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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 i 7?j O + `!i r+ H ?. n z 10 D Y. z T? n + { a a 0 ? ? : W Lr':J Lr 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 ltSEk IA: NANCY ? D h D ? W G f3:Tt ? j .. .. ? ?o m 0 ? Q .. ? o cn C?i \ ? nc? w ? 03 ? r ° m ? H m ? y z D 1-+ 0 Ln u :z) C? C l ? J . pW1 P". ? crt n ? ? ? a ? D S ? O Z -i H z ?K*******?K*****?K***?K***?******** CONTINUE 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 7) r. r. u• - ? fi_ ?f r.e?-?.. q t V A 5 ?OR Y: CITY USE AL i ONLY E RMIT ISSCED t 2 V y ? i l++ ja r? t,.i?q b i ? t n F / 7 T 7 ' I W/Bldg Perm it FEES Vl'?SEWER PERMIT ( INCLLDE SLRCHARGE) ?' WATER PERMIT C I NCLLDE SCBCHARGE)? .? x -S/NYk J* , :,{'•l?t??fp :S 4?"??1. ? . '? i $ '" `' WATER M ETER/COPPERHORN/OL'TSIDE"READER , ??? • . -.- , xr ?+ :3TIZLNK WATER'.ASSESSMENT `{??? t?; z4 jrd??'J,1 ?1%? .. g3SMENT ?TRLTNEA$a ? ??.?Fi?l ? ? '? $ _ ?.. .. ? " LATERAY?-•? ?Ef ItiP?TRC?NK SEWER ?, y .$ e? ehy(jS ; ?? 4 $ -` " '-LATERAL'BENEF ITJTRCNK WATER $ , ????„?`l I,PU R '' EATME NT PLANT SURCHARG] A R ` ¢ LTE Ai ? ? •?{=Y?1. '$ .a.'i sl?lO?HEFt•?;f ':::*• ? y, _, - Ac?t'?'-`r 7.??',z?'' K: r TOTALa ?*??-? , ' ' 6?6 ?.?.. ... , >..?'y'-?a? ?.,5?'ed?..' ??s?.s ... -.,..-?............ . , .. _ n"?t _ _ %•-eais»*i-^-: ?'z{ : .. . : ' . .__ .. ....' .. .. .:.. .. . . . . . ?. ..,, ..,...... ....... ....: .? ' . . ; . '. ,?°:-. , st;: . ... . . .., . .a+. . . _ . . ? '.. ' Ia .: ^. . ._. .,.: , . 1... .. . . ., . .. - , ., y ,r - ' APPROVED BY: ?- TITT ,E ? :.. . ? ? 1 r i ' ? ? , .. . ? ?„ • ? 4.. ` e k - ta. W?? ? ?? , y . / ? z DP:T$ f /?"?: / / a.. . ;? . _. . . - : ? , . ,. . .::._, .. . - . . .. ' -: .: . a ..:...:. ... . ^ ,:.: .._, . 3 u.:= - ?i ? th"xw e.?t?w_,.3"• "`-? ,: . "°?,.. ' ? .:.,?„?" i a?. k". ? Y ?'+ .. ? :. . . .. .. ..,:. K... .-.... . . , 5 . . 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) f ? . _ . . . • .T.t%t2/ ?L?:S?L? ._.. _ .. . , - n.53p,- , - ^ . .. ? ? _ ? 'F^ y .i1Y[Y•Yi: -_ - - . " ' ADDRESSs : JI. .., . . CI'E'S[r $Tj{TE? ZZpI?i 5^ A ?^ _ - r z ' ..._. `.PHONE: • io - AbD . e", ? £or City Use . . NA"E= Plumbers License: ? ? --? A?RESS? Acti.ve ? Expixed ? CITY. STATE._ ZIP: - . ? ? L Not recorded ? . _ . , ? MASTER LICEr15E# . . : ? • , _, __.. _, ,.:... - ?a,??q) ??• • ? ia• w- ? - RGt , . .. . ;, ,? r ;{. . . ? ° NAM: v" 2 - , _ ?'ADDI:Ws: - . MTY, STATE, ZIP: , : PH=: . 1 !1 v ' i 1 M: ' 71' • 9 • D? "'YY7? _ . . . ? CONNECTION 10 CITY SEWETt ? CoND1ECfI0N 2n CITY WP.TER Q OTF3ER ' .:. . 6) ?? ?-• r Q PLEASE HOI.D APPROVID PERMIT F?OR PICK- BY ONE OF ABQ?E '_ - PLE.ASE MAIL APPROVID PE[tMIT 10 1. 2r? 4. ABCNE . - c ? (C izcle one) 7) ? ,? J?1+y ?,?^ r r. u• • 'A /J/l? ??/n lf ?Ul k / _ • .: ;' r . St?In ua1 < ? ?' 1/?^ V1Ci1n ,. : •? *1D1': PAYMFNP' OF FEE AT TIME OF APPI,ICATION DOFS b]OT WRSTl'itT1E APPItOVAL OF PE104T. INSPECTIor7 oF sMM Arm/ox NAMEt : nZ"rAT7ATTON$ WILL AXYP SE SC?HED- : ULID UN7.73, PERMIT AAS BEEN APPROVID. Y Tax Parce ID ) s"'f - •5 a . . . - , DATE OF ORIGINAL BL'ILDING PERMIT ISSL'ANCE: ' _?? ?' f {MOn Yearl ) CSE:. aw?x':,>:1... .?.n t:>:? 11 :_ . ... , ,_ ..- _ .. . ? -.. , . z ? . ...y.,,?..,, < , .. - . , . , ._ . , . ., . . ??... . .. i ' ? ? ??. ,_,.. , .: -'_ .. . ... .'.; .rs _ . .; ..... -. . ?.. ..,, ..._.:'. .:..-? _ : FOR CITY USE ONLY PERMIT # ISSCED F = < zp.i .? ?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) .` .. ? r ... ,. µy . - ? . ... _ . '.._,...: .zi..:?,'. ? . C`.=:cn' ? n:i.?" ' . - .... . . ,. ..,. '.' . , . . +? +4..,. . . w::.. :7'''..? _ , r •. r? St' ?:..',.?K _ ?. ? ? - . WATER METER/COPPERHORN/OL'TSIDE READER WATER TAP ( INCLCDE CORPORATION STOP ) r ? S x Ls i Y'» SEWER TAP . '0 : ? ACCOUNT DEPOSIT SEWER '`''? ?/^Y•? v+. i w:.°. ? r a: ?,4`? tit e.r b : ; 7 '.:_i .: ,. ,:- ? ' . :.. .: ? :;?<?:.x ?G??F-" r Sd ? ?'+ea?.e?- :. $ ' " $ '?? G?y" ACCOC'NT DEPOSIT - WATER F ? . q Fky?? ?iY -. .•: ,? 5 "? . : ,a"? . . ?r"?-? 4T ':?- M?T ?t??am +!' ?$. . ?J:-? , ,?_. sAC ?., `'' ? .• - , ? . • , , ?? ?? ?r. , i4"? .'i.o }'_ . ??. ?"" f.?(,J ' ? .'•???. r tlt?`i? -?.. °?'`T(` v?. ?.. .: ? ?? `r.? P rT12LNK WRTER .ASS,?SSMENT ' ?=- f ? ;,•.:? • ' .'?C• ,. . ? ?????.i t .;,? , { ., ?? .?,?? -" s,' ., ? . . ..?. . . ,< < $ -- $ ? , ? ITRONI( 45E"$ A$AE3SMENT ;,: ? :a t $ ` LATERAL.??EFIT/TRUNK SEWER F K "`1?MS q.` I . : ' ... _... -...a.- J :: $ •- - . $ _ ".. t : , ...... .. . ;'.'. ... ':.:.. . ., r.. - .?r.. l ° ' ' LATERAL BENEFiT/TRUNK WATER " e , t ' j:J?_li?f`'t??`•i•',?j'.:i`?:f3. -...:,•'. %..,;;,._ ..::.. ? ? ... $ AIZJ;R,.aREATMENT. PLANT SLRCHARGE k` fn , ? C i n?lil?:. ? ? i "•.. /^'? .""?'1+?` /` df? } ? _ ?aY TOTALr ''7Fj Y<h+bP M ??. ?xe? 1 ... '-. . ? ,pfa<?f y?L.W? ? i? ??« ' ' ' t .. ? ?? t !i ? J ' 4 / . + .L• e . ?: ? ?T :SG ?.- RECEIPT - ' ? ? °" . .. : ? .. .?. .. .. . .. .. .... .? .. . .. . ,;:.? .:.d . -' . .. ..... . , . ... i ? : ' ? 1 .. ? r " _ .. ? .. ., :- _ m •.? x : ii;.,. p?TM DOES LTILIT Y'CONNECTION REQUIRE EXCAVATION IN PUBLIC R2GHT OF WAY? . . ..?.u'.. ?.. : . ... . . . -. . .: .. . .... ...-<:_ ? . . _ l.. .{ . .... "..: . : : . .? . . . . . .. . ';. ..._a..v:¢.'d YY":i?S L ? .1_f. . .., ? -. .:.._.r .... . : ? 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. _ ., .. . . , . _ . .. ... . . _.. .. -?- .._.. ..?. ;.,.. , .. . . . r. _,.. .: ..G: ?r z:... 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. ' ,. . -tPlea Print) - ? .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: •nL ° rt gW Nbn Yeat 1 n ? FRESIIJP ZQNINf'i/r??^ POSED LTSF i 7 u •• F?'m , rp Rr ?`ita n? ? '??,?Y' j' .r C?CIAL/RETAII,/O?ZCE R 1 SIIS?LE FA?LY ? . ? y n? A Sr,eN"?? ?i-? t , ? 'h 9t ? `?k?wV?' Q IPIDLSTRIAL R 2 DL'PI,F,7S (Twv' CTnits) ?. ? : ?] .INSTITL'TIONAL/GOVIIti?'Nr / RVJ310W1E3OUSE (Ttsree +?Un?.ts? ( Um.ts) R 4 _.,APARTT?r/COI?IDOMINILTI ??`d _ . . , . " , . :.... .:..:., :.. , 2) ?y t .' ? -. : ... 1?iTAIE?• . ,.. ...?. . .. .: ? iifT' ( ?4Y4G• . . ;.:5 .. 'AODRFSS: ? . . ; . , _cixY, srATE: zIP: 5 cA4D • ? . - - ` - ` PxorE df70 .M . --. 3) _ • AM pi• ? Nb1iNE: FIDDRESS:? QTY. STATE, 7.IP:? PHONE: G • ,,: .i? 4 - .;. .: :,. . a. .e.. '..i}'x ' •5) • '. ou v " 1 a• 4.4 • -oi •o?u- . ' ? 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 '. ? • (Circle one) -, ' 7) r r• u.. ? ?Y`l _. , ' •'iC ? Y' Y:I: M f •',• U • I' a?' •.' J I:A• ? h YJI• • p•1 IYti ' 01• • •?• ?' • ? ? ?- r. •? • ?:ti 1 ? : i Y:I. •.tl]?` • 1 1 1 pl' ? •?' :A• • ?'. 1? Y' ' : •?? . ' ? , . ..: :,.. '.: : _ . . . ' I . . ". ! V Y1lIIilOPS'S LICERSE: ACt.7.VE ' • . ' iq ?lit? Not recorded ; . -.: - : MASTER LICQdSE# S?t3d1 x ? .. ? ? ? • - _ . #1t, . . . .,. 4 , ._ . ... i` " ? FORCITY USE ONLY Ap?.6 ", PERMIT # ISSL'ED n, { r ? a ? ? r ? '?'? ?" S :' ?w s 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 '. ?. WATER TAP (INCL[JDE? CORPOn, RATION STOP) ? ?SEWEA ? ,y? 7? °'Aj'k?' ?S. ?t?, r, : ?5? ?£ d V?•cM ?`?+#r ?`.?srr 0. g? , , ACCOLTNT DEPOSIT SEWERyy??.#, ? ?`z'' ' , `•' '??S ?<? ??? ACCOIINT DEPOSIT WATER ?"r,?,?+r#r ??Yi+? ; P?' ?. n - 5 _ ? nA Syia?kMk i *. ..s ?.4 g #•`?h???# k ?#?F?.,?3-?a?'?' WAC ?+yF? u? c!w - n try w1. st?H? 45A h''v" .x.;: I13LAIK GTPrTER'.ASS?SSMENT : _ c . a »- ,.i,p • -°, _. ?.i??? ?. s.. ?? - f.?? ?„?. y ,,.`? -`S"tis?..;? •?'t '?3??? k?..:y?'t 1" ;£ p? i= tT$t?NFF ?EWPR Aq?'iF3SMENT c f li 3 - ._..: ,,. _. . . . . . . LATERA£IT/TRPNK SEWER ?, , ,..._. LATERAL BENEFIT'/,TRLNK WATER ' k S S RECEIPT RECEIPT? ?? : ?-? ,.: ,? ." ? •? ' :; ??? ? - ?? _ ; ? . ., -DOES LTILITY_CONNE CTION REQUIRE.EXCAVATION IN PUBLIC RIGHT OF WAy? ' ? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSC'ED BY THE 9NGINEERING ! ` u NO DIVISION. LIST AS A CONDITION rrrvv........ .__ ., ... . .. .. . . .'..... _ . . . .^3 • .. <.. . y ." y'f?,_ ? '::SUBJECT TO THE FOL LOWING eONDITIONS: . .. ,; ,.. . . ,_ - . .. ... , ,.,: .._ . . .: , ; APPROVED 8Y: . r,? aycJ ::' ., . ; . TITI?$T ?. R 1 ?... ' DATE y D ? ( d ; CITY OF EAGAfV _ ?.:. APPLICATION FOR PERMITSEWER AND/OR WATER CONNECTION c: c a ;M . ..a? ? _- , _. _.. ._ ?.:,._,,- ?' . . . . . . . , ;; YlEF , 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?. Ff1AME: t? ?ADDRFSS: ?' , ; ciTy, sxATE, zIP: n f , , 5440 n p - ? Pxor?: .. .. _ . ., ,: . ? , , - ::3? . u ?: ?• , . ... For City Use . Plumbers License: , ADDRESS: Active Q ? • F k p ired / }?? ?T? \rlli/ N1AL?1 ?i • ..• ? ? y R "LYll1. recorded ? ` ? PFI(]l?: • MASTER ISCINSE# . ?? : tial ... 4] sar • ia• S r ' .?:?w.w - SW . ? / 5.? _ ^S ?Y a4?? i .: ? . . . .; „t ... . _ ', .. ??+p .:. ... . ?•ffV4JaVCJJi 4,.. ? ? ..;. ..A.. .-. . .. .ii .. ..q. '? p ?n- -.. .... . ..:.. : .. .._: . , . . . _ ' ?*? ?./ . ?1CLLL IPi ' - ' ? .. : . . / 4 / -!.._... . , ? , .. . . : - . . ' . - . . . . ?...:LAVLYE . ` ? . ' _ •5) ? '? r• " .? a: ?• a • a? - ?? _ , . . ? 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 .? - c • (Circle one) ' '" 7) r ?• u• • _ -F?-?'? ? "•`1: • Y' bl: YY ? •'? /? • I" •?• ?' } 17' ? h GJI' •?'I IHY.' '01' • 'N /' •?? • 1. 4?' ?.ti ??:! «C?•'.tl.'1? ? ? ? ill ?•?' iA' k ?? Y' i??? - . .. . -.,, , ' o, . . - •: . _ti+ 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 ? m ?? \p w o) b . "?•?q3 ? p z ? i r? ?D 60` / \ 1 l osag•g??E o ???VIL? ?xts%. n?p? 3/, pp 1 fva?o)?00IN ? IbX ta fl??c_ 22.31 22.!! ~t? }\ t ze \ ?. o\?" 5? ? n\?3\ a 3\o O ?43Q. N a3 ? \?Zq\> O 293)\N ? i ? ox `1435.01 a\op. O ? °`\° O h , i?j\rry 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? ? ? v C o ? ` ?q95.5? p ? o 3 a ?o tL ?o 1 ? = p ? ti M -? `? A O) kf) ry f- (9 = 3 S ? 1 C 1 i ? r? V 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 L 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. ? 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 7T.-??,Gh? To,,,ynt?Ci? ' ? Cfeo, .Sedqu? HEAT LOSS CALCULATIOM HEATIING&AOR CONDITI011iING CO. N-cX 26 , -7 s4 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 .? ? .s . . . :_.>.,-,. - - _ . - ?=,;..,. ` .,. <t:. . o?cg M'?l' C `..?i1. , ?? ? f ?.p?CV ? x tx? a?Od@?. ??? s-- _ Eepair::: - ?-? :???Additi?`_-- -?::_ •? ''r`^w - - 1+: A... ?aaaaa?b - x .. y'•? Type oP. Const # oP Storiea;: ' -- s? _ .;, -: ro,-ie ?"-` Inst811-? ? a. - k':':.Pp:-? v ;}=4 . ? :?!_ ?•? ? - s?' ., _ - APPHOYAL ::???:? ?.;?? ? _ --`?i`: ?, «? ? ?, ?IODB. -wt. S ? - ? c ? .. ?_ . ?. 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HO CHAHGFS YBZ HS ALIAYED OHCB BDII.DIHG PEB?IIZ IS ISSU? h ? / ? •? ? ? ? . . . . ? . ?. ; r i_ ? ? ? ' ''f ? a? ? '' ' . _; ' •? 5 ? ? , : !' ? t . ` ? . . ? ? ? : < ? ? .. • ...?i'Pa_?:Ydi? t - "? . . l . . ? ? ' . . .. . . :l????. ..? - iu:6.:afl??? ."`.t- S?ua°c-??.r_ -: r ?' . _ ? . . ?.L_?.?:t,.. F..':....??L3aw..<? i? _,! x.s?.?....3?'w#v? :;? -, .?' •' ? l??i 5?:5 i '-? ' ??g S-i € ??? s.?semoael v: i } zonina /Sub -. S$LARE 'fIEY6HTS' `c?' _." epair... : .??ype of_ Consti' .;,? Additi? • of Storiea;• tF A` ?35+_y ?'_ . - ? ; , NEW HORI?ON 1?OML?S:??"? x??? irlfove? :x;'? ?;;?Length -i' s y,?.,??t?--? ? Damolisli;, Depth s 'EOIC``135 r<. ?' 4Int Impir. ? ,S4LFt?`.i= y_b1Ef??`' ?sw.y?' ?yy? ]jj•ri ]r ? •?,,?;}c. ? "Fe. ?'?Sr4 {? • L1?.i? * ip.Code " ?iiater/Sewe? 3= Police ' ? ?j ? = Planner =•. •;y ,a Council 7t- .-,.<. Rlan Eeview - SAC ;S F"w 777 N8t6[' COnO'7 flater Meter' + . fload Dnit;:-P r ?t ? h.. { y?. . .,W? .. a?,? ?' T- ? v - °y?-i Q 7r'? ?S.°s- ?I;ld$ ?f_. T? - h'P.d??tr ??? r"APC ti. a: Parlm' ?'-?? •-e?.- ..?? D 'GRI?LD r'Y` Y 7 Yariaace Copies ?Addresa r TpiAI, r? s.l?& t ? , ..?..? ,. .c:.. . x City/Zip Code ` z ? Phoae * 435-7524 . ? ? - ' ?,•'-,i: e ? s5':Y= i y'. . r-.c 4. _c;? ?1„ J L { T} ? tiX HOiE:. ADD&ESSBS?FOH COEHEB L023 = C08SHACTOE/HOHEOWBS9ltO3i DESIGHA?S BHICH I3 DFSIEBD. ? HO CHAHGffi IIILL BS ALI.dWED OHCS BIIILDIHG PE@IIT 73 ISSOSD..,'? r ; .-: l - , . . . '( . ? `.i. . ?•? , . ? N - ' ,' ? . • , . . , f ? i: . . . ' 7 3. • .° , .? ? ? .. , . ...?i.ir,??".15?:,:?.'5iais.ax:.t.a?'.l`1:A.... ?-...i"-?bss,?:.1_.s.,_:.r::.SCl.?_._..aGi??e:.i?L.a.y:d.1}L.J4;i?•: a? ? ? . .` .? .; a, . . ; .?• v 'ti` _ ?7VV ? fbYRLi '? ?:YC 8WY . . ? ? ?LLY-?'V1L1.Vi EAGM Yi ,? ,?$?vnuo ?s+..C?lSFIC?lB QF ;SIIE9SL `- C?[ YISH Bl.DCi: tl?r• ? iLAiiOHS Y A ABCHITSCiQRAL dr,8TE0C?OEAL PLAAB? STIQ63'?HD7'a 3 E -OF`° - x ` J r;,a ; Valaationt ? ^? Dia?es OFF1CE USE OWT r ?# ?• ? *? k+ ""' b .{.?:#{+ 3 i_:: :?? iC `?" ?;?3 °`?? ?,''l?;`a?'-s'?yl .{ ?u.. Heffiodel `; ?ZoninB .. -. t f ARE 'REIGflTS ` i ? , BePaie';r _ Type of Const ?' •... ' .?,(-s = yAd?diti? ?#°o?f? ?Storiea`` t?l7V0e ?` ? R}, ,}w? ?v '1 !i? raa?rr t? 4 ?C S /f Dmolish DeptD Impi.? ?. ? -- ?, ? ? 3 ?. ?: ,5? t "Y, R-3-`?y' i` -si? s {s' ?` W8tB2'/SEY9C 1• •.'M $t1I?Cb8I'$@ < ?aQCC9D" ?. ? ?•?`Police.'3'? ? - Plan Eeviev'! ' '9 ,. . ? t`r?, ?SAC,;.}' ?* dti'A"? • _` ,; ? City/Zi.p Code??`F4?t-?!$„ty. 2•+5:?? 'tit"?? ?"' yG r}C13?@Z's f.•l .?: ndti6f[iGt@l.?n _ mIOII@ `.s COUnCll f ' EOSd Qu1t ??? •• 4-0 _ 9-4 BZQS.Offiqi' r r ?L-Cdtl6entr Pl'f ? '. Ara-.?Fa?gr? ? Da= ve rAY s,. . , . p AM ? s.?. .:v. Parka #1Y: >' ;i , Yariance Copiea Addresa ?' ?'s???'c ?;i ?a •cg, ?, ? ?` ? _ z ? "' .: r •/. TO'iAL ?!? ?'? ,?... • ! ? . a'. ' <' _ 'NC ,l 'S t i 4 n. ' ? Y? I . j. '~ R -.3 .. . ? ? '? -• a ? City/Zip Code ? A Ph011@ # 435-7524- i 1 ? - •?4i'.. . , . ,P M?'F.-i?? ??:?yy'.; .tt•3i, ? ' , ,7!° t"*r.F . . Y''. ? •? 4:.IT' l S .. ?.( .>- ?. ?'.- • - ? l. '- a .. ?. ^..•, ? ..<,i}C.. i 3.. '?`, ;? , .i • - ;. . ' .r s HOiEs, ADDEESSB3 FOH C08BES L02S- COH2EAClOE/HOlS80flHB8BIISi DE3IG9AiS YHICH ADD6 5 - L4 DFSIB?. HO CHABGFS itlIi. BS SLLOYED OHCS BQII.DIHG PERHI! I3 ISSIIED r .r v s .t S. - ?.? ? . ei-w a. ,_?:.1,...r?.•:.ti ?[-ui.?,?.,:?i,s4 _...?_.,,. s.e. .:...s _?.':_:a.dic ;!:.i..,ti?s.:?_.e_?,.i,e.su...,.,..?•:3:?J*'c?'f? ? ?? ? AV HmaIm PffiKff ? CLli:K BSGv - 1f0iBt ?BS B8• CF.?SB? 2? CIli OF BiGA1 313KRS - ?.LE OHS _- B84ID?LIAL POE SS[S ?LRffi CIADB,.,Z:38lS OF PI.IlH3 - 4'?iIFICd18 QF SUBYS! := (Hct.E YIiB SLDG: D?i. •?•SEl. -ENBHGi C?iiO? ? •6 - - ' ? x?cwns? ?Ers?,oF;aaca?xscrua?. -?FsraocxaaeL' piags; ?, SSi?OF?SPBC'IFI'CATIONS _?.._- ?.. AIiD*? F?i6BGl?C9i.WLATION3?+ ? `?. ?'?? ' - ,? ??•_ #2?000 I.AHDSCEPS BOND `???? ' '? • ?-?? > , To Be} ITaed,Fors Yalvation??""?Dates'? ? ?.,. C '`=L ?*,'.us. hy ; ,'j?'"? ..?, . ?...::,yff.. .o'?'., '1i•'B' '?9:it.?.' •siai. . S3Ee Address , < ? ? OFFICB OS6 OHLT ? ? 3 • `?? A f'n ?s..:r? a?,y z ? y>ki '?Y'??`rA?-.Y:3 T .. C•??' %'?i ? ?L.?+! ?_Bl??'•. ta' ?,;.?T Ag?? Ere°t ?.?3??• Occupancy K .???• #,+a, :: Parcel/Sub TIiOMAS Tf ALR? AEIGAY'S ??1? :?,, Pa?':,. y .?p=3'PB • ^ :i # of Storiea`= . ..?:?r ? Oimer. NL??HORIZOAf"?IQ?S'?I?:?T? ?'- '?i?"`? i?t'? s''?? ??6?. ? y " i °? ' ? Isove??-? ? ,n t 'i , ?° "? __ •k ,..+! _, '?__. :r'xx'?'? ? ?, .zr ? scr y, kiTater/SeVer Addre? SurCLaP e:i_.. ?. { . .. .'Y Poli va. ?-.,?, fi sa? *ce - ??y > ? Plan E vier.",! •*? 4 ,?.?? SLC V1??: ` YYaAY..:yr Ty?^1• rTr?.y?_ ayc`?t?y ?? q?} t_ CJ.[4;f". . "? f ?a City/Zip Codey e?3YBT wuLL4i?( •' T ?'x'} i f * rt^ , y{'?y. i {¢$?^ ~ x Yplanner . • , . c Nater Me ?? ter, ? . ?7? r?• ? ?? _J YY LI'? ??{( \9 1 ?al ??I?p'F? ? K ' ?. ? 0`? . . ???~Y. ?C YM? ?f,??i? f?Yl? ML?? ?Mt?YY LL{? y'I s y• Ar_L ?__ • ` ..? Y ? ?wf4 ?.? ie? ? ''?i"/`?r .t'R:? - p82'? .??` ? e.t`t:s, ?? ? i/ 4Y ? • ?•??'-' '?a`9:.c v `ef`i } y' _S i'? •? . ; -?_ -. A .rf.,t..?, ' ? +'? . Variaace Copies AddIY30. Y?a34 ?, tsf •_,r' T-.- " ? a 2.c^yr'? }..?.?. ? 1'(n? C a , . s x City/21p Code _ . Y P60n@ # ?. 435-7524 !n . ,: ? ; i? M i. ? s' ?'• s ?i;'' ? , ¦?0.c s ? .; < s . s,? .-'?1l' ?%'?/ `S? ? r?Q?R -e .? rt . ?: ? „l ? `( ?-'?.?}? . ?.° `L ? ??-? ?.•? i ? ? ? '• ?i ? ???Y.?7? '? , i . .r Y: A ? _ . (',+?r c _7`?qJt y Y'r ii ?Z .::3+'f.??. -. S ;R. j v", ? : l. , o- •.r _ ? • .. . . .: ' " -' . . ? jz g ....'#-?a,. . 4..{ ,.. _.. . ,? ? HOiEs. ADDEESS83 FOE CO8HB6.LOT3?- COH2EAC?OH/HOlIE04HSH lIOS! DESIGHAiS pHICHADDBESS, IS DE4IHED. HO CHMFS UII1. $S AIdAiTED OHCS SIIII.DIHG PE@IIZ IS ISSIIED d? r _ . . . ' - O 58f'f7 7a E O ? Q v ?D ol ?° f Q° 'y ^p 3? ?O 31 pp ?c Q1 l? f9l>.o) IN /. F C a ?? 7 = '7! .° 4z E (q35 (9 zs'VI- " a ?V M 9,f] Z9,?J h h 2 O) - i ?/?'?•? ? ? Z\ ?QO \\N ` `?4? I 4 ? 22.)3 ~ Q. 2i•Z? N' 400 3/oo It. ? 84'g7za•k, ?N oN _?(q355/ ? cuwe 93L.z) (vaao) m . .. (7JtQ (93? _ C97Z4) _ l936.7) 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 F+ CCMC( O MBS-KNUTSON ASSOCIATESC? 7 fiOf WMWITYpINGq[[?Sn IYpiVllYti04s fITEfW11EFREM1 ,?A, ?? ?S YwIEIVOIC a?O MIJ?CXIWOM.?pMIFiDTA . 77AJ?O IVG?r D-?joG 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 ,? ?3'? s??! ApplicanYs Printed Name App icanYs Signature ? ?? ? N 0 ? N m W C7 Q a Z H ? a x Y V H 3 (D n w 0) o+ a 0 ? m N ? m 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 .., _ ... ,. / 40' ; OF SURVEY 'z;\-.... L6001( ►AGE ti I,...;L_,a_ MCCOMl3S-KNUTSON ASSOCIATES, INC for • 1 LOME M'MNEEAP`O'Llb HUTCMIIKSOFO 661HNEIFOE TA IGW$ FILE M0. _, 7430 1I ai 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