1605 Clemson Dr
PERMIT
City of Eagan Permit Type: Mechanical
3830 Pilot Knob Rd Permit Number: EA087154
Eagan, MN 55122 . Date Issued: 10/28/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1605 Clemson Dr
Lot: 65 Block: 02 Addition: Thomas Lake Heights 2nd
PID 10-75951-650-02
Use
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Furnace & Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector,
952-445-2840.
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $0.50 9001.2195
Total: $50.50
Contractor: -Applicant - Owner:
K.B. Services Co., Inc. Thomas M Kloyda
430 E. County Rd. D 1605 Clemson Dr
Little Canada MN 55117 Eagan MN 55122
(651) 748-4933
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
CITY OF EAGAN
12352
Y?
3830 Pilot Knob Road, P.O. Box 21-199, Sagan, M N 55121 !
_
. PHONE: 454-$100 ?
BUILDING PERMIT
Receipt#
To be used for 1 017 4 PLEX Est Value $61,000 Date JULY 2 8 ,198 6
1605 CLF:,tiiSON DR
Site Address R3
Erect ? Occupancy
Lot6 5 elock 2 Sec/Sub. THOMAS ?aK HTS ?
Remodel ? Zoning '
Parcel No. ZND Repair ? Type of Const. Vn
Addition ? No. Stories
W Name HORZZON HOMES Move ? Length
i? .V. BOX 136 Demolish ? Depth 27
o Address
420-3900
KPLS Fho
Cit Int impr. ? Sq. Ft.
?
y
ne Install
: o Name SAME Approvals Feas
Address Assessment Permit . SO
City Pnone Water & Sew. Surcharge ?;.00
? W Name '? • sPIS?40I.D Police Plan Review ?
??00
Fire SAC
.00
? ? Address
435-7524
W Eng. Water Conn._??50
<
City Phone Planner WaterMeter-23-40
'
I hereby acknowledge that I have read this appiication and st8te thatthe Council Road Unit
Pi. ??0 0
5/1/8 6 Tr
B?dg
Off
information is carrecf and agree to comply with all appiicable State of .
.
.
Minnesota Statutes and City ol Eagan Ordirtances. APC Parks
Signature of Permittee - - Var. Date Copie ? ?
? .
TOt2I
A Building Permit is issued to: NEVd t3ORI20N HQee$ on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Ofticial
?
- Permk No. Permii Holdw Date Telephone N
Plumbing ' ?L f :s--7?
H.v.A.+C. . 7(0 9O S J
ElecMc
Soflener
Inspectfon Date insp. CommeMs
Footings I ?
Footinys 11
FoundaNon
Framiny
Roofiny
Rough Plbg.
Rouyh Hty.
ln.ul.
Flrepiace
Final Htg.
Final Plby.
Bidy. Final ?v
Cort. oee.
Deck Ftg.
Dsck F?my.
Well Describe Locatbn:
Pr. Dkp.
,
PLUMBIN(i PERMIT
, CITY OF EAGAN
• 3830 PILOT KNOB ROAD, E/IGAN, MN 55121
Site Address
Lot ?a ', _ Block
? Name
? Addre
c City _
?. Name
3 Addre
O CitY
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $1Q.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FOFt CITY OF EAGAN
PERMIT # -
RECEIPT, # -
DATE:
BLDG. TYPE WORK DESCRIPTION
Res. f New
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 S
Bath Tubs - $3.00
Lavatory - $3.00 - --
' Shower - $3.00 - -
' Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
? Floor Drains - $1.50
Water Heater - $1.50 ' ? -
Whirlpool - $3.00
Gas Piping Outlets - $1.50
Softener - $5 00
Well - $10.00
Private Disp. - $10.00
L.---Rough Openings - $1.50 ? -J
FEE
STATE S/C: '? ?GRAND TOTAL: ? ? `-'
PERMIT #
MECHINICAL PERMIT
RECEIPT #
CITY OF EAGAN
, 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ` r'? ?
CONTRACT PRICE PHONE: 4544100 -?
Site Address BLDG
TYPE WORK DESCRIPTION
Lot Block ? Sec/Sub .
i
"
?
Name - Res.
New
M
l
Add
?
?v
Address ,. , . -. . _
? . .
? -on
u
t
C
, .
' omm, Repair
C Ctty L 4R??8@
Other
Name Z.! FEES
?
3 Address " RES. HVAC 0-100 M BTU -$24.00
p C1ty 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°16 OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHARGE PER PERMIT - SO
(ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM 1 s BEYQND $1,000.00)
Gas Piping OuUets # 4:,
Other
FEE
3 v SIGNATURE aF PERMITTEE
s/C,
TOTAL• ? • JU
FOR CITY OF EAGAN
? CITY OF EAGAN ?0 12353
` • ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUtLDING PERMIT Receipt #
To be used for 1 QF 4 PLSX Est value $61 ,000 pate JULY 28 19 86
Site Address 16078 CLEMSON DR Erect 19 Occupancy R3
Lot6 7 Block 2 Sec/Sub. THOMA.S LAICE Remodel ? Zoning R1
Parcel No. HTS ZND Repair ? Type of Const V13.
Addition ? No. Stories
? Name NEW HOR I ZON H4MES Move ? Length 44
= P. O. DOX 1367 Demolish ? Depth 2 7
o Address
MPL
420-390
S Int Impr. ? Sq. Ft
City Phone Install 11
o Name ?E
Z
0 ¢ Address
City Phone
F W Name D. GRI SWOLU
? o Address
< W City Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature oi Permittee ` ' - - - ?
A Building Permit is issued to: NEW HORIZON HOMES
all work shall be done in accordance with all applicable State of Minnesc
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
BIdg.Off. 5j1/86
APC
Var.
Permit '' ''+?• ""
Surcharge 750
Plan Review-? OO
SAC • QO
Water Conn.
Water Meter?00
Road Unit--T500
Tr. PI. '
Parks
COpi@ 00
T..b, I ' uav. on the express condition that
City oi Eagan Ordinances.
Building
? PNmk No. PermR HoWw Dds TNephone N
Plumbiny
H.V.A.G. gl?o1/
ElectNc
Softenx
Inspectlon Date liap. Comm"b
FooNnysl ? w
FooNnys II
foundatbn
Framiny
RooHnp
Rouph Piby.
Rou9h Hty.
Imul.
Fkeptaee
Flnal Hty. /I 03 I- - GL
Final Plbp. - T ?
Bldg. Final
CM. Oce.
Dock Ftp.
Dock Frmy.
WNI Deacribe Loeatlon:
Pr. Disp.
? PERMIT M
• PLUMBING PERMR RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EA(iAN, MN 55121 DATE:
CONTRACT PRICE PHONE 454-8100 NY?
Site Address ' BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Su b
Res. ? New
Name Mult Add-on
?
? Address Comm. Repair
c City Phone Other
O FIXTURES TOTAL
Name Water Closet - $3
00 $
?
3 Address .
Bath Tubs - $3.00
p City Phone ? I Lavatory - $3.00
?Shower - $3.00
FEES Kitchen Sink - $3.00
Urinal/Bidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE r Laundry Tray -$3.00
MINIMiJM - RESIDENTIAL FEE - $10.00 Floor Drains - $1.50
MINIMUM - COMM/IND FEE - 20•00 ? Water Heater -$1.50
STATE SURCHARGE PER PERMIT - •? Whiripool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets -$1.50
BEYOND $1,OQ0.00) Soitener - $5.00
Well - $10
00
.
Private Disp. - $10.00
_;.?_Rough Openings - $1.50
SIGNATURE OF PERMITTEE
FEE -7
STATE S/C:
?
FOR: CITY OF EAGAN GRAND TOTAL• - `'-
W
•4c) _ I
3830 PILOT
CONTRACT PRICE
Site Address •?
Lot Block Sec/Sub _
m Name
? Address • , ' ! ? ;_ ?
c ?
Ci
P
ty hone _. ?
Name
?
c Address
p Ciry Phone
TYPE OF WORK
Forced Air M BTU $`
' 8oiler M BTU $?
Unit Heater
' M BTU ?
Air Cond. M BTU $?
Vent CFM ?
I Gas Piping OuUets # ?
?
FEE
S/C:
TOTAL•
v ?r ,'„i
iICAL PERM[T RECEI
OF EAGAN iOAD, EAGAN, MN 55121 DATE:
IE: 454-8100
BLDG.TYPE
Re.a.
M ult
-11 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 $1,000.00)
.' ?.
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
# .
. ?
REACTLVATE FOR FIREPLACE CITY OF EAGAN ^! -
• 2/ 1.9 J 8 7 3830 Pilot Knob Road, P.O. Box 21-199, Fagan, MN 55121 '?1 2 12354
PHONE: 454-8100 ?_ ..
BUILDING PERMIT Receipt #
To be used for 1 (W 40L= Esl Value i61.400 Date JULY 28 19 S6
Site Address 1807 Cr+$K8ON DR Erect 13 Occupancy R3
Lot616 Block 2-Sec/Sub. ?CjjQB LhJL2 Remodel ? Zoning R„i
Parcel No. ?1TS 2j1n Repair ? Type of Const. v-
Addition ? No. Stories
¢ Name gm HMISON HQM$$ Move ? Length 494
= Demolish ? Depth 77
o Address r.O• ? f367 Int. Impr. ? Sq. Ft.
City Pnone 420-3900 Install ?
? W Name D. aRId1K
? z
8 Address
t W City Phone -
ge that I hav
ct and agre
and Ciry ot
A Building
all work sl
Building C
Assessment
Water 8 Sew.
Police
D Fi
re
En
33'-7524 g.
Planner
this application and state thatthe Council
gld
Off?
mply with all applicable State of g.
Ordinances. APC
)
Var. Date
rmit is issued to: wo?
be done in accordance with all
and City of
Permit ? "db"•w" 50
Surcharge ??00
Plan Review.oo
eAr 575.
PI. "??•
condition that
? I I PermR No. I Pormit Holder I DatO I Tdaphonm i1 I
Illnsoectlon Oate I Insp• II Commenb 1
Plby.
Hty.
Pibq.
Fty.
Dbp.
. . , . . . ? y?=2
. PERMIT #
? . , PLUMBING PERMIT RECEIPT # ?? ??•? -?
? CITY OF EAGAN
3930 PILOT KNOB ROAD, EAGAN, MN 56121 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address • ? i _, r` BLDG. TYPE WORK DESCRIPTION
Lot LILCiP Block 1-11 SeclS u
? Res. New x
m Name Muit Add-on
q Address Comm. Repair
.
c City ' • ?. ? Q1- `- Phone ' - Other
NO. FIXTURES TOTAL
Name Wat
r Clos
t - $3
00 =
C Address - '? .
e
e
Bath Tubs - $3.00
p City -.I - Phone- ' Lavatory -$3.00 _
Shower - $3.00
FEES Kitchen Sink - $3.00
COMMIIND FEE - 146 OF CONTRACT FEE Urinal/Bidet -$3.00
Laundry Tray -$3.00 _
MINIMUM - RESIDENTIAL FEE _$10,00 Floor Drains -$1.5U
MINIMUM - COMM/IND FEE _ 20,00 Water Heater - $1.50
STATE SURCHARGE PER PERMIT - •50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets -$1.50
BEYOND $1,000.00) Softener - $5.00
Well - $10
00
.
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE
?- STATE S/C: -
I GRAND TOTAL• -- ? `?
FOR: C
TY OF EAGAN
t A ? .. `t '`. 4 . . . . ' . .'u ' :. ... . ' ' i . . .
PERMfT # ? 2? '?"
. ? • MECHANICAL PERMIT RECEIPT # -7
CITY OF EAGAN
T
N
DATE
CONTRACT PRICE: :
3830 PILO
K
OB ROAD, EAGAN, MN 55121
PHONE: 454-8100
Site Address
BLDG. TYPE WORK DESCRIPTION
Lot Block -? 3ec/Sub ?
4 ?
i
rl Res.
New
m Name .
_ _
?
,
. '
? . ?
Mult Add-on
Address 4 ;
i
_ _ -: i Comm. Repa
r
? city amer
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
TYPE OF WORK ADDITIONAL 6 M BTU - 6.00
?? . J?
r 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. M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM BEYOND $1,000.00)
Gas Piping Outlets #
Other -
FEE:
S/0. , a v SIGNATURE OF PERMITTEE
TOTAL• ' ?
FOR: CITY OF EAGAN
3830 Pilot Kn
Y
BUII-DING PERMIT
To be used ror 1 OF 4 PL1:X
Site Address - i:-.F,'•i..,
Lot 68 Block 2 Sec/Sub.-
Parcel No.
CITY OF EAGAN C
ad, P.O. Box 21-199, Esgan, MN 55121N2 . 12 35J
PHONE: 454-8100
Receipt #
lue $61,000 pate JULY 28 , y9 66
= o Name SAM
?°, ¢ Address
oti.,.,o
? W Name D. GRI3WOI.D
? jz-y Address
i W City Phone 43$-7524
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with ali applicabla State of
Minnesota Statutes and City of Eagan Ordinances.
Signature ot Permittee -
A Building Permit is issued to: NEW RORIZON HGMES
all work shall be done in accordance with all applicable State of t)Ainneso
Building OHicial - ''O- '`
Demolish ? Depth 27
Int Impr. ? Sq. Ft
Erect es Occupancy i``'
Remodel ? Zonino R1
Repair ? Type of Const V!'1
Addition ? Na. Stories
Move ? Length '? 4
Assessment Permit ~ ''+?•??
Water & Sew. Surcharge ???
'
Police Plan Review.?
_?Q
'
Fire SAC ?
'
Eng. Water Conn.
Planner Water Meter O
Council
Bldg. Off. 5 T86 Rosd Unit
Tr. PI. '
0
APC Parks
Var. Date Copies Q
'
Total '
on the express condition that
Statutes and City of Eagan Ordinances.
? --
11 1 Prrmft No. I Permit MoIdK I Date I Talephom k I
Plby.
Htg.
Plby.
Dlsp.
. - . . . _ / ?
• PERMIT # -7
PLUMBING PERMIT RECEIPj #
qTY OF EAGAN ; 1,
1
?
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ?. ??
CONTRACT PRICE PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot62d' Block Sec/Sub - Z
•-'"=
es. ??- New X
-
` ?
m L
Name 11 ` YI I l, t? Mult
Add-on
Comm. Repair
c City ; Phone'I! . f I Other
NO. FIXTURES TOTAL
Name W
t
Cl
t - $3
00 S-
3
Address a
er
ose
.
;
Bath Tubs -$3•00
p
City Phon WJ ,? _
Lavatory - $3.00
--
' Shower - $3.00
?
Kitchen Sink - $3.00
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMJM - RESIDENTIAL FEE _$10,00
MWIMUM - COMM/IND FEE - 20•00
STATE SURCHARGE PER PERMIT - .?
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00) Urinal/8idet -$3.00 _
L.aundry Tray -$3.00
Floor Drains - $1.50
Water Heater -$1.50
Whirlpool -$3.d0
' Gas Piping Outlets -$1.50 -
Softener - $5.00
Well - $10
00
? .
. ?. 1 Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMf?T? FEE - ?'-'
?
STATE S/C ? u
FOR CfTY OF EAGAN GRANO TOTAL•
PERMIT #
• MECHXNICAL PERMIT
, , RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACTPRICE PHONE:454-81Q0 ? ••
Site Address ' "' - ' ?--'•
BLDG
TYPE WORK DESCRIPTION
Lot Block .
? Sec/Sub .
Fi
N
?
Name es.
ew
4)
? '
i,:_ X",• +
. Mult Add-on
? Address .
c
City. ?
PFiQrie -
1 b Comm. Repair
Other
Name pEES
?
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 - 196 OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
' Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
I Air Cond. ? M BTU STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S!C IF PERMIT PRICE GOES
I Vent CFM gEypND $1,000.00)
Gas Piping Outlets #
?
Other
FEE
5G SIGNATURE OF PERMITTEE
S/C: ?
TOTAL: ?. . ?J
FOR CITY OF EAGAN
, , i
r •
PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EACAN
?''
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: -
;ONTRACT PRICE: PHONE: 454-8100
;ite Address ' - ' r
BLDG. TYPE WORK DESCRIPTION
,ot Block Sec/Sub . ?,
Res. New m Name = - Muft Add-on
? Address i 'I"' cn 'v ' • Comm. Repair
c Ciry "'?' Phone_ ' - 3 pther
Name _
c Address
O CitY -
? TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unk Heater M BTU
Air Cond. M BTU
VeM. CFM
Gas Piping Outldts #
Other r
FEE
S/C:
"-"!cyrti1 , ? TOTAL•
2f` . ? II
20. so II
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/INQ FEE - 1°r6 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
?
CITY OF EpGAN Remerks - ..
Addition Thnmas i.qkP HP g ts?Additirm Lot W.-"_ $Ik Parcel #in
Owner Street 1607 Clemson Drive g?e Eagan, M+J 55122
Improvement Date Amount Annual Years Payment Receipt Date
? STREET SURF. 111.89
STREET RESTOR.
GRADING
I
SAN SEW TRUNK 3 "
,kSEWER LATERAL 37. 61 7.52 15.05 A0121 2 --$
, WATEfiMAIN
*LYATER LATERAL
WATER AR EA . S 4• C1 A0121 2 --8
STORM SEW TRK L ?9 1 A0321'T2 - 83
,STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
6UILDING PER.
sac
PARK
CITY OF EAGAN
Addition'EhoMag
Owner
Witio{} Lot AN 47-Blk # al-_ Parcel # 1(1 _
st,e.t 1607 B Clemson Drive stete Eagan, NIN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 111.89 A01212 --8
STREET RESTOR.
GFiAdING
SAN SEW TRUNK 1973
*SEWER IATERAL !fflL 1981 • •
-- 1 .O A02212 - -S
? ,
WATERMAIN
*WATER LATERAL
WATER AREA 1 8 4.61 A0121 2 --S
STORM SEW TRK 1981 312.37 20.82 1 249• 91 A0121 2 --8
*,STORM SEW LAT 981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILOING PER.
SAC
PARK
CITY OF EAGAN Remarks ?-
Addition Jb0Mas Lalr.e H?3ght Jm? Additioa Lot ?' ? Rik ? ? Parcel #10
owner s«eet 1605 Clemson Drive State Eagan., MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. A 8
STREET RESTOR.
GAADING
SAN SEW TRUNK ?"7 '
.kSEWER LATERAL P9, 3 7. 61- 7.52 15.05 A012112 5-5-81
WATERMAIN
*WATER LATERAL
WATER AREA j+
ST4RM SEW TRK 249 • 91 A0121 2
*STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LiGHT
WATER CONN.
BUILDING PER,
SAC
PARK
CITY OF EAGAN
Addition Thomas
Owner
idition ' Lflt L GK eik A 9-. Parcei #in
Street 1605 B Clemson Drive state Eagan, MN 55122
' Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF, ? 1981 279.71 55.94 5 in,S A01 2 5-5-83
STREET RESTOR.
GRADING
5AN SEW TRUNK
,1SEWER LATERAL 37.
61 .52 • 1.0 A012172 5-5-83
.
.
*UUATER LATERAL
WATER AREA 54.61 A01Z1T2-- 5-5=8
STORM SEW TRiC 1981 312.37 20.82 15 249.91 A01212 -4
*.STORM SEW I.AT igRi
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CaNN,
8UILDING PER,
SAC
PARK
SEDGWICK HEATING & AIR CONDITIONING CO. TEST HEATING RECORD JOB NO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000
ADDRESS L b D? ? C-`???Sa^I
OCCUPANT
SOLD BY
CITY ?g °"vJ S S 122-
v
OWNEF
INSTALLED BY
MAKE ? -c ,1! ON Qllef
SERIAL NO. 5:? e!) _Z le
THERMOSTAT -7' fl"7 CJd ?
VALVE
LIMIT
LIMIT SEfTING
?,6 ?
?
FAN SETTING
PILOT TYPE
? ? ???
?
IGNITION MODEL
PILOTTIMING
PRESSURE 3 • ?? ??''
INPUT CFH
/
STACK TEMP.
FORM 235 (REY. 1189) PERCENT COz 4n?
PERCENT 02
PERCENT CO T
MODEL
INPUT _
VENT SIZE ?
TYPE OF LINER
LINER SIZE
FILTERS: SIZE ??I=a v NUMBER
WIRING ?rr44i.1/E
TEST TAG T,
LIGHTING INST. ?
DATE TESTED
lvu o 3 zooa
COMPANY TESTING
NAME OF
WHITE CAPY -JOB FILE
_ _____ _I
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: ?,? i. r, ?, ra ????.? - APPLICANT:
?ni.y , I r?t t !It l ??I! f `? .'PI1? < <, t . , 11"o 10,0r0 ?
L
-1
I
PERMIT SUBTYPE: TYPE OF WORK: ,iFPaiP
. ?i .? ! i i ; •,? {rFEt?Tll f't DFCK
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
INSPECTION RECORD
CITY OF EAGAN PERMtT TYPE:
3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
? SITEQDDRESS: APPLlCANT:
, .? . ? ? f irl'?i)N [)!z ?- , ,•; . < < F il
i I ilr?t+ti?1 . I. f1i? i I1f Tk3NT?? 7ND t r ?.' 1-?.'H -?:;6F.@! ?f
PERMIT SUBTYPE: TYPE OF 1NORK:
f ? . ; FtiRIR
?,[ ,? ,• 1 ? I 1 iti?i ??k. ?Y{l?.
Permit No. PermR Holder Date Telephons N
ELECTRIC
PLUMBING
HVAC
Inapection Date Inap. Comments
FOOTfS3GS
FOUND
FRAMING
RDOFING
RaUGN
PLUMBING
PI.BG
AIR TEST
ROUGH HEATING
GAS SVC
TEST
iNSUt
GYP BQARD
FIREPLACE
FIREPLACE
AIR TEST '
FINAL PLBG
FINAL HTG
ORSAT
TEST
BIDG FINA!
BSMT R.I.
BSMT FINAI
OECK F?G
DECK FINAL
?l?//V6? ?l• ??o'
CURL - - -
CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road
Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675
SITE ADDRESS: ,? 11: r; F, R 1. uf r APPLICANT:
! il+rFl;l.., i f;F t flf i l,l1 i'? i NI:1 ( t? J.:' 1 ?1..'6f ?,??r,f3
k
PERMIT SUBTYPE: TYPE OF 1NORK: ,;,T-rA tR
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDFOSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FiNAL ?30/Q G?W
SEDGWICK HEATING 8 AIR CONDITIONING CO.
? HOUSE HEATING TEST REGORD
ADDRESS I.r?d? ?4?1V,= CITY ??? ?'?'v ?
OCCUPANT - OWNER /??? 1-- ?d?c2on1 NvuvL?s
HEAT LOSS `-' DATE HTG. INST. l--------
SOLD BY INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA _ FA_ HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE ? iRr(E4N T
Model 39 `f G iq i..l o c'i-4 n C)
Serial _ a 7 8(;4 6,9 9 G..4
INPUT So)cc-, 6
CQNTROLS
34
THERMOSTATT-B Heat Plug
Valve _ 6:1 '-t (l A - ?e
Limit- S i Ewlc o
Limit Setting S d? F
Fan Setting 7 DO° b'
Pilot Type F ?'s0, or-4 ( C'
Pilot Make ? t?' r 1 ?-? K ! Ct4I To 12-
Pilot Model ti 5 C r
Pilot Timing I n15` T Hc.l7
L.W. Cut Off
Pressure -•3 • % ?•?- ? • :3 c;'?
Percent CO
Input CFH 4-7 Z
Percent 02 15 "1r
5tack Temp. d- 15° E Percent CO ?nt,,J&
MAKE QF BURNER -"-
Model
Max. BTU Rating -?'--
MAKE OF FURNACE
Model ?
S
Vent Size
KIND OF LINER SIZE NONE
Draft Hood Regulator yr--;
Filters Size Number
Chimney Location Inside 1___ Outside
Chimney Construction CLAS S L?
Smoke Bomb - Wiring _ OK
Draft Test Tag `1 ? S
Door Pressure - Lighting Inst. n K
Date Tested - y - --, 3 -
Company Testing 5??L,_,? l c-
Name of Tester C ot?! 42"A D
Form 235
GEO. SEOGWICK HTG. & AIR COND. CO.
HOUSE HEATING TEST RECORD
ADDRESS t(005 I CLEMCOh1 T)RIV - CITY ??`?.r--??qiJ
OCCUPANT r..!
HEAT LOSS " DATE HTG. IIVST
OWNER r- titit oR I L? tv ? c?ttiI, - ,
SOLD BY INSTALLED BY_?w
Electrical Work By - =?,C- t? ti,? Gas Line By
TYPE OF HEAT GA_ FA `?-/ HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE `? ??.?.' WiV ? MAKE OF BURNER
Model A w C_, --;--i C, Model ?--?
Serial Max. BTU Rating
INPUT SOi oob MAKE OF FURNACE ?-
CONTROLS
,? ?.
THERMOSTAT-7 ?__? _L?' - Heat Plug
Valve _ & " (o i) - k
Limit `?T?4blC C
Limit Setting
Fan Setting 1 ?O ? 1F
Pilot Type *F-L?=?--' «ON 1
Pilot Make - SPA ?2tt IGN r T .?
Pilot Model
Pilot Timing
L.W. Cut Off ?
i
Pressure 3• 5 ?LJ , PercentCOZ
r ? ?a
Input CFH Percent 0
2
Stack Temp.1?? Percent CO P? e?E.
Model
Vent Size
KIND OF IINER SIZE NONE
Draft Hood _!? DUC-FI'A , Regulator ?,2? ?
1 '
Filters Size Number
Chimney Location Inside ?,<" Outside
Chimney Construction C L:aSS E3
Smoke Bomb
Draft
Door Pressure -`?
Wiring OK
Test Tag _ ti j7-
Lighting Inst. L-2<
Date Tested u - ?L y ' ? ;,
Company Testing I,j «-k
Name of Tester ?' o rv ? L-1 t'-a
--?
?
SEDGWICK HEATING & AIR
HOUSE HEATING TEST RECORD
ADDRESS ?(PD -7 C LFW1???I l? R 1`IE CITY ?
OCCUPANT -? OWNER N ? w 1-lcIz I Zrn 7--t }-l ? iv\r--- ?
HEAT LOSS --? -? DATE HTG. INST. -
SOLD BY INSTALLED BY ?zw1 c-Ac
Electrical Work By 17EJ-1 t2 Gas Line By Sc-a?,?Lsc'?
TYPE OF HEAT GA_ FA ?! HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE _ ?`?- ?! "l?.t i MAKE OF BURNER ---'?
Model _ 34 tq cnl o a-14
" Model ?
Serial .2 -7 B ge
Q 8 9 a-7 3 Max. BTU Rating
INPUT _ S o. o 0o MAKE OF FURNACE
.. _ _. _ , •?----
CONTROLS
THERMOSTAT? Heat Plug
Valve x
Limit - STe vti,\ Lc
Limit Setting a? SC ° F
Fan Setting _ 100 " Fz-
Pilot Type ? L.A?FG-Z iza ic
f-i
PilotMake P.+f- K I f' 17 ot?
,
Pilot Model _ N 5 C 1
Pilot Timing 1r4 'r w& i
L.W. Cut Off -
Pressure 3-5 w• C- - Percent COZ
Input CFH 5v Percent O Z
Stack Temp. I (a a°-- Percent CO
714,
LJaN GE-'
?r
Vent Size
KIND OF LINER SIZE NONE
Drah Hood ?E=1 !'"-; ?J Regulator Vc a
Filters Size Number !
Chimney Location Inside ? Outside
Chimney Construction C_[_H S'S S3
Smoke Bomb
Draft
._--
Door Pressure
Wiring QIlk-'
Test Tag Nl E r,
Lighting Inst. C)I5?
Date Tested - P -7
Company Testing cL!:, I?f
Name of Tester ?? ti ?Q ???,l?
Form 235
GEO. SEDGWiCK HTG. & AI R COND. CO.
. ' HOUSE HEATING TEST RECORD
ADDRESS I C22 ti\A CITY ?Y1f ?nI
OCCUPANT - OWNER ?1EVJ
HEAT LOSS ? DATE HTG. INST. -----
SOLD BY --- INSTALLED BY ??-e ??•-= !?
Electrical Work By Gas Line By
TYPE OF HEAT GA _ FAL:2L HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER
--
Model 3 ?t ?4 5;? Aw cS ?.Lt ? ?: o Mode1 ?
----
Serial a 7 8( ?A S900 r Max. BTU Rating -
INPUT ?5 O, on o MAKE OF FURNACE
? CONTROLS
THERMOSTAT Heat Plug Vent Size
Valve A- yC
Limit C_.o
Limit Setting ? SG? F
Fan Setting loc? ° f?
Pilot Type + F T 46 n1 t C
Pilot Make - SP?t2tiC 1r +?! ?T.r?
Pilot Model
Pilot Timing tN'iTwrIT Dratt
L.W. Cut Off • Door Pressure
KIND OF LINER SIZE NONE
Draft Hood i ti 1ltrIC-7-L,?1 Regulator v c-S
Filters Size Num6er ?
Chimney Location lnside Outside
Chimney Construction
Smoke Bomb
Wiring nK
Test Tag -'4i?
Lighting Inst. -A-?
Pressure 3 • ? I I ?? ? • Percent CO 3 Date Tested - ? - .3a y -- R 7
Input CFH 1-4 ;? Percent 02 Company Testing S cC>!:E? c.J tf-
Stack Temp. ? `? D 0 ? Percent CO .hi??N ? Name of Tester ?-o r-J tR ? ,?
3830 Pilot".;nob Rosd ? - -•;- •
4?,
P. O- Box 21199 PERMIT NO.:
Eagsn, MR 55121 ?v DATE: -•
Zonirg: }l-A No. of Units: ? l cx
OwMr, _?Fk ?iorizqn Iiomes
Mdross:
??ft Addresc 1 0 B Glemson Drive L o L i ClOQ1n:: I
Plumber. T'ha-7pso? P ua: ig
Meter No.: 15 7'L Z 1-11 ,,, Si7e: S/8lf Ralf _.?.:,?o.a?e?????ir%(7---
soder No.: !J .5 N 7.5.5 / oL
.or.e to so npy wkb th. c*y .f
CITY OF EAGAN
3830 Pilot Knob Road
P. 0. Box 21199
Eagan, MN 55121
Zoninp:
Ownsr.
/lddress:
51te /lddross: Plumber:
- ' ;
I MeM !o 0I1 wi1h tM G!p ef h"n
OriiwsaM.
By
Deft of Irnp.:
TotoL• ?Peter
Qote Pcid:
SEWER SERVlCE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Cannettlon Qqrqs: i r
Acwunt Depwlt:
Prnnk Fee:
Surchorye:
Misc. Chorpas:
Total:
Qob Poid: -
? CITY OF EAGAN
; 3830 Pibt lKnob Road Wp?TER SERVICE PERMtT
? P. C: BLx 21199 PERMiT NO.:
1
Eagan, M1N 55121 ? DATE:
? Zoninp: F;3
No. of Unifs:
pN,ner; ;7ew ilorizon 110110?1
Address:
Slta Addross: 160 5 _ve '' t s I I
Plumber.
Metar No.: -171/11- )nnd
SlZe: C
LDid?eks ?•?.
Reador No.:4?N ??Sl/ T?L Y rmit Foe• •? TA?DLI
I Nrw ft s+ow/y vi16 !w Cky of Lm"
ora.. RE Hux. c?,o?o?: - , - , ,
C7 roral:
BY Dot? Paid:
of I r?sp.. 1.,..,
CITY OF EAGAN
3830 Pilot K;;ob Road
P. O. Sox 21199
Eagan, MN 55121
Zanirq:
Ownar. . = I:
Addreas:
Site Addross: 1
Wumber.
SEINER SERVlCE PERMIT
PERMIT NO.:
DATE:
No. of Units:
I orN fr aw* rvilr !v CMf of ioow
OrJhwnem
By
Dofe of (r".:
11.
ConrncNon c]mme: ? - ;
/1oca+nt 0.podt:
Prrmit Fes:
Sureharpr.
Misc. Choepm
Total:
DOM Pold:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilox iCrwb Raad
P. 0. 8 11199 PERMIT NO.:
Eaga±? 5121 ' DATE:
Zcntrp: - No. of Units:
Owrwr.
Addnsi:
Siro llddress: '7' as?- ' cive : ' ?`h?>• -'ts -,
Plumber. ;:? •,4r, ? ? 1 . ?r:>
Meftr No.: 702 15Z
siu:
Raodsr No.: Q ? /U ?
1 ym te o?lp wMl? 1M Ci1y of 4wnj????? rr.
, ?:et=r
BY . Dot? Poid:
olf i?sv: rnsp.:
Pilot Knob Road
Box 21199
i. MN 55121
b MAql?r wIK !V eJ1q of gaNs
SEWER SERV'!CE PERMR
COflMCtIOfl Q101gl:
AcODUnt DlpOilt. _
PoIR-Jt FM:
51JKhOf+ge:
Misc. Cha?pm -
Totol:
Qoh Paid:
/C) -i- 8"(o
WATER SERVICE PERMIT
PERMIT NO.:
DATE: -
No. of UMts: `1- •i i,.
Ca?nettion Cho?ye:
11cammt Deposlt: _
Permit Fee;
Surchorps:
WUsC. Chorpm _
Total:
Date Paid:
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pilot Knob Road
P. Q Box 21199 PERMIT NO.: Eagan, MN 55121 DATE:
Zoninp: : ' No. of Units:
OwrNr: i?r:
/lddrcss: T-
5tts Nddrca:
Plumber:
I y1'N t'O sOmpy wbb 1? ??se"m
OrdIIMII[M.
of Insp.:
CoI1I1eCt(On O1ofw: G, -
Aomurrt Deposif:
Pe1TM1?t Fe!:
SNiCF10Pge:
MifC. CF10rom
Totaf:
Doh Pold:
[e caw* wft !M Cihr ef Eogew
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7?*********7?*******7?*********7?*****?****
CITY OF EAGAN
CAf'NIEfi: S TFFiMINAI_ N0: 776
DR7E : 0 r/2 i'/98 7lME: 15 : 35: 3E,
xn:
NAMF:
3210 3001 007 CLEMSON DR
2155 9001 1607 CLEMSON DR
3430 3001 1607 CLEMSON DR
3430 5001 1571 BAYLOF CT
2t55 9001 1571 BAYLOR CT
3210 9001 1571 BAYLOR CT
3210 9001 1569 RAYLOR CT
2155 9001 1569 BAYLOR CT
3430 9001 069 BpYLOR r_T
3430 9001 3557 CLEMSON DR
CR0954q0
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CITY QF EAGAN
CASHIEfi: S TE:RMINAL PtQ: 776
DA7E: 07/27/98 TINfE: 15:35:V
ID:
hAFIE :
50.00 205 3001 1557 GLEMSOI! DR 0-50
0•50 3210 9001 155' CLEMSON Dk 50.00
2.25 3210 9001 15E9 BAYLOR CT 50.00
0'75 2155 9001 15E9 BAYLOk CT 0.50
0.50 3430 9001 1563 BAYLOR CT 0•75
50.00 34:30 9001 1605 CLEMSON DF 2•25
50.00 205 3001 1605 CLEMSON DR 0.50
0.50 321.t1 9001 1605 CLEMSON DR 50.00
?'? 3?1U 900i. i.57i RAYL(]R CT 5a•?
205 9001 1571 EsAYLOR CT 0-50
C0NTINUE CR035400 CONTINUE
** GqNTINUL- USER II?: NANCY ?K* C0NTINUE
?*?K?*:k?c***?*?K**?K********?K*?c??K?K****k??K** **?K?K***?k?K*?K*?K***?K??c*?**?K??K***?K**?k?*?K**
CITY OF EAGAN ?
- ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N° 12355
' PHONE: 454-8700 6<)
BUILDING PERMIIT Receiptq /
7obeusedtor 1 Ol"4 PLEX EstvaIue $61,000 paie JULY 28 ,1986
16015B CLEMSON DR Erect 99 Occupancy R3
Site Address
Loc 6$ eiock _? secisub. THOMAS LAKE Remodel ? zoning R1
Parcel No. HTS 2ND Repair ? Type of Const Irn
Addition ? No. Stories
Q NEi9 HORIZON HOMES Move ? Length 44
W Name ? Demolish ? Depth 9 7
o Address P•?? • BOX 1367 Int Impr. ? sa. Fr
Ciry MPLS phone 420-3900 Install ?
i0 Name SAVAE Aoorovals Fees
0 i Address -
?
? City Phone
U Q
W W
F
U Z
aW
Assessment_
Water & Sew.
Police -
Name ?- _flRISWOLD Fire
Address
Phone _ 435-7524 Planner
I hereby acknowledgethatl have read this application and statethatthe
information is correct and agree to comply with all applicable State of
Minnesota Statutes anU City of Eagan Ordinanc .
Signature of Permitt ee_ efv
A Building Permit is issued to: W HORI ZON HOMES
all work shall be done in accordance with all applicable Stpte?of j$innesc
Council
sidg. on. 5/1/86
Var.
Permit +' j1o.w
Surcharge 30.50
Plan Review 158.00
SAC 575.00
water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.00
Tr. PI. 156.00
Parks
Copies
Total $2. 089.00
- on the express condition that
of Eagan Ordinances.
Building Official
FSR SALE,EUNIT,?830 Pilot Knob Road! P.O. Box 2G-A7 9, Eagan, MN 55121 NO 12352
' PHONE:454-8100 l S
BUILDING PERMIT Receipt#
7obeusedlor 1 OF 4 PLEX Est.Value $61,000 Date JULY 28 iy86
SiteAddress 1605.CLEMSON DR Erect ?l Occupancy R3
Lot6L5 Block Z Sec/Sub. THOMAS LK HTS Remodel ? Zoning Rl
Parcel No. ?ND Repair ? Type of Const. Vn
Addition ? No. Stories
NEW HORIZON HOMES Move ? Length 44
= Name Demolish ? Oepth? ?7
o Address P• O. BOX 1367 Int. Impr. ? sq. Ft.
ciry 1''PLS Phone 420-3900 mstau ?
i o Name-
sa Atldress
? ,....
U?
W W
CZ
U =
aW
Phone
Feee
Assessment_
Water & Sew.
Police -
Name D. GRISWOLD Fire
Phone 435-7524 Planner
I hereby acknowledge that I have read this appl ication and state that the
information is correct and agree to comply with all applica6le State of
Minnesota Statutes and City of Eagan O'ylinances.,,O?/
Signature of
A Building Permit is issued to: 1IMrv t
all work shall be done in accordance with all
Building Official
Council
Bidg. On. 5/1/86
Var. Date
Permit +? J1o.vv
Surcharge 30.50
Plan Review 158. 00
SAC 575.00
Water Conn. 5 0 0. 0 0
WaterMeter 63.50
Aoad Unit 290.00
rr. Pi. 156.00
Parks
Copie
Total 2.0 9.00
'"•""' on the express condiNOn that
of Minnesotp-5talqtes and City of Eaqan Ordinances.
.
CITY OF EAGAN
?• ? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 12353
' PHONE: 454-8100 G</ vY
/
Bl
ILDING PERMIT Receipt u
7obeusedlor 1 OF 4 PLEX Estvalue $61,000 Date JULY 28 19 86
SiteAddress- 1607B CLEMSON DR Erect m Occupancy R3
Lot6ZBlock z Sec/Sub. THOMAS LAKE Remodel ? Zoning R1
HTS ZND
Parcel No Repair ? Type of Const. vft
, Additian ? No. Stories
? Name NEW HORIZON HOMES n.tove ? Length ad
BOX 1367
P
O
; Demolish ? Depth-i'
.
.
Atldress
° IntImpr. ? Sq.Ft.
MPLS 420-3900
City Phone Install ?
a
o
Name SAME Approvals Fees
8 ¢ Address Assessment Permit $ 316.00
? Ciry Phone Water 8 Sew. Surcharge 30 . 50
? Police Plan Review 158.00
WW Name D. GRISWOLD Fire SAC 575.00
?
?a nddress
Eng.
WaterConn. 500.00
<w city pnone Planner WaterMeter 63.50
Council Road Unit 290.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatihe gldg.Off. 5/1/86 Tr.PI. 156.00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Ea en O Jinances APC PBfks
.
Var. Date CopieS
Si9nature of Permittee Total $2•089. 00
A Building Permit is issued to: N HORI ZON OMES on the express condition that
all work shall be done in accordance with all applica
6le St/?q/ of
Minneso tes and Ciry of Eagan
? Ordinances.
?
?
BuildingOfficial t x1[.fd?-G- ?
y
CITY OF EAGAN ?
Bl11LDING PERMIT
Receipt#_T ?
7obeusedfor 1 OF 4 pLEX Est.Value $61,000 Date JULY 28 ,?9 86
SiteAddress 1607 ? CLEMSON DR Erect ?J Occupancy R3
Lot 66 Block 2 ? Sec/Sub. THOMAS LAKE Remodel ? Zoning - .??'
Pa?cel No HTS 2ND Repair ? Type of Const_?-
. Addition ? No. Stories
a NEW
Name HORIZON HOMES nnove ? ?ength dd
=
P
?
BOX 1367 Demolish ? Depth-?^.-??
;
° Address
•
. Int.Im r
P ? Sq. Ft.
City MPLS phone 420-3900 Install ?
o Name $A? Approv:
=
?¢ Address Assessment_
? Ciry Phone Water 6 Sew.
?W D. GRISWOLD
Name Police-
Fi
F W re
? ? Address En
g.
<W ciry pnone 435-7524 Planner-
I hereby acknowledge that I have read this application and state thatthe
information is cor?ect and agree to comply with all applicable State ot
Minnesota Statutes and City of Eg?an OrdinanC95?
Signature of
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55,2, N_, 12354
PHONE: 454-8100 (?S? J
Council
Bldg. Off. 5/1/ 8 6
Var.
Permit y `??' V? V V
Surcharge 30.50
Plan Review 158. 00
SAC 575.00
Water Conn. 5 0 0. 0 0
Water Meter 63 . 50
Road Unit Z90.00
Tr. PI. 156. 00
Parks
Copies -?.?..8.??p
A Building Permit is issued to: ??+%•• nvnl t.vp nvinc? on the express condition that
all work shall be done in accordance with all a ca State of Minn(?Sota atutes and City of Eagan Ordinances.
Building Official \? ??-O`d?-??
?---------------
I Fa?(fi?e-U?
? Permit#:
i Permit Fee:
Date Received:
I Staff:
L _______________
Date:
Tenant:
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address:
Suite #:
RESIDENT / OWNER Name: Phone: h-5 S3 - 19 b I
Address / City ! Zip: ? ?J ?
CONTRACTOR Name: SE?l ! License#:
Address:
City: State: Zip:
Phone: Contact Person:
TYPE OF WORK XNew _ Replacement _ Repair Rebuild Modify Space Work in R.O.W.
Description of work: e?
PERMIT TYPE RESIDENTIAL
Water Heater _ Water Softener
_ Lawn Irrigation ? Add Plumbing Fixtures
I RPZ !_ PV8) C_ Main X Lower Level)
Septic5ystem _WaterTurnaround
New
Abandonment
RESlDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (inciudes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
'Water Tumaround (add $147.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductworic, etc.) (inciudes $.50 State Surcharge)
TOTAL FEES $
I hereby acknowledge Nat this information is complete and accurete; that the work will be in confortnance wifh 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 sta without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and app I of plan
JTL
X Tom M nvAcl x
ApplicanYs Printed Na e ApplicanYs ig ature
NOV-21-2008 14:47
City of Papn
3830 PIIOt Knob Road
Eagan AAN 55122
Phone: (651) 675-5675
Farz:(651) 675-5684
P.02
?--------T--------?
j C C
; ?4F;oe: yo ? `o 1
j Daze Reoorjed' 1
I I
I Staff: _.. ....- 1
- - _--_ ._ - - __
L
2008 RESIDENTIAL PLIjAAB1NG PERMiT APPLiCAT10N
;
Date:
Tenant•
Suita #:
RESIDENT/OWNER Name:_..-_LSC'-....-.. v Y D/T _PhOne:
naaress i cey i zIP! /60$` ?L?s-l
CONTRAC"1'OR Name: , a g/? ?z- ?LU???Uce?se x??5? 73
Address: _-
CiIY; _0 (?f _....- State: Z/V imp_
PhaneCort4act Person: .... ---
TYPE UF WORK ,..._ New REplecement _ Repeit _ Rebuiid _. MOdify Space _ WOdc in R.O.W.
DOTCN tbn o} Work:
PERMR'nPe AES
IDENTIAL
`
I
J? Water Heater _ Weter Sot[ener
_ l8wn krigation Add Plumbing FxNres
? RPZ J^ PVB) (_ Main _ lower Lavel)
Septlc SyStem Water TufnafOllfW
New I
Abandonment
RESIDENTIAL PEES:
$50.50 Mlnlmum Water Neater, Water Sottener, or water HeaFer and Soflener (ncludes 5.50 State Surcharge)
$30.50 lawn Irrgation (includes $.50 Stace Surcharge)
$50.50 Add Plumbing Fixhues, SeptiC System Abandonnen 6 Waler Tumaround' (includrs $•50 SYdte Surchar9e)
'W ater TurneraVnd (add $136.00 if a 518' me[er is requireA)
$100_50 Septlc S"tem New (310.0o pet as Wrin) (includas CouMy fee and S.SO State Surcharge)
$90.50 Fire Repair (replace burned out appfancas, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES ¢
1 TBfEOy+ dfMOW1eu9B [flaz mis 4fU?a i5 wmpmc a?u aW?.w?o. u.u. u?e ...nn o.. w... w..........?......._... -' __.. __ -._ ,
Fagam, that I understand this is not a permit, but only an applkauon far a perma, and work is to sia?t wtthout a p , that the werk will be in
accord?awitlh the approvadp?Ly/t a? ?thec^as?e d work which requRes a revlAw anE appwa o? -
X J'?l! ? i r7 ?t/ x
ApplicanYS Printed Name Appl7 nYS Signature
Site Address:
FOt OFFICE USEReviewed By:
Air T
? lnspeettons. .,,_Under Gr+ouna Rougt?In . '. i ?t (?[ts ?es[
DO NOT WRITE BELOW THIS LINE
S U B'TYPES
? Foundation
? Single Family
? 01 of _ Plex
? 02-Plex
? 03-Plex
? 04-Plex
WORK TYPES
? New
? Addition
? Alteration
Replacement
? 05-piex ? 16-plex
O 06-plex O Fireplace
? 07-plex ? Garage
? 08-plex ? Deck
? 10-plez ? Lower Level
? 12-plex
O Accessory Building
? Porch (3season)
? Porch (4-season)
? Porch (screenlgazebolpergola)
? Storm Damage
? Miscellaneous
? Pool
? Ext. Alt. - Multi
? Ext.Alt.-SF
? Multi Misc.
? Interiorlmprovement ? Siding ? DemolishBuilding`
? Move Building O Reroof ? Demolish Interior
? Fire Repair ? Windows ? Demolish Foundation
? Egress Window ? Water Damage
• Demolilion (entire building) - give PCA handout to applicant
DESCRIPTION: !1
Valuation ?00 Plan Review
(25%_ 1 00% ?
Census Code
# of Units
# of Buildings
Type of Consk ?
REQUIRED INSPECTIONS
Footings(new bldg)
Footings (deck)
Footings (addition)
Foundation
Drein Tile
Roof: _Ice & Water _Final
f4c, Framing
Occupancy -4 fi ?'"
Code Edition ;f Lq ' "
Zoning
Stories
Square Feet
Length
Width
Fireplace:_R.I. _AirTest _Final
-7'C- Insulation
Reviewed By:
RESIDENTIAL FEES:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S8W Permit & Surcharge
Treatment Plant
Copies
Total
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock Meter Size:
Final/C.O.
? Final/No C.O.
? HVAC
Other:
Pool: _Footings _Air/Gas Tests _Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall
Building Inspector
Page 2 of 3
? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
? Eor:DTjce_Use 7q
Permit#: '
?
I Pertnit Fee: ?
I
I Date Received:u `? 2' KJ I
I ?
I
j Staff: I
j ?---?
?.? 1??
iD?'WI?W L L - /? 0 r
?
200 BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant Name:
(Tenant is: _ New / _ Existing) Suite #:
PROPERTY OWNER Name: G f} , Phon :eve? d'` 2'Z
?/.??,
Address /City / Zip:ltlx?o!yz"r-lYl S0N /vllL
y
Applicant is: _ Owner x Contrador
TYPE OF WORK Description of work: ?0
,5-2 ?c;? ??
C
t
ti
C
ons
ruc
on
ost: -
CONTRACTOR Name: hvG, License#: 'ZU36(5OZZ
Address: U(5 S
City: ?'?Li'1l? /44 ?A) State: 6/ /J Zip: S_JO z
Phon? Contac[ Person: ?.?-?
ARCHITECT / Name: Registration #:
ENGINEER
Address:
City: ' State: Zip:
Phone: Contact Person:
Licensed plumber installing new sewedwater service: Phone #:
` NOTE3 Plans and'supporting documents thatyou submit are considered to be public information: Portions of
the information may be ciassiiied as non-pubiic if you provide specfftc reasons that would permit the Cify,to
?`-conclude fhat the`` are trade secrefs. . '
I hereby acknowledge that this information is complete and accurete; that the work will 6e in conforma ?e i the ordinances and codes of the City of
Eagaq that I understand this is not a pertnR, but only an application for a permit, and work is not to t rt vithout a permiY, that the work will be in
accordance with the approve lan in the case of work which requires a review and approval of plans.
x LM
Applic nYs Pri d Name Applican s ign ure
Page 1 of 3
FOR CITY USE ONLY
PERMIT # ISSC'ED
77 V8
Pd w/Bldg. Permit FEES:
$ $ ?-?`? SEWER PERMIT (INCLPDE SURCHARGE)
$ $ ?O 5?1 WATER PERMIT (INCLL'DE SL'RCHARGE)
$ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCL[.'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ 16-. ?--? ACCOUNT DEPOSIT - SEWER
$ $ /S-, ci`d ACCOUNT DEPOSIT - WATER
$ Sooc?CD $ " wAc
$ S75'UO $ sac
$ $ TR('NK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRC'NK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$_, /5Z PO O $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ S J? d G TOTAL
4Z/ 7Z
RECEIPT RECEIPT
DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES ZF YES, THEN A"PERMIT FOR WORK LVITHIN PUBLIC
Q
NO ROADWAY" MUST BE ISSLED BY THE ENGINEERING
DIVISION
I
. L
ST AS A CONDITION.
SUBJECT TO THE FOLLOWING (!ONDITIONS:
APPROVED BY: a(( K-?e l?/ SC.»--i ./?.f -
TITLE:
DATE:
. ,
CITY OF EAGAN
APPLICATION FOR' PERMIT
SEWER AND/OR WATER CONNECTION
? R-1 SINGLE FAhIILY "
? R-2 DL'PLEX (TF,o Onits)
? R-3 MWNHOT'SE (Three + Units) ( Onits)
R-4 APARTN]ENT/CONIDOMINICTM ( Units )
P ease Print
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF E}ISTING STRCCIL?RE, DATE OF ORIGINAL BUILDING PERMIT ISSL'ANCE: . ~'
' Nbn Year1
PRESfSTf 7ANING/PROPOSID L'SE:
Q COI?PgRCIAL/RETAIL/OFFICE
? IDIDC'S'TRZAL
n INSTITL'TIONAL/GOVERIZg,'NT
2) ?
NAME:
ADDRESS:
CITY, STATE, ZIP:
PFiONE:
• 3) • u . a• ?
- NAME:
ADDRESS:
i CITY. 5'PATE, ZIP:
PHONE:
4) r?• • ? iZ•
N21ME:
ADDRESS:
CZTY, STATE, ZIP:
PHONE:
MASTII2 LIC,ENSE#
*ATR: PAYMRNP OF FEE AT TIME pF
nrPLIcAazoN ooFS Nom ooNsTITUM
arrROVp,r, oF PERMIT.
INSPEGTION OF SETWER A[ID/OR MTII2
TTIti'TAT7ATTpNS WII,T+ NO1 BE SCHFD'
ULID UNPIL PERMiT HAS BFEN
APPRaS7ED.
rui. ?y VbC ..?
Plumbers License:
Active
H EScpired
Not recorded EKE
St In1ti31
4-
•5) n v i a: •?• : o • s? - a? -
? CONNECPION RO CITY SE.'LM CE CONMDCpI0N 10 CITY WATER rl OTFIER ' .
6) ? v •? r ? PLEASE HOLD APPROVFD PERMIT E'OR PICK-DP BY ONE OF ABC7VE `--- -- -
? PI.EASE MAIy ApPRC1t/ID PERA'lIT TO 1. 2. 3, 4, ABOVE
(Circle one)? I fJ
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E RMIT ISSCED
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CIT.Y. OF EAGAN ?
. . ?. .
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
r- , PIease Print
PROPERTY AnDRESS: * ? loO7 ?A DAY?SfM
LEGAI, DESCRIPTION:
5 1"1
Q IAIDL'S'TRI
Q INSTZTi'T
?. ?.. .
; ,'«??. AtnEt
R 1 SIIQGLE FAMILY
?
' 4464
R 2 DL'PLEX (4t`o LTmtsJ
R 3 TOWWHOCTSE (Three + Units)
?R 4 ?APARTN?Tf/CODIDOMIDTIL?M ( Un1ts)
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NA"E= Plumbers License:
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CITY. STATE._ ZIP:
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? CONNECTION 10 CITY SEWETt ? CoND1ECfI0N 2n CITY WP.TER Q OTF3ER ' .:.
. 6) ?? ?-• r Q PLEASE HOI.D APPROVID PERMIT F?OR PICK- BY ONE OF ABQ?E '_ -
PLE.ASE MAIL APPROVID PE[tMIT 10 1. 2r? 4. ABCNE
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APPI,ICATION DOFS b]OT WRSTl'itT1E
APPItOVAL OF PE104T.
INSPECTIor7 oF sMM Arm/ox NAMEt :
nZ"rAT7ATTON$ WILL AXYP SE SC?HED- :
ULID UN7.73, PERMIT AAS BEEN
APPROVID.
Y Tax Parce ID )
s"'f -
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DATE OF ORIGINAL BL'ILDING PERMIT ISSL'ANCE:
' _?? ?' f {MOn Yearl
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: FOR CITY USE ONLY
PERMIT # ISSCED F = <
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.? ?P ! t
-Pd w/Bldg. Permit FEES: "
s',?,? ? ?+??r.?t!?•??. ,• .... ..,.i':_ ...3,- ,:::
,:,':$, SEW?`P.ERMIT (INCLLDE SLTRCHARGE)
M? .?li ' . .. .- Y . . .:.. . .'.... w?J.? ... ?' ...
WATER PERMIT (INCLUDE SC'RCHARGE) .` ..
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WATER METER/COPPERHORN/OL'TSIDE READER
WATER TAP ( INCLCDE CORPORATION STOP )
r ? S x Ls i
Y'» SEWER TAP
. '0
:
? ACCOUNT DEPOSIT SEWER '`''?
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DOES LTILIT Y'CONNECTION REQUIRE EXCAVATION IN PUBLIC R2GHT OF WAY? .
. ..?.u'.. ?.. : . ...
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-. . .: .. . .... ...-<:_
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? Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN POBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEE RING
Q NO DIVISIO
Na LIST.AS A
CONDITION.
_
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.. . . ,
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SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY:
?.r :. .
CITY OF EAGAN
APPUCATtON FOR PERMIT
SEWER AND/OR WATER CONNECTION
*70TF: PAYMFTTP' OF FEE AT Tne OF
APPI.ICATION D0E5 N0T OOD6'1i717iE
APPROVAL OF PFF4YIIT.
naseDCizorr oF sEwEx Arro/oR tEUM :
rNsrar.raTrONS F7B,L NOT BE SCHED-
ULID UP7FiI. PERMIT AAS BEEd
APPRWID. ' ,. .
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? .1) PROPERTY,ADDRESS: ??QQ?J ?' ???W •?.- ??Il'. .:; s .• -
LEGAL DESCRIPTION: ? ? '"`L? -..- •
Lot B1ockTSub "ivision or Tax Parce ID y
. . ?? ,?.... . ._ ?.?r
IF E7QSITNG STRC=!URE. DATE OF ORIGINAL BLTILDING PERMLT ISSCANCE:
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PHONE: G
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? WN[gC.TION 2U' CITY SEWEE2 ? COASIF7LTION TD CITY WATER ? OfHER ': ..
- 6) ? ?• -• r ? PLEASE HOLD APPROVID PERMiT FOR PICK- BY O(? OF ABOVE --- •----
PLEASE MAIL APPROVED PERMIT TO 1. ? 4. AHOVE '.
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MASTER LICQdSE# S?t3d1
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e?'?Pd w/Bldg Permit EEES:
h ,?.?+• .:a ;, , . ,?; +, ?e .? ?- ??,? ?, -
SEWER PERMIT (INCLLDE SURCHARGE)
.?i?C).. .?WATER..PERMZT (` x'.,5?=::. .`INCLUDE SURCHARGE) ;
':;
,:;x. .......
WATER METER/COPPERHORN/OCTSIDE READER
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WATER TAP (INCL[JDE? CORPOn,
RATION STOP)
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ACCOLTNT DEPOSIT SEWERyy??.#,
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LATERA£IT/TRPNK SEWER
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RECEIPT RECEIPT?
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-DOES LTILITY_CONNE CTION REQUIRE.EXCAVATION IN PUBLIC RIGHT OF WAy?
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? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE ISSC'ED BY THE 9NGINEERING
!
` u NO DIVISION. LIST AS A CONDITION
rrrvv........ .__ ., ... . .. .. . . .'..... _ . . . .^3 • ..
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TITI?$T ?. R 1
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CITY OF EAGAfV
_ ?.:.
APPLICATION FOR PERMITSEWER AND/OR WATER CONNECTION
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, l ) PROPERTY ADDRESS :
LEGAI, DESCRIPTION:
IF E7ISTING
DATE OE' C
) LSE: _ .,,
*ATR: PAYMFM' OF M AT TIME OF
APPI.ICATION DOES NC7P COlUSPTNIE
APPR0VP+L OF PERNIIT.
nvsencrsorr oF sEWER Arm/ox VWmt
rrterAr.raTIpNS WII,L Nl7f BE SCfIED-
ULID i7DTPB, PERMIT HAS SFEN
APPRdVID.
"?? ` U ?.?.srs,ta,ltw/XL1A1L/[?FZCE t?
(? II?STI2L'TIONAL/GOVERt?1T R 1 SINGLE FAM.?Y °° t
?.:?'f-,?A.
R 37nc?IOLTsE (Three + Unats) .( Uni.ts) ;
?APARTi?7S/CODIDOMINIC?M ( Lhuts )
2) ? ? . t?.
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?ADDRFSS: ?' ,
; ciTy, sxATE, zIP:
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5440
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Pxor?: .. .. _ . ., ,: . ? , ,
- ::3? . u ?: ?• , . ... For City Use .
Plumbers License:
, ADDRESS: Active
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. ? NNNECrION TU CITY SEMR ? CONNEC'fION TU CITY WATEEt ? OTFIM
f) PLF.ASE HOLD APPROVID PII2MIT FOR PICK- SY ONE OF ABOVE _. -- •-- .
? PL£ASE MAIL APPROVID PET2MIT RV 1• 2a? 4. ABOVE .?
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PERMIT#
RECEIPT DATE:
MIDEPTIAL PLlTMB1N6 PEPJMiT AiPLICATION
CrrY oF rAe"
3830 Pu,ar xAOS au
VAG".UN M 22
? ?
851?81-46T8
5
? ?
FEB 2 0 ?001
Please complete for. ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
SITE ADDRESS: A01- ./I 64e I.4?7 /
I?
OWNER NAME: : 4-2 TELEPHONE #: ,-?05
CODE)
INSTALLER NAME: MT. Rooter TELEPHONE #:
pus r., te. 40 (AREA CODE)
STREET ADDRESS: 21ym011th AdN 55441 --
CITY:
S51-OSSS
Place a check mark neut to tNe oermit work tvoe
STATE:
ZIP:
New residential dwelling unit under construction and not ownedoccupied $ 90.00
? Add-on, modiBcation or atteration to existinp dwelling unit, including: $ 50.00
• ahandonment of septic system
. new installation/repair/rebuild of RPZ
. lawn irrigation system
. waterturnaround /P
?
Nature of work: /
-
Septic System, new/refurbished - $ 225.00
. includes County & Consufting Inspector fees
• requires MPC license
State Surcharge $ .50
Tot21 ?50
Reminder: Be sure to schedule inspectlons of alterations, i.e. water
I hereby acknowledge that I have read this application, state Nat ihe iMormaiion is wrtect, and
is the applicanYs responsibility to notify the property owner that the City of Eagan assumas no
operetional and maintenance activities to the facilities constructed under this partnft within C?
etc.
O e 2001
ITTEE
Updatetl 1101
CITY OF EAGAN
3830 PIIAT'KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
?
mm"ThS.;;;; PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ -----------------------------'
WORK DESCRIPTION
N0.
NEW CONST
ADD ON
REPAIR
OWNER NAME: /
SITE ADDRESS: /''?t7'?5 <?1EM?? 0 4
LAT: .(150 BLOCK ?- SUBD. ??w
INSTALLER: 0 J
ADDRESS:/Vf7 1F?)Lc /'y`G°
CITY: v-t7' A4J ZIP:
FOR CITY USE ONLY
PERMIT # i
RECEIPT #
DATE:
COMPLETE THE FOLLOWING:
FIXTURES EA.
ADD-ON MINIMUM 15.00
SHOWER 3.00
WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 3.00
KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00
FLOOR DRAIN 3.00
GAS PIPING OUT.
(MINIMIJM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
TOTAL
-Tw
?
SUBTOTAL $ S.
?
ST. SURCHARGE .50
O
TOTAL:
POMMEAGTAL?iNDUSTRPALc PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZZP:
PHONE #:
FOR: _
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $_
STATE SURCHARGE $_
TOTAL:
(SIGNATURE)
CITY OF EAGAN
1 ?nS ?
CI??rnSd? Z I
(935.5? p
? Q
? 4 n
3 ? 4ro ? :lu a
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o) b
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fva?o)?00IN ? IbX ta fl??c_
22.31 22.!!
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2Y.33 2iV.
3/ ?93
N' 00 3i? ?o_??(q355) ?
O N84'¢7 Za•w ?^?
(9?380)V ?cuwe (93L.z)
?-C?aEpI ? ? O?V-M0 D• • • 1 `
. (736i7 (938-3) (9374) _ C93?,7)?-
-? _
0 Denotes Iron Monument
a Denotes Wood Stake
X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation-
(000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 937.0
-4- Denotes Direction of Surtace Drainage Proposed Lowest Floor Elevations 93z5
1 hereby certity that this is a true and correct representation of a survey of Me boundaries ot
Lots 65, 66, 67 and 68, Block 2, THOPLAS LAKE HEIGHTS 2N"D
ADDITION, Dalcota County, P4innesota.
And of the location of all buiidings, if any, thereon, and ail visibie encroachments, if any, from oi
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 24th day of- Anri? 19 86 ,
452 ??
?aul A. Johns n
Land Surveyor, Minn. Reg. No. 10938
McCOMBS-KNUTSdN ASSOCIATES, INC.
3J?JJ ceMfutn?C uGUtdi a w0 SuAvtrM . Slf[ M.n"
?`?• WMNEUOLIt M.p MtJiCMIMDM.M?NNECOiA
a
i= 40CERTIFICATE OF SURVEY
OOS IAGE rOr
?
7q30 Nw ?ON HCNN&S
• 3o b 4? 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)i 5'a. 7r
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4675
New Construction Reauirements RemodeVReoeir ReauiromeMs
3 registered sRe aurveys
2 copies of plans (indude beam 8 window saea; poured fid. desipn; etc.)
1 energy wlwlations
3 copies of tree preservation pkn if lot platted after 7l7/93
required: _Yes _ No
DATE:
OESCRIPTION OF WORK:
STREET ADDRESS:
? ??
LOT BLOCK
- ? .--.
/ 1 605
? 2 capies of pWn
? 2 ske surveys (exterior addKions 8 Aedcs)
? 1 eneigy calwlatlons for Mated edOitions
COST:
So xJ -L-)i2
? SUBD./P.I.D. #:
PROPERTY
OWNER
Name: ? f f-?YK? Phone #:
u.. ?..,
Street Address:
CONTRACTOR
ARCHRECTI
ENGINEER
City: State: Zip:
Companv: Phone #: ?? "65YO
Street Address: License #:
City: A4?-Dlz/2oU? State: Ik) Zip: 55 3 l
Company:
Phone #:
Name:
Registration #:
Street Address:
Ciry:
Sewer 8 water licer.red plumber (new construction only):
and lot change are ?equested once permit is issued.
Penalty applies when address change
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable
Stafe of Minnesota Statutes and City of Eagan Ordinances.
Signature af Applicant:
OFFICE USE ONLY RECEIVED
CertificatesafSurveyReceived _ Yes _ No AUG 0 7 1997
Tree Preservation Plan Received _ Yes _ No _ Not Required BY'?---
State: Zip:
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
Base Fee $50.00 COPIES $2•25
5urcharge $.50 Total Fee $52.75
Subtatal $50.50
SITE ADDRESS:
P.I.N.: 10-75951-650-02
1605 CLEMSON DR
L07: 65 BLOCK: 2
THOMAS LAKE MEI6HTS 2ND
DESCRIPTION:
REBUILD DECK
Rii'ildIng Permit Type OECK
Building Work Type REPAIR
-'Census Codd'"\ 434 ALT. RESIDEIVTIAL
REMARKS:
FEE SUMMARY:
COlVTRACTOR:
NELSON, KEITM
18'511 86TH Pl N
MA'PLE GROVE MN
(612) 420-6550
L
FERMIT
PERMITTYPE: BuzLozNG
Permit Number 030611
@ 7/2 7/9$
Date Issued:
- Applicant - QWNER:
14206550 KLOYDA THOMA5
1605 CLEMSON dR
55311 EA6AN MN
I hereby acknowledge thet I have read this application end state th-at the
information is correet and agree to comply witFi all epplicable State a'f ht'n.
Statutes and City of,Eagan Ordinances.
APPI ANT/P MIT SIGNATUEc-
ISSUED BV: NATURE
?
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
30 ? ?so CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681 -4675
New Construdion Reauirements
RemodeVRaoair Reauiremants
1 3 registered site surveys ? 2 wpies of plan
? 2 copies of plans (Include beam 8 window saes; poured ind. design; etc.) ? 2 site surveys (aMerior additions S decks)
• 1 energy wlculations ? 1 energy calcuiations far heateG addRions
? 3 copies of tree preaervation plan H lot platted after 711/93
required: _Yes _ No '
DATE: Z , :ZCONSTRUCTION COST:
DESCRIPTION OF WORK: " 14DC UWy
STREET ADDRESS:
LOT 4 -.0
? BLOCK
2" SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: zyE2R17.C3Y1? IL'ILL ? Phone #:
U., M.,
Street Address:
City: State:
Company: /(P /;4,y-
Zip:
Phone#: qZd G5702?7
Street Address: &-7/ 9'(07' A__ License #:
State: Zip?s3?
Company:
Name:
Street Address:
City: State:
Sewer & water licer.-ted plumber (new construction only):
and lot change are iequested once permit is issued.
Phone
Registration
Zip:
Penalty applies when address change
I hereby acknowledge that I have read this application and state that the information is corre and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
?
?CITY OF EAGAN PERMIT '`
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Mi nnesota 55122-1897 Permit Number: 0 3 0 6 Z 0
(612) 681-4675 Date Issued: 0 S/ 12 J 9 7
SITE ADDRESS:
1605 CLEMSON OR
LOT: 65 BLOCK: 2
THOMAS LAKE HEIGHTS 2ND
P.I.N.: 10-75951-659-02
DESCRIPTION:
RE3IDE
@'uilding,permit Type
,euilding Wiar.k Type
= Gensws Code
\
;
\ 3 (
`i
SF (MISC.)
REPAIR
434 ALT. RESTOENTIAL
?
?
?`?,???:
REMARK5:
FEE SUMMARY:
VALUATION
Base Fee
Surcharge
Total Fee
$237.25
$8.00
$245.25
$16,000
CONTRACTOR: - Applicant - OWNER:
NEISON, KEITH 14206550 KLOYDA THOMAS
18511 86TH Pl N 1605 CLEMSON DR
MAPLE GROVE MN 55311 EAGAN MN
(612) 420-6550
:I hereby acknowledge that I have read this'application and state that the,
infnrmati,an is correc,t ancf agree tO, camplY :;w3,tft alJ,.appljea°ble S:tate 'of M,?D;
? Statutes and C3ty ofi Eagan Ordinanoes. ?
APPLICANT/PERMITEE SIGNATURE ? ISSUED B. IGNA7URE
. • .
July, 1997 Re _ t l-r U-7 C) ?.?5, d N 0 (Z
City of Eagan
Eagan, Minnesota
To Whom It May Concern:
The holder of this letter is hereby authorized to build a deck up to a total area measuring 10x20
on the pcoperty owned by Horizon Hills Home Owners Association. The holder of this letter
understands that because the deck is built on Association property, it becomes the property of the
Association, with the unit associated with the deck continuing to exercise their private use
exclusions.
The Association will ensure the deck is constructed and the cement footing is poured to meet the
City of Eagan building requirements and will order the final inspection of such when work is
completed.
Please feel free to contact me with any questions or concerns.
Sincerely,
Horizon Hills Home Owners Association
41e-n"`.«? -1 A
Barbara Koob, CMCA
PropeRy Manager, Member-At-Large
cc: File
P.O. BOX 27423. EAGAN. MN 55121
f6121 688- 0695
HORIZON HILLS HOME OWNERS ASSOCIATION
i
Q
m VF o? ?
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3 a ?o tL ?o
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f- (9 =
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60` /
D 58¢'g7 ?a ;tc D
OO ! Oo
? (937p) ?ry /
N'-?
n\ \ v1\?y o (434,5)
\o
9js 29.if N h Q
??? 0 \\?w h A
VX \14350)
•
O h
N (? ?
N'?)??`l ? i_ \ry ? y
N
C?' I?
'???? ?m?-
I
22. 4 o
3i4 ?0 i
' N?(9355)
GN84'47ZO??,yp
(43B.6) ' rcuwe (93G.z)
: CL E`M"S`0%C/ °m
. . (73t6) (93$3) _ (9374) ? (93,7)
-?
0 Denotes Iron Monument
° Denotes Wood Stake
X000.0 Denotes Existing Elevation Proposed Top of Foundafion Elevation-
(000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 937. o
-4- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 937.5
I hereby certity that this is a true and correct representation of a survey of the boundaries of
Lots 65, 66, 67 and 68, Block 2, THOP7AS LAKE HEIGHTS 214-D
ADDITION, Dalcota County, 24innesota.
And of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 24th day ot- Anr-, .19_86,
Paul A. Johns n
Land Surveyor, Minn. Reg. No. 10938
CERTIFICATE OF SURVEY
McCOMBS-KNUTSON ASSOCIATES, INC. fiOC
(•? LOMSUIIIYG [1G1N[[RS B ?/JO SUIIY[YOIIS N SIT[ R41M!{f ?? ??/?p/.y(??/ ?/???? \ ?) ?? ??/??? /????
? •,?? FllEb4 ???V
WMhE.VOL?f ry MUICwIHSON.Y1MNEiOTA ? I IVl •?? V ¦ ¦V 7430
S
4
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation n 06 Duplex
? 02 SF Dwelling ? 07 4-plex
n 03 SF Addition ? 08 8-plex
0 04 SF Porch o 09 12-plex
0 05 SF Misc. 0 10 = plex
? 11 Apt./Lodging ?
0 12 Multi Repair/Rem. o
? 13 Garage/Accessory o
? 14 Fireplace n
?15 Deck
WORK TYPE
? 31 New o 33 Alterations
0 32 Addition A3"-'34 Repair
GENERAL INFORMATION
0 36 Move
0 37 Demolition
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
Const. (Actual) Basement sq. ft.
(Allowable) Main level sq. ft.
UBC Occupancy sq. ft.
Zoning sq. ft.
# of Stories sq. ft.
Length $q, ft,
Depth Footprint sq. ft.
APPROVALS
Planning Building
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies ?
Total:
MC/WS System
City Water
Fire Sprinl$ered
PRV
Booster Pump
Census Code. ?f3 f'
SAC Code
Census Bldg
Census Unit ?
Engineering Variance
Valuation: $
°k SAC
SAC l3nits
1997 BUILDING pERMIT APPLICATION (RESIDENTIAL)?
CITY OF EAGAN
5830 PILOT KNOB RD - 55122
6814675
New Constiuetion Reauiremants $qmodeVReoair Reauiroments
? 3 registered site surveya • 2 copies of plan
? 2 coDies of pians (indude beam & wintlow aizes; pourod fid. tlesign; etc.) ? 2 site surveys (exterior additions & dedcs)
? i energy calwlations ? t ene
rgy ceiwlatione tor heated additions
? 3 capks of tree prexrvation plan H lot platted eRer 7/1/93
required: _ Yes _ No DATE:
D 7 ?/?'? SouJ '
- / -7 -;? CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS:
?
6
LOT BLOCK
"L-- SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
Name: Phone #:
Street Address:
City: State: Zip:
?? "?O Ssd
Company: /V,r- So y? Phone #:
T
Street Address: License #:
City:.14-t?L (? 2e o,-r State: R4 NJ Zip: ss?
ARCHITECT/ Company:
ENGINEER
Phone #:
.5"'a- -2g
Udid- ? -12
Name: Registration #:
Street Address:
City:
Sewer & water licer.ged plumber (new construction ony):
and lot change are iequested once permit ia issued.
State:
Zip:
Penalry applies when address change
1 hereby acknowledge that I have read this application and state that the iMortnaQon is correct and agree to comply with aii applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY RECEIVED
Certificates of Survey Received _ Yes _ No AU G 7 189
Tree Preservation Plan Received _ Yes _ No _ Not Required B:
'/ .
! CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: BuiLoxNG
Permit Number: 030610
07/27/9 S
Date Issued:
SITE ADDRESS:
P.I.N.: 10-75961-660-92
1607 CLEMSON DR
LOT: 66 BLOCK: 2
THOMAS LflKE HEIGHTS 2ND
DESCRIPTION:
REBUILD
&+3'ild'i'irg Permit Type
f,Building Work T,ype
:'Census CodB?
,,
?i
,
DECK
DECK
REPAIR
434 ALT. RESIDENTIAL
,
. ?.. . r-?; . . . ?
REMARKS:
FEE SUMMARY:
Base Fee $50.00 COPIES $2•25
Surcharge $.50 Total Fee $52.75
Subtotal $50.50
CANTRACTOR:
NELSON, KESTH
18511 86TH PL N
MAPLE GROVE MN
(612) 920-6550
- Flpplicant -
14206550
55311
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OWNER:
HELTEMES
1607
EAGAN
STEVEN
CLEMSON DR
MN
i herehy aeknowledge that I have read thCs application and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and Gity of Eagan Ordinance;s.
I
PPLICAN PERMITEE SIGNATURE
Iss URE
J
HEAT LO55 CALCULATIONS
?•
76•
HEATINGBAIR
CONDITIONING CO.
MINNEAPOLIS, MINN.
Weatherstrips A,S.H.V.E. Con6truction No. Insulation
Nrindows Doors Guide
Reference Out yyall Int.Wall C9iling Roo1 Floor Kind HowApplied
Yes-No Yes-No iy__
gPL fkje-' (, Room Length lQ Width Height FI, fioam LenBth Width Heiqht
YJi ndows a nd Doors- Cracka ge and Ar ea Windows and Doors-Creckage and Area
Na,
. aW, O,nn leiene Ni ?le oUl ce'k fi. s?a1L No. W?dlh
o} en NoipM1tene
of Nn. al
li hu Lmeal ry.
o/ creck Aiea
s4. [I•
2- ry ^ 1(a
C08I BLY COBI Bf0
Infiltration 1 31 7(pQ Infiltretipn
Glass ZKI) Giass
Exp. well Exp. wall
Net exp. wall 2. Q Net exp, wal I
Int. wall Int. wall
Celling Ceiling
Floor i(J 24 (y? Floor
Total BW. 3 Total Btu.
Required eq, ft. E.D.R. or sq. ins. W.A. leader area RSquired 6q. ft. E.D.R. or sq. ins. W.A. Leader area
enqth -)_ Width
FI. ?YV.,? Room L
1' Height
FI. Roan Length Width Height
Vdindows and Doors-Crackage and Area YJindows and Doors-Crackage and Area
No' WitltA
ol enB Heiq?t
Of ene No. 01
b hla lineel ry,
ol creck Aren
nQ. h.
NO' Widlh
ol one M?nqn?
nl ana No. uf
b hIS lineal iL
ol oBCk 4rea
s0• ft•
r 9 a ,
I Qio (p
Coef Btu Coei Btu
Infiltration IS 11^7 "iya23 Inf iltration
Giass .?? QQ? Glass
Exp, wall Exp. wall
Net exp. II ?.g2 -l+? Net exp. wall
laL?µ f 2 "10 .22 lnt. wal «
Ceiling Ceiling
Floor )LX I 47. ` ? Floor
Total Btw `? 411'7 Total Btu.
Required sq. ft. E.D.R. ar sq. ins. W.A. Leader area Reqwred 6q. ft. E.D.R. or sq. ins. W.A. Leader area
lt? om lengtK 1-3 Width Height FI, Roan Length Width Height
Windows a nd Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and Ar ea
NO' W1tllb
of ane Hei 9h1
ol oene Na. ul
ii hls Lineal IL
of crack 0.ea
s4• tI.
NO' Wiron
ul ane H' p?n
ul pxne Nn, ol
h hts Linaxl IL
ol crack 4.ea
ea• N.
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HE t M
Coe( Btu Coef Btu-
Inliltration Infiltration
Glass Glass
Exp. wall ' Ezp. wnll
Net exp. wall 7>c."6 ?(p ?.{ Net axp. wall
Int. wall Int, wall
Ceil-ng ? Ceiling
-
-
- Flao. L.? ? -? s 62- -
--F=l ?,N ---- _?
Tutal Btu. Total Btu.
Required sq. It. E.D.R. or sq. ins. W.A. Leader area Roquired 6q. h. EM.P.. or sq. ins. W.A. Leader area
IV'i V_Vuf'.% `Lv's?J
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HEAT LOSS CALCULATIOM HEATIING&AOR CONDITI011iING CO.
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MINNEAPOLIS, MINN.
Weetherstrips A.S.H.V.E. Construetion No. Insulation
Wndows Doas Guide
Heference Out. Wall Int. Wall Ceiling Poof Floor Nind How Applied
Yes-No Yes-No 19_ .
FI.L_%vIN(,j p_ Aoom Length ^LZ Wid[h 1 Z HBipht ? F1. (`(1nSTC9, ?r?Roan Length 'Y O -N4d1M Height
YJi ndows a nd Doors- Cracka ge and Ar ea Windows a nd Doors- Cracka ge arvd Area
Na
of ann Haiyht
ol ene No. of
li hIS ?meel h.
ol crdck Area
ea. It.
N.' WfA?h
01 ene Hoip?t
Of ene Nn. of
li hts Lineel 11.
of crBGk A!eB
?a f
6
2 ti?*_ a. z a
? A g Pl 15 .Z SZ.c. Y1?c y..a
2 b 1 l O t-K ka?
Coef Btu Coef Btu
i„nit.,tio„ inniuee+m 21 3 '758
Gless Z9 -so Glass 1 501
Exp. wall 3.1 X 1 ? Ezp. wall
Net enP. well a q, 1 g1 Net ezp, well n 9• 25 0
-InT-WBti- oo'r 1 117 222 Int. well
ceirna ??_ ??2 2b ceiiine ?a? 2,S i
Ploa Floor
Total Btu. 7,517 Total Btu.
ReQuired sq. tt. E.D.R. or sa• ins• W.A. Leader erea Raquired sq. /i. E.D.R. or sq. ins. W.A. leader area
FL ?ti?N(? Hoom length { 3 Width Height FI. ? '?"?»4lef?c?om Length I5 Width 10 Heiyht
Windows and Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and Ar ea
No. Widih
ol ane He?pht
of ana Na. o?
li hta Lineel it
ol crack Area
,a. ft.
N-' W,??h
o? one Hiuqnl
?fa?tl No. ol
b h ts lineal It.
o( treck Aree
aq. fI.
o A fir?V
r ? 2? ?l
?-
Coel Btu Coet 8tu
Inliltretion 22q0 Intiltration ?? 3?! /?
c,)
Glass
Glass
I?
Sn S/
`
.h?
Exp, wall yC ? ? Ep Exp. wal I
Net exp. well ? Net exD. well 2 2, 3.2
Int. Wall Int. wAll
ceilin9 ` ?R.? 2•$ 2 Ceilinp t?0 2.j -15
-Floor Floor
0
00
Totel Btu. s Tolal Btu. 3 .Zg
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area' Required sq. it. E.D.H. or sq. ins. W.A. Leader area
FI. Room Length °`a Width ? Height Rown Lengfh ? Width ? HOiBht `
Windows and Doors-Crackage and Area W indows a nd Doors -Cracka ge and Ar ea
Nn. ??,th
o ana e?pM
o Mf ane No. of
li his L,neul Ip
ol crack Area
sV. 11.
NO' N•?Nn
u? ane
ut OTne Na. ol
b hts Lmeal h.
of nack 4rex
sp. It.
Coef BW Coet Btu
InliltratiOn Inliltration
Glaes Glass
Exp. well Exp. wnlt
Net exD. wgI l Net exp. wall
Int, wall Int. wnll
Cail;ns 1 ax? a. ? i o C 8,I i n9
Floor
. '
Flnor cic,
Totai Btu. Total Btu.
RequireJ sq. ft. E.D.R. or sq, ins. W.A. Lnader area ? O Raquired 6q. IL E.D.R. or sq. ins. W.A. Leader erea
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0 Denotes Iron Monument
1) Denotes Wood Stake
X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation-
(000•0) Denotes Proposed Elevation Proposed Garage Floor Elevationm 937.0
-4- Denotes Direction of Surtace Drainage Proposed Lowest Floor Elevation= 9375
I herebY ce?tifY tAat this is a true and correct represeMation oi a survey of the boundaries ot
Lots 65, 66, 67 and 68, Block 2, THOMAS LAKE HEIGHTS 2ND
ADDITZON, Dalcota County, P4innesota. -
And of the location of all buildings, if any, fhereon, 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 2- 4th day oi Anr= ? 19 _ 86
-
Pau1 A. Johns n
Land Surveyor, Minn. Reg. No. 10938
i`= 40 CERTIFICATE OF SURVEY
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ME CHANICAI: - (RESIDENTIAL)
Permit Application
(00A 33 City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephoue # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Fandly Dwellings
Townhomes and Condos when permits are required For each unit
naee -7
Site Address Unit #
Property Owner
cz
, Telephone # (diJ J
Contractor SLGGi??f1CK kEA71NG 8 AIR r^?' ^'-'-•••° ^
Street Address 8510W3nFwort;:;
NINIf1E8 g?S 6"1 City
State (952) Z'8ip.?e
Telephone # ( )
The Applican[ is _ Owner t/'? Contractor _ Other
Add-on, modifcation or alteration to existing dwelling unit $ 30.00
fumace replacement ?..liYVYLa?(- Y? ? ? ? `?6 ?" b7d
_ airexchanger
? air conditioner
ceWN.l?'W
other
State Surcharge $ .50
?
Total $ Jo'sd
I hereby apply for a Residential Mechanical Pemut and acknowledge that the information is complete and accurate; that the work will
be in conformance with che ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
pemvt, 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??1INF1.71 !' C_ .A1pi 1.i5/3YPJ, cl' c_?7
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SEDGWICK HEATING & AIR CONQITtON1NG CO.
891D WENIINOR7tiAVENUE SQUTH • MINNEAPOLIS, MN 55420 0 (952) 8131-9000
AonaEss I6 6.i;- t6 c re.e, ??" -,or- CI,Y
OCCUPANT hG, r 6 4jP v b
SOLD BY S t! / L IC
MAKE 4 t•, ?-,ci x ^
SERIAL N6. ?W 3 1
7HERMOSTAT
r "'??2) C7
VALVE -?1
LIMIT
LIMIT SETTING
FAfd SETTING _
PILOT TYP E
?
cv
4 tn.t t'1 X
m IG1dITION MOAEL
? ? r{ L' 7?f L
m PILO7 TIMIlJG
N PRESSURE PERCENT C02 o
LO
? J
rr
INPUT CFH PERCENT Oz
m o ?
STAGK TEMP. PERCENT GO
??'GL'J"?`tG•
OWfdEft
FfEATIMG
TEST REGORD
.ios No. 5' 3 kGa
[NS7ALLEID BY 4?7 y~' ?
MQDEL
INPU7
G(s0 ? ?r
IGy 6rf- v 7?
VENT StZE r
7YPE OF LINER
?! h
LINER SIZE
FILTEHS: SIZE 44 ?
WIRIFfG N rf`'f o , !4
TEST TAG
LIGHTING INST.
X
NLIMBER
DATE TESTEfl 7?10 ! d3
COMPANYTESTING 1(?? ?J L /
NAME OF TES7ER
FORMDISTRIBLITIOM: INHITEODPY - .IOBFlLE YELLOl4CaPY?CIN
to y407
2004 RESIDENTIAL PLUMBING PERMIT APPLICATtON
CITY OF EAGAN
.. 3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
/S Sp
Date Ao / c7/ I Od
Site Street Address 1&101b l? ??G?c) ?JZU(,? Unit #
Property Owner Telephone #&?I-) 58"'/'?
Contractor Telephone # ( )
Address City State Zip
The Applicant is: wner _ Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
_ Water Softener !-Water Heater $ 15.00
&,-'replacement _ additional I
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ .50
Total $?'S Sa
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
ApplicanYs Printed Name ? ? nts ignatur
??01
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
-49'1T.S_6
Datej\A, 1 t`7 I l15 r?
Site Sfreet Address 1 t0D?" C ?'ernsb0 ?? R. Unit #
Property Owner ?-P?Ll'e LQ.n!? Telephone #(L5I ) 454 -QUpoZ
Contractor 9-Yf T"I?z \?lOYIV Telephone# (4tSl )3LOs??9 C)
Address 3b`TD 0Odd Rd City ,-lk-l State t?IN Zip "rJ?, ti23
The Applicant is: _ Owner ?Contractor _Other
Alterations to existing dwelling
_ Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
Other: $ 50.00
Water Softener ? Water Heater
_ new LC replacement $ 15.00
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
rotal ` g l5
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work wili be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
ApplicanYs Printed Name Applic nYs Signature ; Il
?I JAN 1 9 2005 ?
??u
This repuest vold
78 momhs fmm
I v i .
3680 l
Ienues[ Oate Fine No. ReuPh-in Insper,tion ?
.?_?, I` (k? qw etl? peaAy Now II Notity InsPec
%
X Yes ?NO or When Ready
.>,6censetl Electrical ConVactor I hereby raquest inspection oi ebove
n Owner elactrical work installed at
Stre e Address, B o Houte Na. c
ecimn o. Townshi0 Name or o. Range No. Coumy
Occu t (PflINT)
l?
oto
?am?' Phone No.
Po?uppli er I
U-? ? .4ddress
Ele r C(nhacmr iCompanV Name)
?rn ? r? ???PC?.`???i Cnntraptors License o
%?
Mailina AAJress ( vact?or0? Wner Mak
%? ?V inB I tla[nioM+'
? I ? ?^
1 i?^? ? ? T
A h rizetl Signatur IConVa toJO Making nstallati 1 Phone Number 'ka 33 ??-
MINNESOTA STATE BOARD OF ELECTNICITY . L,4?.THIS INSPEGTIDN ftEpUEST WILL NOT
Griggs-MidwaV gldg. - 0.aom N•191 BE ACCEPTEO BY THE STATE 80APD
1821 University Ava., SL Paul, MN 55100 UNLESS PXOPEX INSPECTION fEE IS
Phona 1612) 29]-2111 ENCLOSED.
E8.00 s (W1-0<
?` ?,? ; SQUESTuFOR EL?EC?TR?I CALg'NSPEC1T?IONck ot venow =ovv. ?
T1 7 "J(" Below Work Covered by 7his Request
- Tt App1 W. Q Equipment Wired
U
iances
lewl, rd Reo. TVPe o1 Bmltl g Tcrnnnrarv SeNilZ
? Lighti Fi
Water Heater ny
_ Fler.vii: Hi
I Bldg.J , A r Cond-tione Bulk
nmF
Service Envance
Above 200 Amps? ? :11 to ?v? ?+ITIPs Am a
I c P I Abo e 100 A ips Above 100 P? orl
This requesl void
18 monffis tmm .
?a l s .?1•?a
C 36808
Re ue3t,Uate--?
i ` Fire No. Rouph-in Inspection
eq ed?
?ReadY Nuw ill Nntify Insoec-
??r When flead
? { Yes ?No v
,E!Fticensed Elecirical Convactor I heraby request inspec<ion ot above
? Owner elecvicel work installed aL
St eet Atldress, Bo or oute Na.
e
I Ci
ecUOn o. Township Name m No. Range o. Counry
up/'a?nt I`PflI T)
?M./ 1
Y ' Phone No.
P. Suppli r Atldress
EI ncal Contractor ICompany m
nmc ?, i
?? Q. Contr tor's License
-a N.
ilinB ddres ICont actor or Owne
n r aking In tallationl
u horized ie awr (CO acto
? ? ner aking Ins[allationl
P e Number
MINNESOTA STATE 90ANO OF ELECTRICITY
Grig9s-Midwey Blde. - Aoom N-1 91
1621 Universiry Ava., St Peul, MN 55100
Phone 16121 297,2111
k_fJ3 TNIS INSPECTION PEQUEST WILL NOT
BE ACCEPTED 6Y THE STATE BOARD
IJNIESS PNOPER INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-oa
? See instructiens for comoleting this form on beck ot Yellow copy. 9 J
i:+ -%r%n n o "r" aPl.,w Wn.k Covered bv This Request
. ?
s vvv
d
Wir -
W??ed
EqwV??ent
FAtl R.P. Type ol BuilEing e
AODtiantes
7emporary Service
Home ?22 e
Duplex Water Heater Lightiny Fixtures
Apt. Buiidinc? Dryer Electric Heatin
Commercial Bldg.
Furnace Silo Unlonder
Indusirial Bidg. Air Conditioner Bulk Milk T&nk
'
Fa
rm 00nrr per, v OthFr Isnec
Ity1
t er Sueclfv Otber Othur
Compute lnspecuon hee tselow
tl Fxe. . Service EnVanceSize tt Fee Fexders/Subfeetlers N Fee Cir uits
? Q? ta 200 Amps 0 to 30 An ps
R-"T"T4h??v 700 31 to 100 Amps si_ to 100 Amps
00-
signs ?N?..?o? ?,?r.......,.. S? TO AL F J
Re?+arks ? / )
Rough-i^ ?. I he ElacVicel
i^.oeom,, na,eev
certify thet the above
Finai
/? (& ) ?J - 'nspeclion has been
mede.
mla repues[ voio le mv???a-.^
ihis reauest void
18 months trom
Ai 4.q; 9 7 L g. ?i? 3 7" m a- U- _W, 15 - 5 o
Re?uest Oate
' fire No. Rough-in Insuer,tion
Requiretl?
Ready Nuw ?II Notitv Inspeo-
[?
6 T ?Yes ?No ,o' When ReadY
icensed Electrical ConVector
I hgreby request inspection of above
? Owner electrical work installed at:
Street Address, eox or Route No.
1(,a C e San Dr; ue- Gity
Ea cz?
ecuon o. Township Name or No. Range No. County
O upant IPflINTI Phone No.
3
o 20? e_S cao
a -
Power Supplier Adtlress 1/3 Llf?> ??. ,S'tre e ./ f-- (?(J ?
r
Elechical ConVar.mr (CO_?3ny Name)
? e f n ?-r s1-r es a?, CnnVactor'. License No.
Mailing Atltlra (CO tracmr or Ownar Making Instailationl
1? a rac . ne AD.. n I'I11) -S_s30 "7
Au? (Conttactor/Own Making Installatio 1
c Phone Numbe.r
m, asr??y?
MINNESOTA STATE BOARD OF ELECTNIGTY ? THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bld9. - Room N-191 BE ACCEPTED BV TNE STATE BOARO
7821 UnivarsitV Ave.. St. Paul, MN 55104 UNLESS PPOPER INSPECTION FEE IS
Phone (6121 297-2711 ENCLOSED.
` REQUEST FOR ELECTRICAL INSPECTION E1B-00001-04
y y y ySee instructions for compA??::.; torm on back ot vellow copy.
A'??J?a q2 -'X" Below Work Covered by This Request +cl ? ,%
New Add flep. Type ol Builtling Appliencea Wired Equipment WireA
Home - Range Temporary Service
Duplez Water Heater Lightiny Fixtures
Apt. Buliding Dryer ElecYrie He2tln
Commercial Bidg Furnace Silo UnlodJer
Industrial Bldg. Air Conditioner Bulk Milk Tani<
Farm ome. 5oen v omc, 15uc?.1tv)
t er 5necifv o[ner otner
Compute rnspectron hee tlelow
p Fee Service EnfranceSiza # Fee Faeders/Sabfeeders # Fee Cvcuits
/ C] U to 200 qm s 0 to 30 Am ps o? O to 30 Am s
Above 200 Amps 31 to 100 Amps 31 to 100 Am s
Swimming Poal Above 100_Amps Abave 100_Amps
Transiormers Irrigation Booms Q PartiaVOther Fee
i? .
0' 1 S
TOT?tiL FEE _?
? /J
/
?, ?he?Elecvical
InsoectoF,-
cerlity thet the above
Final ie "inspaction has been
made
.
ThlereQUesfvoidl8montlrefrom (/'_ - -
This repuest void y_AL
18 rtwn(hs from .
fr' 2CQ(iQ
O
..„ - -
Feq st Oate
?_
`
(? fire No. 0.ouph-in?InsGac?ion
equi
tl. Eqeatly Now ?II Notity InsPec-
ior When Ready
_
y
_ C e
?No
_'t9i`?Ecensed Elecvicai ConVactor 1 hareby request inspaction of above
I-l n.....,.. electrical work installeA et
$tr 9t AdAress, Ba or oute No. .
el
??' Cit
/
'
ecnon o. Township Name or No,
I p?n9e No. County
Oc u ant IPflINT) P?one Ne.
V
rr
Powe I upplie 1
?'F_A
? V Atldress
'
E ' al Contraaor ICompany Nam s License o.
Conva or
Mai?ing Address ( nVact r r ner Maki 9 nstaiy9tion) (/
l!
?
f
UIJ? ?
?
? orized Signatuonva tor Ma ine Insta atio I 7ho Number
???
MINNESOTA STATE BOARD OF ELECTflICITY . 1' LJ I"jarc..T ..?. oE....EST ..?? •?..
Grigps-Mitlway gltlg. - Roam N-191 BE ACCEPTEO 8Y T14E STATE eOAND
1821 UniversitV Ava.. SL Paul, MN 55104 UNLESS P0.0PER INSPECTION FEE IS
Phone 16721 297-2111 ENCLOSE?.
REQUEST FON ELECTRICAL INSPECTION es-ooooi.oa
w
? See inshuctions for completing this form on back of yellow wpy.
L?5 ?
2fa (? C? "x" Below Work Covered 6y 7his Requesl 3
' Ad Hapv Type of Bulltling ApP?-encea Wired EquiVmemt Wired
Nome Range Temporary Service
Duplex Water Heater Lightiny Pixtures
Apt. Building Dryer Electric Heabn
Commercial Bldy. Purnzce Silo Unloeder
Industrial 81dg. Air Conditioner Bulk Milk Tenk
Farm ONer Spenly ?her 15uentyl
i ,r Suecity Oiher Oth(<r
p Fee ServiceEntrance5iza H Fee Feeders/5ubfeeders # Fae Circul?s
Oto200Am s Oto30Am s Oto30Am
Above 200 qmps 31 to 100 Ainps 31 to 100 A s
Swimming Pool A6ove 100-Amps Above 100-Amps
Transrormer5 Inigation l3ooms Partial-'Other Fee
Signs Special Inspection S TOT
Remarks ? ?? ?
Rough-in ,
F
?
I /??"
(
bove
pq
Final w - Oate
- een
T018 request vo10 ltl momrre nom
This re9ues[ valtl C!-?/ ? Y?
18 rronths 1mm . C V
36810 L (___ -7?:
Reque s f]ate I
??
I
b Fire No. Roueh=in InsVeciion
9mesd' 0NO
?peaEY Now?Jill Netifv InYPer
?ar Wh n PeaC
?.censea uectnca? ConVactor I hereby re0ueai inapection of above
? Owner electricel work installed ax:
Stle c Address, Bon or Rpyte Nq.?? i ?
?? u City
ecuon o. TownsM1ip Name or No. qanee No. Coumy
OcVpqnt (PqINTi
ri 5 Phone No.
Power piier Address
?" cal Convactor ICompany Na 1 Contractor's Licen e No.
MailingAdJress ontracto o OwnerMa?,inr ?s?a{la[ionl
?? ???
A t rized Signat e IContr tor?0 r Malc-ng In allati n)
,.e,?u i?.??72ce? Phone Number
?I a MINNESO7A STATE eOAflD OF ELECTNICITV
Griggs-MiCway eld0. - Room N•191
1821 University Ave., St. Paul, MN 55104
Phone 16121297-2111
HIS INSPECTION PEQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PPOVEF INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION Ee-00001.04
?
1 See instrvc[iens lar com0laiinq this lorm on back ol vellow coOV. cl 3
'?.8 1 O 'X" Below Work Covered by Thrs Request
AAd Rep. Type ol BuilEina O.oVlioncea WinA Equiumam Wired
Home b?q Ranqe TemporarV Service
I I I I Industrial 81da. IM Air Conditioner I I Bulk Milk Tank I
M iee ServiceEntrBnceSize !t Fee Fande,rs/5uItfeeders b Fee Circuits
0 to 200 Am s 0 to 30 Am s 0 tn 30 Am s
Above 200 qmps? 31 to 100 Amps 31 ta 100 A s
Swimming Pool Above 100_Amps Above 100_Am 5
Trans(ormer5 Irrigation t3ooms Pgrtial.'Other Fee
Signs Special Inspecvon 5
EE??jI
Aemarks TOTAL
?f
NouBh-in
?
?
? I,the ElacVical
L
• ?' Insoector, neraby
certil
thal the aCOV
Final ?
•?.?j
?y- y
e
insoeccion
has bean
? m
ede.
Tia raquast voiE 18 manMa Irom
~ a
f
1-7
PERMIT
City of Eagan Permit Type: Building
Permit Number: EA106505
Date Issued: 0812412012
~it~ of 11QR Permit Category: ePermit
Site Address: 1605 Clemson Dr
Lot: 65 Block: 02 Addition: Thomas Lake Heights 2nd
PID: 10-75951-02-650
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434 - Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are
not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $4K $103.25 0801.4085
Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195
Total: $105.25
Contractor: - Applicant - Owner:
BAC Construction Services Thomas M Kloyda
3032 Minnehaha Ave. S 1605 Clemson Dr
Minneapolis MN 55406 Eagan MN 55122
(612) 721-5500
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK ink
i For Office Use
Permit
of bian I I
3830 Pilot Knob Road Permit Fee: b • 6
Eagan MN 55122 Date Received: I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
1 I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 16-11- 13 _ Site Address: ckq~ J_WE'gom 7
Name: Cr &/a ~l 4Iy inG7rf'1Phone: (1-2. 721-
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Description of work: Re-mg F _A7//No
Type of work -
Construction Cost: - 1 n _I -t-1 • s D _ Multi-Family Building: (Yes
•
Company: R 19 L
c7 O J 7. Ct & ~/7.$~~UG7 Contact: _
Address: City: m[Q a ~nIi
L s
OontmeWi' r-~ ? l
State: /1N Zip: J`~_s Phone:
License j - 1 9 2 0 2- Lead certificate 2 , f
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
-Yes --No if yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone: _
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public If you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 464.0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to rive locates of underground utilities. www.conherstateonecall.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.
Applicant's Printed Name Applicat s Signature
Page 1 of 3
•
• Use BLUE or BLACK Ink
For Office Use4!11/16 L�(� G3
City
Permit#: l I !
EaQali Permit Fee: ( L . C3
3830 Pilot Knob Road —7- _/
Eagan MN 55122 � Date Received:
Phone:(651)675-5675 [��.C„�..I�'ei~�:0
Fax:(651)675-5694 Staff: v..
JUL 142017
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7//3/✓7 Site Address: /405- £"`°` W'✓ '( Unit#:
Name: Def, 'T/ /6-' S /O 'N Aroie AXe b Phone:
Resldent/, eD
Owner Address/City/Zip:
Applicant is: Owner C Contractor �,,, ��
,0 tZ t @/r ZO deerAl t. /tic/,,
Description of work: /0,
Tp'of work ;
Construction Cost:_ SVed Multi-Family Building:(Yes ?C' I No )
Company: CTP%f 6 i at 'T -A/ Contact: . 610yr
Address: /57/), &41-44-yr-e. I ve. City: /1,90,2 e Li td
CGfliv ///// ,^
• State:MN( Zip: '�5> -V_ Phone:467-914/4'iirCti Email:A.u1-g/l r'fz CTrerd s
License#: S( Zz-9f.2 Z Lead Certificate#: J,4r F/1)-d$'
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:
Epf fly b {4 f t,� S 3" ,
, ro
the inform a it a i is r
1
..,4 .-, 1 dthater� ,,,b a 'Sr'r,
0'7
.,rig
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.000herstateonecali.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota 7- e Building Code st be completed within 180
days of permit issuance.
r/
x .. iy x ,r /.w LLQ
Applicant's Printed Nam Ap ricant's Signature r
Page 1 of 3
DO NOT WRITE BLOW THIS LINE t' 7 ,
SUB TYPES
Foundation Fireplace Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family Garage _ Porch(4-Season) Exterior Alteration(Multi)
Multi Deck Porch(Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation A 3, ateOccupancy I'j?G-3 MCES System
Plan Review Code Edition 01 n 2 0 iS SAC Units
(25%_ 100% 2'=') Zoning f'D City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length / Fire Suppression Required
Type of Construction V? Width 2
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
>O Footings(Deck) Final/C.O. Required
Footings(Addition) jo Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: _Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: / `u 1-1,9 , Building Inspector
RESIDENTIAL FEESR�� �.4GT� )b•X iv • rt'''") r) ��9Xio
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
l � 0(-------7 S
�� �; :� � £ o �E 6DU1LM Ex' rf- i
4) �,0 !o® IN f� �� l�
n v 3. rimmic437.0)
33
e® � (9355) ® =`� ?j� ...11`/Zlr ,� 0 ,\o ' p t
i ,',).... ;1\. .\\:Ct \ C1?)-\ a3
�r Ai .\ it'
93J. . 2�.r3 \N k /
_;.(9" O 7\ \ \ N . 103--•°)
1 C 1 1 ® \ k� a. \
e— ' �\ o nO \ °` \-7:42
® h
N
22.33 22.33\ V.
Co�I 14 �N E .a° .IOC 193 '�� Is11.17
3/ �. 1j ERIE-(9-7-)5't,75
•
01/1/81''7 2o.'W c
F1 vc/o
jc%5i, (flea) /a/XtD'
(93 0)
r- (936.2)
________cCEN CENT'S DRI VV
Mak) (938 3) - (937-f1 (936.7)
o Denotes Iron Monument
0 Denotes Wood Stake
X000.0 Denotes Existing Elevation Proposed Top of Foundation Elevation=
(000.0) Denotes Proposed Elevation Proposed Garage Floor Elevation= 9370
-4--- Denotes Direction of Surface Drainage Proposed Lowest Floor Elevation= 937.5
I hereby certify that this is a true and correct representation of a survey of the boundaries of
Lots 65 , 66 , 67 and 68, Block 2, THOMAS LAKE HEIGHTS 2ND
ADDITION, Dakota County, Minnesota.
And of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or
on said land. It also shows the location of the stakes as set for a proposed building. As surveyed
by me or under my direct supervision this 24th day of Anri? 19 86
-� 111,
Paul A. Johns
Land Surveyor, Minn. Reg. No. 10938
LE CERTIFICATE OF
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MCCOMl3S-KNUTSON ASSOCIATES, INC for
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178743
Date Issued:08/31/2022
Permit Category:ePermit
Site Address: 1605 Clemson Dr
Lot:65 Block: 02 Addition: Thomas Lake Heights 2nd
PID:10-75951-02-650
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:
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 -
Marlys A Peterson
1605 Clemson Dr Unit A
Eagan 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