF PLAHS , .
Td
3 CERFZCt?TtS OF` Si?RVEY
? - 1 SET:.OF EN£RGY CALCEiLI-'.7'IQNS
? c?y= ooU ?.
To E_ [!.sed For: ? RESIDENCE ? ?ValuaLion Date:
c;te Aderess: ? 9•3.•Q?? ? . . , ?
-. - ? ' o?mnlm 1 Y- . OFFICE USE ONLY
Iloo ? Q _ .. .
? Lot: (02 Block ? S>ct/Sub•7HOI?AS LK £reGt'? ? _ Cccupancy :_ :
- HEIGHTS '?emoael Zoning _
P_rcel ;epair TYPe' of Const .
'.9.of Stb
° -_ :' _ - . _ , • ".; - Enlgrge_ Z.
Ck ries -
- aner : NEW HORIZON HOlAES, ING. '.%Fiove,• Length
, Deinolish. D-pth , - -
J:ddress ? P.O. BOX '1367.? ' Grade -? Sq Ft ? .' ? .
Ci?y/liP.. Code ? Plpls:, iRinn -.55440 -------------------- ------°------- .. .
Pnone - 420-3900 ? .. ? . APPROVALS . . .. ? " ..- f Contractor SAmE Assess-.ents FErmit
? - kete'rlS ?er' Surcharge
kddress ' - `Police '- - P2an P.evieu '
:. _
- ? - -Fire SAC ,
City/Zip Code . , ngr.._ '-" Weter Conn-'-
? ? Planner _ Water Meter- ? ' -
Fnone ?
- . ?.. ? .; uncil noad Unitr ,
- - Bldg Of?rks
Arch./Engr.: D. GRISUIOLD.. ,- ; APC: Treatrsent•Pl , -
•-. - -. ?. _ .. .;. ??" _
Variance -
hddress. TOTAI.
; CitylZip Code
? Phone p •435 7524' '
? _ •' +? ? _ - .
?
I'd
F . ' ' 4. 6 4 i?Xi
. !i •
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a _
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,
?. - .. ..:- ..._. " .r:
.
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? . ? ., . .. . , ?. _ . _ .. ? .
1 ,.. . ? . . . . .. ?a. ., .. ? ...... ! ._. '. .. _ ... . _.... .? .
/
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%
.'- '- •: .. :_?r ..< 1 . a mt:a ::.b kt.;' _ ?^,c .. . s 't, ?
- .-::19$5 8E3ii:DZNG"PEP3[IT &PPI.?CATIfl:t_- CrTT'OF £AGAH
h -. . -- ' -- ° ` HOTE: 7 ALL CONTRACTORS fSUST $E ?LiCEHSED- IiIFH TH£ CITY :OF. EAGAN
.. UNI 'r
. , itJCLIlDE 2 SETS OF PLkNS
. ' ' 3 GERTIFICETES OF StlRVEY
- " 1 SLT OF EN£RGY CRLCl1Le:TIOIdS
i oF 4 _ ? ??oao
To °= Used Fcr: RESIDENCE `- 1'a2uation:_ Date:
Site Address: 1G,04 PQan„ii[rn aFr3CE USE OHLY
Lot: (pL Elock Sect/Sub. THI IMAS LK : Erect'•, Gccupancy CZ-3
HEIGHTS Rea,odel _ Zoning pp
Parcel 0 - fiepzir Type of:Const g.
- - ' .. ` •' Enlarge. : ..0'of Stories
0w7er NEW HORIZON HOMES, INC. ".Move _ Length
, Demolish. ?pth -Zl
Rddr=ss . P.O. BOX 1367 Grade Sq Ft City/Zip.Code plpls.. Minn ..55440 -=-"-----=------------------------
- Pnone 420-3900 " APPROYALS
Contractor SaIAE , Assessmen*s Fermit
h'ater/5°wer Surcnsrre 30.$D
Address - . Police _ ; Plan P.e.view
- • , "- ? = Fi"re ,. SAC
City/Zip Code - -" Engr " Water Conn 5pp.
{
- Planper . i,'ater Neter.
Phone - Cduncil fioad UniL. ` Z¢?O: •
Bldg,Oft / ?erks •
Arch./Engr. D.. GRISWOLD APC' Trest.:ent Pl
. Variance .. :, . o? ?1??
Address -- TOTAL
? • _ . x?
City/Zip Code
Pnone # 435-7526
., . . - . . . ,. - :. .. , .. ._, ' . ; ,. . -,. n .'`-. - ., i.' . . _ .
' -. ' . .'. ' _ -- .. _ 2 . . . . .
. _ . . . . - f `? : .. .
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,. ,,. > .?.
.
, .. . _ . .. . ... , .? ._ .
. . . .. . . . .. . _. .. y ., - _-. . _ ..
.
. .. ... . _. . _ • . .. . ,- . . .. - _ . . .. .._ . . ,- . . .. _ . , . ....4'I
? ys h t, S ?? ??:? 4
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3 f ?
`11385 B6IL:DjAIG,.0.E$PIiT `??P3sICATIC}tt ? xI,2'€'£}F E??,3N;' `? " `.r-
- ' }}flTE ALL' COHTBACTORS KUST $£rLICENSED NITH 'i'FIF CIT% :O£ EAGAEI'
UN_IT `1?t " - ;?- ?
PNCLUDE 2 SETS: OF PLAhS
' - 3=CERTZFSCAT'cS Of $URVEY.
1 SrT CF ENE3GY CRLCULATIDI:S
• 1 c)F¢
70 °= Used For: RESIDENCE V2luation:, Date:
. Site,Fddress: _ j(,0U0_F11.: ('Qo???. I OFFICE USE OHLY
Lot: 63 Block (-Sect/Sub'THOIVAS LK Erect'? Occupancy'- -
- - HEIGHTS Pemodel Zonirig
Parc=1 P repair Type"of_Const -
- --' ,-Enlarge . 9 of Stories
Oa;rer NEW NORI20k NOPIES, INC.',. Nove Length
Demolish Depth
Address P.O. BOX 1367 -Grade Sq Ft -
. .. . . , . . - . ,. , .
City/Zip Code. IApls.; 17inn.55440...----------------------- ----------- '.
- Phane 420-3900 - ' 9PPROYALS Contractor SAroE Asses'smen±s Perr!it
- ldater/Se::e_r ,Surchsrge
F.ddress Colice Plzn E=view
_ . . . -: Fire , . SAC •
City/Zip Code . -` - Engr - Water Conn
- Planner .' Hater Ftetei
Phone Council Road Unit -
Eldg Off9/(, r'r.s
Arch./Engr.__ O.GRISmOLU : 'APC.. reatsent.Pl '
- - , Variance - 2 . .
Address . - : TOTAL
Ci*Y/Zip Code
%
. ._ .. _' ('. . ,-- .
Phone 0 435-7524,'-_- _ . .. .. - ' . . - . . . . .. . ;:. `?, , .
. . . , ,. . . . ,,._ .. . .
_ . , ?.. - ? _ . .
_ . . . . , . . u.s - . ? . . _ .
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. Ti?TE ?i .?CUt?f?{??UB§'i:HiISI BS:2.ICEHSE?:'HI?'H,r,T[#? ??3?"-OF,EAGd74?; ,° .
?
'? '?` ?, ,•-? ._ -?. o ? ?INC?L!!DE ?2 SE3'S QR ?'L?NS: ,;.
CER'f'IfICAT ES OF SURVEY
i 5E1 CF ENERGY i,"nLCULl±TIONS '
. :0 3 Used For- RESIDENCE .: Vaiuaticn: ?. D2te: q--,3- g? -
.. . . ?. _ ' ?. . . - .- -i? . - . - . .
- Site rddress:. linnto• -CQnm,n[Siti-'?_ JOFFZGE._USE OHLY
Lot: _(04 . Slock --) Sect/Sub TH6MA5'LK £`rect' Dccupancy ..
? HEIGHTS ? 'em6d°1 Zoning ' s
Farcel repair. .' Type' of Const
Enlarne . - ' 1` of' Stories -
?. - C*ar,er NEW HORIZON HOPIES, ?INC ? ?- 1•SOVe Length
, Demolish - D°pth
?Rddress?-- p,p. 80% 1367 Grade. ?Sq Ft
. . . . : , :, ? . ?.. . ?. .. . . .
, . City/ZipCo3e Iqp1s.,..Rlinn: 5544U,.. ------------ ---------- ------------
. . . . . - . . _. .._ ` . .. ?,. .. . .. . . . . . .
- Phone - 420-3900- ? - - APPHOVt.LS - ? ? ContracLor. SAWE ? Rssessmeni5 :'Ferrit
- idaterlSe.._. Surcharge
Address ' Police " `.PTan =eview? `
Fire
City/Zip Code Engr WaIer Conn
..: ' _ Planner. ? h'a'ter N,eter? - ?
Pnone Council Road Unit.
_ Bldg, 0:: y' rks ?
_ ArchJEngr, D: GRISWOLD -- ' APG -eat*;,ent Pl ,
Yariarice
kddre ss
iTOTkL,
. .. _ . -_ •?-? - - - -
. . : ,
, .:_ . :?•. : , u .
CitylZip'.Code
? ?. Phorie j
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2ATION 1991 BUILDING PERMIT APPLI?ru
CITY OF EAGAN ,vV0 a 4
SINGLE FAMILY DWELLINGS M[TLTIPLE DWELLINGS COPII4ERCIAL
2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS ,
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: 4;rw alnrvu?f Valuation: ? Date: 9/
Site Address 16,x C1¢/r(S4n/ O,e
Lot dV Block ?
Parcel/Sub '/H.Y" [K /fi3 Z ^'p
Owner ? /yJA+TF?.SG?
Address W-- uf.*!5?Af /?Q
City/Zip Code XLZ
Phone
? Contractor Si{+A-
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
OFFICE USE ONLY
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length I G '
Depth I c S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off.
Variance
FEES
Bldg. Permit -'2S.C"J
Surcharge
Plan Review
SAC, City
SAC, MWCC
Watei Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL
Phone #
? q /?2e agrees that all work shall be done in accordance with
(Sfgnature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
' ?•+ ,
C?EMSON o O,P/VE ,
m.
? -
I
i ip' S86°/3'70"E
i 3 o= ?e 1.00
i : =.33
IQ
? \F 1' ?v/? p ?
• ? b w
. ?
:
O 1? ? d I
ri) T ?
'" ?O l9
2 O
O zo P? 7a
O
tl' r p ly i?' N " ?:
? Z 2 "M
i zz.»
i1.00 3I,00
S 8 6'/3'Z O"E
I hereby certify that this is a true and correct representation of a survey of the boundaries of:
Lots 61, 62, 63 and '04 Block 1, THOMAS LAKE HEIGf?TS 2ND ADDITION,
Dakota County, Minnesota.
And of the location of all buildings, if any.thereon, and aIl visible encroachments, if any, from oron
said Iand.This survey is made only in connection with a mortgage loan now being placedon the
property and no liability is assumed except to the holder of such mortgage or any other interest
acquired by the reason of such mortgage. It is understood and agreed no monuments have been
placed for the purpose of establishing lot lines or boundary comers. As sunreyed by me this 7th
day of November 19 85
?aul A. Johnson
Land Surveyor, Minn. Reg. No. 10938
40' MORTGAGE SURVEY
•?• .? for
CCOMBS-KNUTSON ASSOCIATES, I174301 zsi is
:?»»?? Co.:nL,,.G ,.G,.«.=.?.o,U,.,,on .,,TE.,...,? „LE
?. NEW HOR/ZON HOMES
WMMEAMLIS.N1IfCMIMONr?JYMfIMLLYINNESOTA
HORIZON HILLS HOME OWNERS ASSOCIATION
ARCHITECTURAL CONTROL APPROVAL
According to the attached copy of your Architectural Control
Application dated ?'Y?cw? ?U ? i9G ! for the addition/
alteration ot A „nlc?n r-Fr:l.?.:;-?. .
approval is granted pending the receipt of a City of Eagan
Building Permit.
Once you have obtained a City of Each Building Permit, please
mail a copy oE it, along with any applicable drawings as required
for the building permit, to:
Horizon Hills Home Owners Association
Attn: Architectural Control Committee
Post Office Sox 21423
Eagan, Minnesota 55121
As stated on your original Application, no work may begin until
the Architectural Control Committee has been supplied a copy of
your City of Eagan Building Permit.
TZ,.l?,u approved completion date of this addition/alteration shall be
I Igci I If your project is not completed
bylthis' ate, please contact the Architectural Committee for an
extension request. Failure to obtain an extension by the
approved completion date could result in HHHOA completing the
addition/alteration project and assessing the costs to you.
Date: ? Approved by:
x 4Je-nSic,rY1% - &c? -?i1?-e? `b QU ? lj? 1 U '
White Copy - Homeowner/Canary Copy - Horizon Hills File
N"'\ n
CITY USE ONLY
L ?115 BL _/ a RECEIPT #:
SUBD. (L p? DATE: SS? /Ca I 9?v
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction
X
Date
Add-on air conditioning
Add-on fumace
Add-on air exchanger, i.e. Vanee system, etc.
Auqust 15, 1996
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL $2o. so
SITE ADDRESS: 1606 Clemson Dr.
OWNER NAME: Susan Brown PHONE #: 681-9331
INSTALLER NAME; Fredrickson Heating & Air Conditioninq,Inc.
STREET ADDRESS: 3650 xennebec Dr., #1
CIN; Eagan STATE: m ZIP: 55122-1003
PHONE #: ( 612 ) 452-2775
?26-??
19 k
2/84
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRINi)
1) PROPERTY ADDRESS:
IEGAL Dy..^4IPTION:
STRIiCFL*t2E, DATE GF CtZT=\11F, RiILDING P::ruffT ISSu^r=:
-V'.-a31 .
PRFSEh?' Yi ?7IVf:/PT?P(?SEJ U5?': M R-1 SIhTGT,E FA??IIS.Y i
? R-2 DUPLEX (2StiU UNITS) ?
0 R-3 T7iuTIIiOfJSE (THI2EE + UN225) ( UNITS)
O R-4 APARa124P/CODIDQMINItNi1 UNITS)
E3 aXIMErCIAt,/xErAU,ioFF2cE O nMUSTRIAL
Q INSTIZSPCIONAL/GCIVERNMENr t
.I
EASE PRINT) N7?ME:
-2)--APPLTCANP *,M
ADDRFSS: CITY, STATE, ZIP. PH(k??
?
3) puMBER NAME• -? I.. P NT ' :--. -.- ° -- FOR CITY USE ONLY ?
'
ADDRESS: ?
PLONBERS,L" i
ICENSE: ;
% ? Aetive ?
CITY, STRTE, ZIP; Expired
?
.
ot f Netord !
' PHONE= ' PLUNBEP LICENSE // ?
/
I
n
Q) pLCfjppNr/(7F7NER . (PLEASE PRINT) NAI`4E:
ADDRESS:
CITY, STATE, ZIP:
PFiONE:
5) IIdDZCATE WHICH PERMIT IS BEING RDQ[TFSIIED;
? CONN=ON M CITY Sa1ER .
? CONNDCTION ZO CITY WATER
? OI'HM (PLE15E DFSCI2IBE)
6) IINDIGATE OLNE:
? PLEASE HOID APPROVID PERNLiT FOR PZCK-UP BY ONE OF ABOVE
? PLEASE MAIL APPROVEU PERMIT M 1. 2. 3 4 11B CT7E
(Circle one)
,
7) SIGIATL'RE: L?I, AAav- DATE: I U'a•!l5
. ,.
. .. .. .. .. .. _ ";i?:???..,.+ .. . .. . .. . .. .. .. . .. . .. .. .. . .. . .. . ..?+?-?
F O R C I T Y U S E O N L Y
PERMIT 4 ISSUED
`
, _ .. .
. .... , !
FEES : $ /L % -S L' SETi'IER ?4BMIT , ( I'_VCLLD: SUP.CAARGE )
$ /G' S u WATER PERP4IT (INCLUDE SURCHARGE)
. , $ G3 ?G ' WATER.METER/COPPERHORN/OUTSIDE READER
' $ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
, $ ACCOUNT DEPOSIT - SEWER
•
$ / S-LG ACCOUNT DEPOSIT - WATER
$ WAC
--- -
- S
- ' ?: ? -
°
b --
-' -- -... , _ - -- : - ... _ ,
SAC '
_ •
, .. ,
..,. . ?
S TRUNK •Te7ATER -ASEESSM
+E
NT
$ +
?
TRUNK 3EWER''ASvSESST
$ •t } .1`.y yi?l li
n ERALi; BENEFIT?TRlJN${" SEWER
$ LATERAL BENEF'IT/,PRUNFC` WATER
$ OTHER, _
'
..
.
. • -.
, ..,., ., . .. ,
.TOTAL?b'
:
.
';
.
,
hr..
$ _ ?-/?G ??'C.. ' .• , . yi ...
,
..
:
AMOUNT iPAID/RE(,'EiRT??.
DOES UTILITY
CONNECTION REQUIRE 4
EXCAVATION IN PUBLIC RIGiIT OF WAY?
0
YES •,:
IF YES, THEN A"PERMIT VOR WO1FK 'FIITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? NO ENGINEERING DIVISION. LIST AS A CONDI-•
TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
- DATE: /v
O 1 ? ? I•. `':?..J t,? ?•l .
Xle
?! fJi/ ?1l?/ ?! ? i! Ri? ?!? R iJq w:lr l?F i 1! ?-JR ?Rl? Ri ?k? !?! ?!!R# Ri P!? l?'k ?-? Ft? w!? r1k s# w w
..... .... ,. ,..,. .
??+ew+?e???.arie+e??.cr?y+tr+t?r*++swii:.iwAs,??.;.??!!?... . ............ .... .. . •
....... .... _ ....... r.p"'E'y'+sh+?f ;,,j??!
F O R C I T Y U S E O N L Y
PERMIT " ISSUED
? . ? .., ,
. . _ -... ..i?t . .. •, _. .. .. .
FEES: S ?lJ? ?C ' SETtTER pvRNIIT (I:VCLCD: SUP.CHARCE) -.'
$ `G S ?WATER PERR42T (INCLUDE SURCHARGE)
• $- C 3, WATER METER/COPPERHORN/OUTSIp$ READER
$ WATER TAP (INCLUDE COKPpAATION S
$ TOP)
SEWER TAP
- ACCOUN'r BEPOSIT - SEWER
$ /S OC= ? ACCOUNT DEPOS IT -WATER ?
S ?uar;_e? WAC -
$ ? ,..
----- -SAC
TRUNK WATER ASSESSMENT
$ ' .. . -• , .. . ?" '
TRUNK SEW$A P.SSESSM,ENT
$ LATER1aS, HENEFIq`/TRtJiVK SEWER
$ LATERAL BENEF'IT/TRUNK WATER
$ vcOTHER , _ <y>
• ? .-• `?;'
TOTAT.
. . ; t: .. ' a .. r. ?. t.. ] . ..
-- $ 'AMOUNTPAID%RECEIPT,# DOES UTILITY CONNECTION REQUIRE EXCAVATION ZN PUBLIC RIGiiT OF WAY?
YES TP YES, THEN A"PERMIT FOR WORK,WZTHIN
PUBLIC ROADWAY" MUST BE ISSUED BY 3'HE
Q NO ENGINEERING DIVISION. LIST AS A CQNDI--
TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE: n
DATE: l0 ?% . • ? ?
. . _ ? .... . B?".
arsr mmka rW OPPt
?t sesm Vt+ mum rq no:r"
w? ?+ ?e ? rE ? ?.e+ ?r;!'' ?lM?ii'.
. .. .. .. .. ., 1
s_ AL/aa
CZTY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
1) PROPERTY ApDRESS:
T.Ff'AT• DE.SG4IPTION:
(PLEpSE PRINT)
? =S'_=_` 0 SS'RliCTCF2E, Dr1TE OF OsZT.G :?AL BIIITifJING P?-?•iIT ISSurZ=:
PRESEN7 =?MX:/P?20POS'E?J USE: N R-1 SIINGLE FAMILY
D R-2 DUPLEX (Ih0 UNITS) _
? R-3 ZC74vDII-IOUSE (ZBII2EE + UNlTS) ( UNITS)
O R-4 APAItngSPr/CUIDaMIINiLM
? CCIqllERCIAL/RE.TAII,/QFFICE '
p lMUSmRTnT•
p INSTITU7.'IONAL/GOVEMZ=
? AppLICANp (PLEASE PRINi) . . ..
.. ... . . . .. _ ?
rrr?: , ? (I 2a
ADDRESS:
CITY, STATE, ZIP:
MisioL
? PF?h?: ?? • . ???
3) pILMBER ??. - EA E R3 T) -- - FOR CITY USE ONLY i
R E MBERS LICENSE: ?
t ILYVILV I I 111 0 ADDRESS: (= Active ?
CITY, STATE, ZIP• C] Expired' ?
PHONE: Not? f Reco'd ?
PLUMBER LICENSE #
, -
4) aCC..'UPANT/OwNER
. NA6'1E:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
PRIN
5) INDICATE WtIICH PERMIT 25 BEING RDQUESiED:
? CONNDCTION M CITY SEF7ER
? CONNFX.TION 10 CITY WATER
, ? OTAER (PLEASE DFSCRIBE)
6)
oINE: -
E] PLEASE HOLD APPR()VEp PERhLTT FOR PICI<-UP BY ONE OF ABOV$
? PL£ASE Mn,IL APPROVID PFR%LLT ZU l, 2, (9 4 ABWE
?l (Circle one)
7) SIG417U'RE:
DATE: • ' .,
4. , '
z/sa
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
(PLEASE PRIHi)
1) PROPERTI' ApDRFSS:
LFJGAL D°SGR2_n'PZON:
T" `?'`C??= - ? S'?'RI;CTTRE, DATE OF Cc2TG?TEIL BJI'iJIIQG PTMST ISS,;P\G:
PRESEv'T ZC`I i]f;/PROPOSED USE:
-.Ll - HYYlaLIf:LYl' _.
NAME:
ADDRESS:
CITY, STATE, ZIP:
PMNE:
W R-1 S7Di13LE FAM2LY
? R-2 DUPLEX (ZWO WiITS)
E3 F-3 TJ4vMOUSE (REREE + L1NIT5) ( LINITS)
? R-4 APARaUFSPt/CODIDOMIIJItLtiI UNITS)
Q COMMERCIAL/REIAiI,/OFFICE
o INMusrxIAt
Q INSTIZU.TIONAL/GdVERN-MR
?
i
._ E PRIN • . .... ._..
3) PLUMBER I;AME: fOR CITY USE ONLY i
ADDRESS: ? PLUNBERS LICENSE: ?
Active ?
CITY, STATE. ZIP: ? Expire ?
A?OtK P?: Q Not Rerord i
PLUMBER LICENSE k
4? OC.?[JPANT/OWNII2
. NAME:
ADDRESS:
CITY, STATE, ZIP:
PFK)f1E:
ASE PRINT
5) INDICAT'E WHICH PERMIT IS BEING REQUESTID:
? CONNF7CPION TO CITY SEFIER
? QaNNDCPION TO CITY WATER
? di'Fm2 (PLFASE DESCRIBE)
6} IlVDIC.AT'E OlZE:
7) SIG4A7J'RE:
DATE: • ' S
? PL£ASE HOLD P,PPRWID PERMIT FOR PICK-UP BY ONE OF ABOVE
? PI,F1iSE MAIL APPRO`IED PIILM.IT 'IO 1, 2, 30 4 ABOVE
? , . (Circle one)
.. .. .. .. .. .. . ..
??ew.sE+nris.?a??ra?rtre•d-....r???r+i , ? *+asriw. ..?
s++=?.: ig.s.F?: :. ?!.? . . . ... .. ... .....? ? .. t!!..: .. . !!?t+?? .?-.:?:'.
F O R C I T Y U S E O N.L Y
PERMIT 9 ISSUED
. , ,.. ..
. . .. • . „ .
• ,
FEES: $ f? ?o SErJER PERMIT (IVCLEDE SUP.CHARGE) "
$ 16, C-c, WATER YERP7IT (INCLUDE SURCHARGE)
WATER-METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
ACCOUNT CEPUSIS - SEWER
ACCOUNT DEPOSIT - "WATER
WAC
SAC
14
$ TRUNK, WATER •:A9SE6SMELdT
? .• _• ,, ; . N...z?.:
$ . TRUNK.SEWM -P,SSESSNTENT
$
'.,.LATERAL BENEiIT/TRUAIFC' SEWER
S ..??LATEitP.I;' BEN£E'IT/TF2UI7FC' WATER
'OTHER. '-
r, . ili.. . 1• J' 1'JW? .1$ ." . : :? TOT.AI:'?
%?? . . . ,.,,,
• UG',. _ . ?; .
: S Ub!, • _•_ AMOIINT PAID/R,?CEIPP ,
4 _
DOES UTILITY CONNECTION REQUIRE EXCAVATION,IN PIIBLIC RfGHT OF WAY?
? . ;t-
YES IF YES, THEN A"PERMIT FdR'FiORI{' PTITAIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
Q NO ENGINEERING DIVISION. LIST AS A CONDI-•
TION.
SIIBJECT TO THE FOLLOWING CONDITIONS:
RPPROVED BY:
TITLE: -
.
TiE •, •, jU/(J J ?/ ' '. ?"'. ti" .; . ? `: ? 4 .
/k iJ? ?lfr wwi4 ?m mm,! ulLm 01imPa ipt i" Rm O1k,+7 FkWleF1pi" Rii Wf.a s%wv! W:pw
l?+? ?tA a?t ?}? e?er me
2/84
(PLEASE PRINT)
1) PROPEEYI9' ADDRFSS:
rECAr• Dy..^4IPTION:
?1- F"'{71-c-='?: S?'IF'iCTtJRE, Dr?TE OF CRGi.?•VAI. RiILJT ING Pt?zAIT ISSuR\:E:
PRESLVTr _-071IY:/P?DPOSED LTSE• ¦ R-1 SIIQQE FAtiffLY i
O R-2 DUPLEX (4h0 WiITS) I
0 R-3 TG4v'MOUSE (TFII2E:E + UNiTS) ( UNITS)
p R-4 APAR'II'ETPP/CONIDCYNINI[M - ( UNITS)
p CQMMERCIAL/RELAII?OFFICE '
O ItMUSTRIAL
Q INSTI'NTZONAL/GOVEReIENt'
- 2)- -APPiSCAN'P . _ _.._ , IPLEASE PRINi)-- tn.
NF1ME:
110
ADDRESS:
s
CIZ"l, STATE, ZIP: I
i
PFK?? ?
?
3) pukMER. NAME• - E PRI -• - FOR CITY USE ONLY
?
ADDRESS: PLUMBERS ENSE: +
• Act?e !
CITY, STATE, ZIPs E ued j
2 2I t of ecord ?
P?: q?7-i ? PlUMBER LICENSE q
_ aSf'FF ?T,'T, .1
-
4) OCCCTPANT/(XaNEEt
NAME:
ADDRESS:
CITY, STATE, ZIP:
PFiONE:
CITY OF EAGAN
APPLICATION FOR PERMIT
S£WER AND/OR WATER CONNECTION
lk(P ASE PRINT
5) INDICATE WHZCH PERMIT IS BEING REQUESTEp:
* CONNECTION M CZTSt SEFIEEt
? C=7GTION TO CITY WATER
? 0niER (PLEASE DESCRIBE)
6) INDICATE ONE:
E] PLFASE HOID APPR(NID PERMiT FOR PICIC-UP BY ONE OF A&TJE
? PI.FASE MAIL APPROtIFD PIIRMIT TO 1. 2, 3Q 4 ABOiIE
? (Circle one)
7) SIQNATT.IRE: DAT'E: ID.q. 8?
??
ti,.
. ...., -
? .....: .•.
.e....:?.....irs.?kls "M' .`:?ii:ii:i?!!!!r?nt.!ts?,!'?i!pl?'4?...
F O R C I T Y U S E O N L Y _
PERMZT 0 ISSUED
F£ES: $_ SEYlER P°RMZT (I97CLliDv SUP.CHARGE)
-?
$ /G' ? G WATER PERPIIT (INCLUDE SURCHARGE)
5' l ?c%U WATER.METER/COPPERHORN/OUTSIDE READER
$ WATER !PAP (INCLUDE CORPORATION STOP)
$ SEWER TAP
ACCOUNT DEPUSIT - SEWER
$ ?S?UC ACCOUNT DEPOSIT -'WATER •
$ WAC
$ SAC -
$ :TRIINK• 4
ATER ASSESSMBPTT
$ .
? t ' • ' • ?.';: '
. TRUNK SETrFtR':ASSESSMENT
$
Z?LATEi2AL BENEFIT/fi14UNIC SEWER
$ LATERAL'BENEFIT%TRUNR WATER
$ QTHER
?
.. 4.•r r ..1. ?.+
?... :?:
! . ? 1 •i
: 1
+
t
. .
,
: {.
$ + .:: . - ' . . < <.. t _ r•• . .
?T?}...
' ,
,
,
•
•'!' F
f'
'
.
`
`
?
$ LXJ ? ' AMOUNT PAID%RECEIPT
v.
DOES UTILITY CONNECTION REQUIRE EXCAVATIO,N'•'1N'PUBLfG.?.RIGHT OF WAY?
? YES IF XES, THEN A"PERMIT FOR WORK WITHIiV
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LZST AS A CONDI-•
TION.
SUSJECT TO 2HE FOLLOWING CO[VDITIONS:
APPROVED BY:
TITLE:
--4AZtE ? ., /U 4U !JS/ , • : ,; : _ ,? _ ,i
.
, . . _ .
i
3??) ?-4 v
1999 FIREPLACE PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675
Date: Anl? ( I ? ! ?j 9?
Description of Work _ Canstruct nerv fireplace _ Alrerntioies to existing
? Install gas iiisert aslv _ Install eas line oielv
Other
Iob address: C ?y Ll r l? Mso D
Lot. ? Block. Subdivision/P.I.D. #-.-?-\2oYVLO. Ll L0.1Cs n??S
Applicant (circle one only): Own Contractor Permit Fee: 560.50
Name: / 1 V,S CP n / ?uLL (/
PROPERTY Last ? First?
OWNER ?? M 1 1 ll') ?/ /., . .--
Strzet Address:
op, ,I /?r?
Phone #: ?7Lj ( /.>3o?
CiTy ?aaah state:zq?v-- Zip: s.s
Y? 1,1"eSL D f??rPr I P I Phone4: ?
ComPan? ?f?
FIREPLACE
IVSTALLER Street
City 6 UwK () ? ) I toj State:
Zip: 5.?33 !
Company: Phone #:
GAS LINE
INSTALLER Street Address•
City State: Zip:
t hereby acknowledge that I have read this application and state that the information is correct
' and agree to comply with all applicable Sta[e f Minnesota Statutes and City of Eagan
,
Ordinances. ? 4-
/
I
I '1 f I
???
L l- ---- - 1'
-?031 g
2005 RESIDENTIAL BUILDING PERMfT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Telephone #(
New Conslructlon Reauiremenis RemadeVReoair Reauirements Office Use Onlv
3 2gistered site surveys showirg sq. ft. of lot, sq. ft. of house; and all roofed a2as 2 copies of plan Cert of Survey Recd . _ Y_ N
(20°h maximum lol caver.ge allowed) 7 set o( Energy Calculations for heated additions Tree Pres Plan Recd _Y _N,
2 copies of plan showirig beam 8 window sizes; poured Pound design, etc. 1 s'rte survey for addttiorts & decks Tree Pres Required ` _ Y _N
1 set o( Eneigy Calculatbns AddiL'on - i/Micate ifai-sne septic system On-sife SepGc System _ Y_ N
3 copies of Tree Preservation Plan'rf bt platlad after 711/93 i
Rim Joist Defail Optlons seledlan sheet (buldings wM 3 or less unHs)
Date 1`? ?SJ??` C nstruction Cost
MWO&
C 1
?
Site Address 1lp V4?
?11 ?,?(!1 ? UniUSte #
Description of Work `Q.C_V- ? W!• ?1?? ? 1
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner Telephone #
The Home Depot A.H.S. Inc.
Contractor
3200 Cobb Galleria Pkwy.
Address Atlanta, GA 30339 citY
State 763-542-8826 Telephone # ( )
License #20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet
(Jsu6missiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
"Y ? o.?
Telephone # ( )
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved p an in the case of wark which requires a review and
ap oval of plans.
, ^ ? . ? L 1,'J LS I .'
Y U
pp icanYs Printed Name pplicant's Signature 7'15 I I?
Installed
Siding and Windows
LIMITED POWER OF ATTORNEY
CuUNTY OF COBB
STATE OF GEORGIA
KNO W ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sai_es loca±ed at 660 Mendelssehn Avenue North, Gnlden Valley, r?IN
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Ina ("AgenY') as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sigi and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary arid appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Power of Attemey are
limited solely to the express powers delineated herein and appl_y solely to the Work.
This Limited Power of Attomey shall expire and automaticailp be revoked on the 21st
day of May, 2004, which date is one year from the execution hereo£ Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN WI'?NF_'.SS WI-IFREOF this Lim?ted PoNver ofAno?ney is e,sectrted this
21 st day of May, 2003
David N. Katz
?Ij
S WORN TO AND SUBSCRIBED BEFORE ME by David N. ICatz on this
21st day of May, 2003.
??Sp
1Votary POic in for the State o et'(i orgia
Niy Commission Expires: January 21, 2006
?96816.v3 -
Proudly sold, furnished and instalied by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
~? ?b2b
2005 RESIDENTIAL BUII.,DING hRMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reauiremenfs RemodeVReoair Reouiremenfs Office Use Onlv
3 re9iste2d sile wrveys showirg sq. ft of lot, sq. ft of house; and all roofed a2as 2 copies of plan CeR oi Survey ReW =Y _ N
(20%mazlmum lot coverage allowed) 1 selof Energy Calcuiations for healed addNOns Tree Pres Plan Recd _Y _ N,
2 copies of plan showing beam 8 window s¢es; paured found desgn, etc. 1 stte survey for addfllons & decks Tree Pres Required - _ Y_ N
1 set of Energy CalculaGons Addition - indkate i(on-sile sepUc system O"ite Septic System _ Y_ N
3 copies of Tree PreservatWn Plan if IM platted afler 7/1193
Rim Jo'st DefaO OpUons selection sheet (buildirgs wilh 3 arless undS)
Inf L1 nLPY
lP ? ? -
Constructian C
o
st
Date _1_ / _'S* _G75
\
Site Address ? ?p 6 q c?m5 ?\ 1)( ' ?
?
?
rjXc.y<a .? UniUSte #
Description of Work L?Pac_e -1 (itJl Aq,"s Q cinUf Ck/ / r/1 '--4A;S77
Multi-Family Bidg
Y
N Fireplace(s) 1
2
0
_
_
_ _
_
Property Owner Telephone #(t9 S1
The Home Depot A.H.S. Inc.
Contractor
3200 Cobb Galleria Pkwy.
Address Atlanta, GA 30339 City
?
State 763-542-8826 _ Telephone # ( ) I
License #20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDIN
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code Category . Residential Ventilation Calegory 1 Worksheet • New Energy Code Wa
(4 submissiontype) Submitled Submitted
. Energy Envelope Calculetions Submittad
Have you previously constructed a building in Eagan with a similar plan2
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone # (
N If so, 25% dlan review
I hereby apply for a Residential Building Permit and acknowledge that the inforxnation is complet
that the work will be in conformance with the ordinances and codes of the City of Eagan and tt
5tatutes; I understand this is not a permit, but only an application for a permit, and work is not to
permit; ?Jbat the work will be in accordance with the approved plan in the case of work which reqi
appro of plans. ?
p ic t's rinted Name App icant's Signature
and accurate;
State of MN
tart without a
a review and
?
Installed
Siding and Windows
I;IMITED POWER OF ATTORNEY
CviJNTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installed Sales loca?ed at 660 Mendelssehn Avenue Norch, Golu'en Valley, MIIV
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("AgenY') as my true and lawful
attorney-in-fact and do authorize and grant said aftorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the."Work").
The powers conveyed to the Agent by this Lim,ited Powerof Atterriey are
limited solely to the express powers delineated herein and aprt_y solely to the Work.
This Limited Power of Attc,rney shall expire and automatically be revoked on the 21 st
day of May, 2004, which date is one year from the execution hereof. Further, the
powers conveyed by this Limited Power of Attomey may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN Wi"rNESS WHEREOF this Limited Po«er of A?temey is e:cecutc3 this
21st day of May, 2003
.
David . Katz
S WORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21 st day of May, 2003.
1
IVot?ary?P69ic in for the State o eorgia
n1y Commission Expires: 7anuary 21, 2006
396816.v3 .
Proudiy sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
473 V 7s
New Construcfion Reauirements RemodeVReoair Reauirements Office Uu Onlv
3 registered site surveys showing sq. ft, of lot, sq. ft. of house; and II roofed areas 2 copies of plan CeA of Survey Recd _ Y_ N
(20°k mazimum lot coverage allowed) 7 set of Energy CalculeUOns Por heated addifions Tree Pres Plan Recd _ Y_ N,
2 copies of plan showing beam & window s¢es; poured found design, etc. 1 site survey for add'Aions & decks Tree Pres Required _ Y_ N
7selofEnergyCalculalions Addifion - indicate'rfonaifssepticsysfem On-sfleSeplicSystem _Y _N
3 coples of Tree Preservafion Plan rf lot platted atter 711193
Rim Joist Detaa Op6ons seleGion sheet (buildings wilh 3 or less un0s)
Date "1 /??o l Q s -Construction Cor'? OD
SiteAddre 160 y-16-641B /706 UniUSte #
Description of Work S7711 arA?51' 61 ' A/Jn/OOc.? 1?) :?]
Multi-Family Bldg 7?' Y _ N Fireplace(s) _ 0_ 1 _ 2
?r^sidawf) w?Y??
'
PropertyOwner ? ??i?mnnJ
Telephone#(?.S )q59 -0 47/x
Contractor Vd<n
vG
,
Address C/Gl /F •??nic:Oro??' City Se- ?'J i AJL
State! v?N2Sabl_ Zip .5-5 7J Telephane # (6,57 ),;57 -I06 I
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Calegory 1 Worksheet • New Energy Code Worksheel
(Jsubmissionrype) Submitted Submitted
. Energy Envelope Calculations Submitted
In the lasf 12 months, has the City of Eagan issued o permit for a similar plan based on a master plan2
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an a lication for a permit, and work is not to start without a
permit; that the work will be in accordance with the pprove an in the case of work which requires a review and
approval of plans.
?lC? h iti) ku ?i Cy.
Applicant's Printed Name
7qg73
r
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWction Reauirements
3 registeied site surveys showing sq. R of iot sq. ft. of house; and all roo(ed areas
(20 % maximum lot coverage allowed)
1 Soils RepoA if proposed building is to be plaoed on disWrbed soil
2 copies o( plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calwlations
3 copias of Tree P25ervalion Plan ii lot plattetl after 7l153
Rim Joist Detail Options selection sheet (buildings wHh 3 or less units)
Minnegasco mechanical ventilation form
RemodeVFteoair Reauiremenls
2 copies of plan showing foolirgs, beams, joists
1 set of Energy Calalafions for heated addiUOns
i site survey for additions & decks
AddNOn - indicafe i(on-stte sepfic system
Zb. 06
office um anro
CerlofSurvey,Recd- . _Y _N
SoilSRepod' _Y _N
Tree Pres PWn Recd _ Y. _ N.
TreePres,Reauired _Y. _N
Oo-siteSepticSystem _Y. _N
Date / I-7
SiteAddress Cr /OG
'Gq9 CL Construction Cost Kd? ;p
`
LMSGW DQ. UniUSte #
Description of Work Qti?LAL6 lOx 20 Dc C},r PGecH WGr C7?WFV SlN°Ycr'1)
Mul[i-Family Bidg ? Y _ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner HGE120N M (,LS CSCG41 BW/LE?) Telephone#pS) ) 22-4-5LI(?)2 C-2)
Contractor V(Ck `? ??oic CGV,,1'+RN`+'
Address
State M N k1 2GlN bN vE I!. City i'Wvbr_ Gn?,? ??E??F(?f
Zip 5507 7 Telephone #(C1 ?'j2) Ll3Z 23)l E Xj k?'
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enefgy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted .
In the lasT 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, daTe and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that tbe information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes, I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
M I kr-- ? v??I IfV?? ?-,
ApplicanYs Printed Name Applicant's Signature
DO NOT WRITE BELOW THIS LINE
?
Su6 Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext.Alt - SF
? 04 02-plex ? 10 08-plex to 18 Deck ? 23 Porch (screen/gazebolperoia) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvues
? 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 Windows/Doors
VLV 34 Replacement
[ 'DemoliFion (Entire Bldg) - Give PCA handout to applicant
DeSCriptl011: Water Damage _ Yes .
Valuation Occupancy R- -3 MCES System
Plan Review 100% or 25%
Census Code 43q Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length a? Fire Sprinklered
eF7
Type of Const V
Width
? o
REQUIRED INSPECTIONS
_ Footings(new bldg) _ Sheetrock
_ Footings (deck) FinaUC.O.
_ Footings (addition) _LeV FinaUNo C.O.
Foundation HVAC
Drain Tile Othet
Roof
Ice & Warer Final _ Pool Ftgs Air/G as Tests Final
_
_ Frazning _ _ Siding _ Smcco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S8W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
r
CLEMSON o D,pIVE
m.
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? ie` S86°/3'70"E
3 1.OQ
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zo
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%D
?t-
i1.D0 P' g L Y---
S 8 6'!3'Z O"E
1
V'F?`
V?eck ?_-,
tc? x 2Gt
I hereby certify that this is a true and correct representation of a survey of the boundaries of:
Lots 61, 62, 63 and 64 Block 1, THOMAS LAKE HEIGFTS 2ND ADDITION,
Dakota County, Minnesota.
3k ?er?
And of the location of ail buildings, if any, thereon, and all visible encroachments, if any, from oron
said fand. This survey is made only in connection with a mortgage loan now being piaced on the
properry and no liability is assumed except to the holder of such mortgage or any other interest
acquired by the reason of such mortgage. It is understood and agreed no monuments have been
placed for the purpose of estahlishing lot lines or boundary comers. As surveyed by me this ?th
day of November 19 85 ,'/ ?? /7
//
?aul A. ,Tohnson
I
Land Surveyor, Minn. Reg. No.
McCOMBS-KNUTSON ASSOCIATES, INC.
»ta.suuiNo [NmxE[ez 4 wco :uMrnoRS 0 sir[ ru?v?a
?._:?'?^ WHNEAIOLIS.1MC111MSOHMYAp{IYLL,WtpE50TJ
= 40' M
SU RVEY
aooc rwce fQr
23f 18
NEW XOR/ZON HOMES
?430
'7Z1 $ 7a---
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements
3 registered site surveys showing sq. N. of Im, sq. H. of house; and all roofed areas
(20% mazimum bt mverage allowetl)
1 Soils Report 'rf proposed building is l0 6e placed on disturhed soil
2 mpies of plan showing beam & window sizes; pou2d found design, etc.
7 set of Energy Calcula6ons
3 copies of T2e Preservation Plan M lot platted aiter 711/93
Rim Joist Defail Options selection sheet (buildings wBh 3 or less units)
Minnegasco mechanical ventilafion form
RemodeVReoair ReauiremenGs
2 wpies of plan showing footings, beams, joisls
1 set of Energy Calculations for heated additions
1 site survey tor addifions & decks
Addifion - indicafe il onafte sepfic system
X. a)
_..
Office Use Onlv
CeROfSurveyRecd Y _N
Soils Repod _Y _N
TreePiesPlanRecd _Y, _N_
Tree Pres Required _ Y _ N
On-sileSepticSystem _Y _N
Date?/ /
SiteAddress t(?(x
Construction Cost
A UnitlSte #
Description of Work pfI i-ACr IoX`ZG pF_ cr
Multi-Family Bldg ?, Y_ N Fireplace(s) _ 0 _ t _ 2
Property Owner I l0OZ.GM1 HUS C? t? 91N1 LEY? Telep6one #(6?'j I) 22`4-t482 (-2)
Contractor 'THC- D EL k °r DGUCL Covti PANY
Address 11Co3?2 AK
state (v1 fJ i2r,N ptvt ii?,
Zip r? G-77 City i1?jVER ('aa.VC tIEl6"
Telepnone #(9 rj2 ) LI 3Z - 23 ) I G x11d?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv I Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In ihe last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a masTer plan2
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone #( )
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor Telephone # ( J
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
M i kr ?2voM ?? &'- /-?
Applicant's Printed Name App ical nYs Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_ plex ? 09 07-plez ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 DS-plex 0 18 Deck ? 23 Porch (screen/gazebo/perola) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors
f 34 Replecement `Demolitlon (EMire Bldg) - Give PCA handout to applicant
DCSCrIptl011: Water Damage _ Yes
Valuation Occupancy MCES System
Plan Review 100%or 25%
Census Code Zoning p 7) City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length 7- C3 Fire Sprinklered
Type of Const Y? Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS
_ Sheetrock
FinaUC.O.
?O FinaUNo C.O.
HVAC
Other
_ Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
W indows
_ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
CLEMSOIV o
m.
4;1?Q
.5 lxa
Dk/VE
? I
I ?8' S86°!,j'p0'E
I
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F ?,a-
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,
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0
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v
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n ? ?L
to
_n ? ^ n
3I.00 31.00
I hereby certify that this is a true and correct representation of a survey of ihe boundaries of:
Lots 61, 62, 63 and 64 Block 1, THOMAS LAKE HEIGF,TS 2ND ADDITION,
Dakota County, Minnesota.
16D?o 34
And of the location of all buildings, if any. tfiereon, and alt visihle encroachments, if any, from oron
said land. This survey is made only in connection with a mortgage taan now being placed on the
property and no lia6ility is assumed except to the holder of such mortgage or any oiher interest
acquired 6y the reason of such mortgage. It is understood and agreed no monumenis have been
placed for the purpose of establishing fot lines or boundary comers. As surveyed by me this ?th
day of November 19 85 ?
?aul A. Johnson
Land Surveyor, Minn. Reg. No. 10938
? McCOMBS-KNUTSON ASSOCIATES, INC.
?t•)5))ca?mamc ncwe[as 0 wa zuernoet ? ait ewans
-j%%,40? MORTGAGE SURVEY
?t •?E for
231 1B
IME?. AvFw kna/7nAv NnMf-s
\
2006 RESIDENTIAL PLUMBING PeRMiT aPPLicaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date2!
Site Street Address %D.?.? r1' Unit #
Property Owner Telephone #?}- lfv?? ???a(.
el
ephone #
Contractor 4 L?/aCC?iras T
!
,
Address???yo?/?j?!?P (??+ City State? 2iq<S?33"Z
The Applicant is: _ Owner X Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. !f you are installing onlv a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
"
_WaterTurnaround (add $130.00 if a 5!8
meter is required)
_Other:
.4Water Softener _ Water Heater $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the
work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accord e with the appr ed plan in the event a plan is required to b viewed and approved.
O
Appli nt's Printed Name Appli ai t's Signature
:,
1
4
1 1.---78- 4
6--
Apr 04 2013 11:42AM HP LASERJET FAXBAC CONST 6127223447 page 4
City•••oE a!'
3030 Pilot Knob Road
Eagan MN 55122
Phone: (661) 075.5676
Fax: (061) 675.5694
Use BLUE or BLACK Ink
For QHioe uor
Permit #: __ U
Permit Fee:
Date Received: __
Staff:
�l 3
X013 COMMERCIAL BUILDING PERMIT APPLICATION
Date: Site Address:--(� ode C (e ms o r� I>
Tenant Name: _ ar► �r1_— (Tenant Is: ___ New I ?_ Existing) Suite 0:
Former Tenant:
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Name: Phone:
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Address / City / Zip:
M►Iloent Is: Owner ___ Contractor
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Deaorlptlon of work: C11 C r_1(.1,S tl) E, eche laf�-Lll:_�u 1-c1+ D+''
Construotion Cost: .
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Name: c' o�.,$_L •51=it1(1 License #: lGleD�p.
Address; (\ae_ba b21 — City: f \ P:
__.39,12--__1±,a' -_4
State: Zip: VCS Phone: Yr' -7.2_ 1- a -so 0
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Contact: .. Emell: . * S,2(c S. IQ
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Name: Registration #:
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Contact Person: Email:
Llceneed plumber Instal in. am sewer/water service:. __, Phone l0!:
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CALL BEFORE VOy DIG. Cell Gopher State One Call at (691) 454.0002 for protection against underground Ut
cell 48 Nouns before you Intend to dig to receive locates of underground utilities. www. aopherstateoneoell.org
I hereby acknowledge that this information Is complete and accurate: that the work will be In conformance with the
codes of the City of Eagan; that I understand this le not a permit, but only an application for a permit, and work Ia not
permit; that the work will be In aboordance with the approved plan In the case of work whlrequires a review end app
Ity damage,
rdinences and
!tart without a
sI of plans:
Applicant's Printed Name Applicant's SI attire
Page 1 of 3
Apr 04 2013 11:44AM HP LASERJET FAXBAC CONST 6127223447 page 6
,UB TYPE4
Foundation
_ Commerolai!Industrial
_ Apartment.
Miscellaneous
L401. /( C(k 3)
DO NOT WRITE BELOW THIS LINE
_ Public Facility
_ Accessory Building
Greenhouse / Tent
Antennae
WORK TYUS
New _ Interior Improvement
w Exterior improvement
Repair
Water Damage
Addition
Alteretlon
Replace
Salon Owner Change
DESCRIPTION
Valuation
Plan Review
(25%____ 100 %__)
Census Code
g of Unita
# of Buildings
Type of Construction
)iEQUIRgp (j1SPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Decking __Insulation ___Ice & Water _Final
Framing
Fireplace: Rough In _Air Test __Final
Insulation
Meter Size'
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Exterior Alteration -Apartments
Exterior Alteration -Commercial
Exterior Alteration -Public Facility
_ Siding
Reroof
Windows
Fire Repair
_ Demolish Building"
Demolish Interior
Demolish Foundation
Retaining Weil
'Demolition of entire building — give PCA handout to applicant
MCES System
BAC Unite
city Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final ! G.O. Required
Final / No C,O, Required
Other:
Pool: _Footings _Air/Gas Tests _Fins'
Siding: __Stucco Leth __Stone Lath Brick
Windows
Retaining Well
Erosion Control
Final CIO Inspection: Sc.Odul. Fire Marshal to be present: ___Yea No
Reviewed By:.
, Building inti<psct:or Reviewed By:
COMMERCIAL EV)
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
S&W Permit & Surcharge
Trrntment Plant
Treatment Plant (Irrigation)
Park Dedication
Trail Dedication
Water Quality
Water Quality
Water Supply & Storage (WAC)
Storm Sewer Trunk
Sewer Trunk
Water Trunk
Street Lateral
Street
Water Lateral
Other:
TOTAL
, Planning
Page 2 of 3
Apr 04 2013 11:42AM
SAL
HP LASERJET FAXBAC CONST 6127223447
((d-(- I (00-cP C(c
page 2
1 Il
CONSTRUCTION SERVICES LLC•
dbs ion Chimney •
• Banner Rooting • Award Exteriors • Champ
3032 Mlnnehah* Ave. S.., Minneapolis, MN 06400
Phone 4312-721-5E500 Fax 612-722-3447 47 0. www.050015.net
WAVA
ti�rl
Horizon Bills Toliirnlaorne Association
Various Addresses
Bolan, 1ViN
rci
... J. �.+
, nl
•
I1 _11.
-IRS BUILDINGS #181804.1606
REMOVAL OF EXISTING ROOFING & REROOFINGNDR, #32 T 1342-1540. CL<:MSON DR:
CLEMSON DR, #261574.1576.C1.EMS
material down to the roof deck, clean up all debris, and ul away
removing tothe lob its
1. Remove existingburoofing in using plywood and tarps as much as possible.
Protect the building and landscaping of the house.
debris from the existing root a dumpster will be put In close proximity
2. Remove roof sheathing as needed to allow insulation contractors access to the attic, Note- This item of
contract price at a rate of $2.04 per square loot.
work will be performed over and above the o4
3. Install new pre -painted, gutter apron or drip edge on all lower edges.
4. Install GAF
Weatherwatch` nderiayment 6' up roof from all lower edges and 9' at upper Main buildings
only.
5. Install an 18" wide strip. of 3F Weatherwatch undertayment 8" up sidewalls and onto roof deck.
therwatoh urideriayment 3' wide, up entire length of all valley areas and a 3'section at all
6. Install GAF Wes 's\vent penetrations.
7. Install and cover the remaining roof areas with GAF Shingle -Mate wrinkle resistant underlayment.
8. Install custom -fabricated, 24- wide, prepainted galvanized metal valley, W-styte•
9. Install a 7 self-starter course with self sealing strip at all eaves to ensure the seal of the first course of
shingles.
10. Supply and install new GAF Tinmbertine HD Lifetime fiberglass shingles. Color
11, Install shingles with tour (4) galvanized roofing nails per shingle.
Install matching hip and ridge shingles using minimum of two (2) galvanized roofing nails.
12.work.
13. Remove the existing siding at all sidewall location and reinstall upon completion of roofing side
metal shingle tins course for course with shingles, at roof to wall transitions (i.e.
14. Install new 26 gauge atm � �[ � r-'�
walls and chimneys).
'II'�71•u w,.7P I �o. .
CO: Bailey Enterprises
1775 Selby Avenue
St. Paul, 1V1N 55104
s'!'M,7�a'%o`:,r..,
Use BLUE or BLACK Ink
For Office Use
My Permit * _I of We I Permit Fee: C
3830 Pilot Knob Road O
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: - I 13----- Site Address: L604 . j ba 1 Ob 8 nit`# 10
~
Name: 4.1 tl 17 fiN1IgOS Phone: &4. 7-21- -S' t'o d
Resident/
0wn'er Address / City / Zip:
Applicant is: Owner Contractor
Description of work: Aemgi-cy . r1-
Type of Work -
Construction Cost: _ '2
Multi-Family Building: (Yes _Z Z No
)
AG
Company: Contact: ,-&#~f - ~ en
Address: 303- )a~1a~__ _ City: MLQY ea'P1 ,
Contractor
State: ! Zip: J J-yO b
~ Phone: (Q c2 - ? 2.1-55-0 d
License Se - 19406 Z.- Lead Certificate -lA.i,_ - 2 !Y29'7
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:
MOTE: 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) 45440002 for protection against underground utility damage. Call 48 hours
before you intend to dig to rive locates of underground utilities. ME.Qwherstateonecail.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
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.
x_ t/!Jl2a-beYA x r
Applicants Printed Name v Applica s Signature
Page 1 of 3
•
r r For Office Use44
ik 1 • Permit#:AG A
•••• ���� � Permit Fee:
1641 .
Date Received:
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 eY _ t i
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 .1 Staff:
buildinginsoectionsecitvofeaaan.com •
2019 RESIDENTIAL BUILDING PE MIT APPLICATION
Date: Site Address: /404/ U1441774/ Q Unit#:
. Name: '0/ /T-4. /07474 16, '' Phone:
+ f
O Address I City I Zip:
Applicant is: Owner X Contractor
, Description of work: tz ,3& V KKiu4'' aeAlle.CL& r✓ rc.Type
>�® ./d c�•b
Construction Cost: Multi-Family Building: (Yes /No )
• Company:f L 1.c71e46TTdr'te ,WYl1 ltd 'C,Y�PEontact: ;Jr.
Address: 14 //2 6fH2 eze ,4if°G City: Iy LvE y1 1J e k
Cotte / / ;.
State: 1. ,Zip: 6-n-/,4y Phone:4S/�yti+' `' ►ail:,/irlp►vcrywerszw.i/,e yt3,0,f C
License#: PL 2294 IL Lead Certificate#:
If the project is exempt from lead certification, please explain why:
Iris4 Atiwoy7t. ;4171
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:
z may be
NOTE:its' ix. . .' sP
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.aooherstateonecalLorq
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 tans. ,r
x 'LL fit yr x 4itif
Applicant's Printed Newts Applicant's Signature
DO NOT WRITE BELOW THIS LINE /60q C16-ale 71 DiL- . / 6 ,06 7
SUB TYPES
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
Multi ,0 Deck
— — Porch(Screen/Gazebo/Pergola) _ Miscellaneous
iQ 01 of,Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement. _ Siding _ Demolish Building*
_ Addition
— Move Building _ Reroof _ Demolish Interior
Alteration — Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION _
Valuation ' Z1 `��9' Occupancy ,...14.4_=., MCES System
Plan Review Code Edition m.1 'ZAP i J SAC Units
(25%_ 100% )O) Zoning J___D City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) )6 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 Pan Other:
Reviewed By: 1.--n1 in/ k/7iit- , Building Inspector
RESIDENTIAL FEES 19 d /D r / o 19 .9.,7",
Base Fee
Surcharge 6) • / /57 s i, •5p• A7 -
Plan Review
MCES SAC M;,' ;nl ✓6t 7.-. 4r--
City SAC
Utility Connection Charge t Xi frX), f u:"•' 4,5
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA172748
Date Issued:10/14/2021
Permit Category:ePermit
Site Address: 1604 Clemson Dr
Lot:61 Block: 01 Addition: Thomas Lake Heights 2nd
PID:10-75951-01-610
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kathleen M Groettum
1604 Clemson Dr
Saint Paul MN 55122
Home Depot Usa Dba The Home Depot
2455 Paces Ferry Rd
Atlanta GA 30339
(763) 852-1044
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA179304
Date Issued:09/28/2022
Permit Category:ePermit
Site Address: 1604 Clemson Dr
Lot:61 Block: 01 Addition: Thomas Lake Heights 2nd
PID:10-75951-01-610
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kathleen M Groettum
1604 Clemson Dr
Saint Paul MN 55122
Champion Plumbing Llc
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature