1612 Clemson DrFoR saL F T. t?. CITY OF EAGAN ti0 13016
•;, __ .' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?-
` PHONE• 454-8100
BUILDING PERMIT ? Rece;pt # ?. ` '. V
7obeusedtor 1 OF 4 PLEX Est.value $64'000 Date D?'?'??SER 29 ? 19 86
SiteAddress 16I4B CLEMSO N DR Erect Occupancy R3
Lot 7 Block 1 secisub. TRAILS OF Remodel ? Zoning
Parcel No THOMAS LAKF. Repair ? Type of Const ?
. Addition ? No. Stories
¢
Z ?vame NEW NC)RIZON
? HOMES Move
Demolish 0
? Length 27
Depth
o ,c
. O. BOX L3 5
Address ? I
t
I ? FL
S
City fIIPLS phone 420-3900 mpr.
n
.
Install 0 q.
a
ov
U¢
H
rvame SAN1E 5 3 4- 7 3$ 8 ( MARTY ) Approvals
Address paqer # Assessmenr- Permit
Phone
? W Name D. R. GR I SWOLD
?z
Address 11975 PORTLAIVD AVE SO
i W City B' VILLrOhone 894-62$7
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 of Permittee
` EW HOR I ZON HOIMEq
Water & Sew.
li
P Surcharge "` • ""
-162' 50
Pl
R
i
o
ce
Fire ew
an
ev
SAC 575.00
Eng. Water Conn. 500. UO
Planner Water Meter 63.50
Council Road Unit 290.00
Bldg. Off. 12 29 ? Tr. PI. 156.00
APC Parks
Var. Date Copie
Total 'pi, IU4 •00
J
A Building Permit is issued to:
all work shall be done in accordance with all
Building
on the express condiUOn that
of Minnesota Skltutes and City ot Eagan Ordinances.
r
Pwmk No. PMmR Nolder DNe TNephoM N
Plumbfng
H.V.A.C. ?
ElKhic ? j--q
? ?.
Soltener
Inspectlon Dst* Inep. Commads
F°°""g' i
Footinge II
Foundatbn
Framiny
Rooling % 4 L '
Rouph Pobp.
Rouqh Hiq.
traul.
;'IAV7 oor
Finpiaca
FinN Hty. S .t9 7 ? . /?
Ftnal Plbg. =?.Q? AL
&dy. Final J .s9 r C. /J
Cort. Occ. i 29 d'7 ?• -
Oock Ftg.
Dock Frmy.
WNI
Pr. Dbp.
F?
I
.. - -??- r,•Ft;;?i?,
t
.
. ? ? ?.
CONTRACT PRICE
Site Address
Lot Block Sec/Sub
Name
2
o Address
? C:... P..---
Name
Address
FEES
10.00
20.00
.50
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
PHONE: 454-6100
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repeir
Other
NO. FIXTURES TOTAL
Water Closet - $3.00
?
$
Bath Tubs - $3.00
Lavatory - $3.00 ,
Shower - $3.00
Kitchen Sink - $3.00
UrinaUBidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
Softener - $5.00 ?
Well - $10.00 '
Private Disp. - $10.00
Rough Openings - $1.50
FEE
BTATE S/C:
GRAND TOTAL•
. 4*FiiS? ?
CONTRACT PRI
Site Address -
Lot
Name _
?
c Address _
City
? Name _
c Address _
p City
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
MECHANICAL PERMIT RECEIPT # A-2 -7
CITY pF EA6APl ?
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
? PHONE: 454-8100
Phone
M BTU
M BTU
M BTU
-'? M BTU
CFM
FEE
S/C:
TOTAL•
BLDG. TYPE
Fies.
Mult
Comm.
Other
WORK DESCRIPTION
New
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC tNCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA.
COMM/iND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODEIS - 12.00
MIMIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
FOR SALE T.N. CITY OF EAGAN ? ?t
3830 Pilot Knob Road, P O. Box 21-199, Eagan, MN 55121 ??- 13?1 u d5
PHONE: 454-8100
BUILDING PERMIT Receiptfi '
ro be used tor Z 0 r^ 4 PLEX ESt. value $6`# ?000 Date ?ECEMHER 29 y 98b
Site Address 16328 CLEMSOfJ DR Erect ? Occupancy R3
Lot 6 Block 1 secisub. TRAILS OF Remodel ? Zoning PU
TFfOi°lA5 LAKE
Parcel No Repair ? Type of Const u
. Addition ? No. Stories
m :-dEW FIOR I LON FIOMES Move ? Length 44
i a?
P.O. BOX 1367 Demolish ? Depth 27
o Address
City MPLS Phone 420-3900 Int Impr. ?
Install ? Sq. Ft.
a Name SAi•1F 534-738$ (IMARTY) Appro+ra ls Faes
? a Address Assessment Permit • 00
? City Phone Water & Sew.
li
P Surcharge 32 . 00
162.50
Re
i
Pl
?
?W Name D.R. GRISk'OL17 ce
o
Fire v
an
ew
SAC $75•0 0
= o Address 11975 PORTLAND AV?. SU
U
'
Eng. S O L? . 00
Water Conn.
]
W B*ViLL $94-62$
? city $none Pl
er ter 63 . 50
W
t
M
ann a
er
e
290.00
I hereby acknowledge that I have read this application and state that the Council
B?
? 2 9 Road Unit
?
156•00
PI
information is correct and agree to comply with all applicable State of d9 r.
.
Minnesota Statutes and City of Eagan O dinancps. APG Park5
•y? ?
Signature of Permittee - '-_ ?
?•?'"?--'
- Vaf. Date Copies
-,2
104
U
0
y
? ,
.
Total
iJEW HORIZOtd HOME?
A Building Permit is issued to:
on
the express candition that
all work shall be done in accordance with all apolicable State of Minnesota Statutes and Citv of Eaaan Ordinances.
I . ! Permk No. ) Permit Holdw f oata I TMsphone M I
e. 4.
7-1-rrI I t.A•
Diep.
,. . _ . _..._... ..
• ,• MECHAMICAL PERMIT RECEIPT #
' CITY QF EAGAtd
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
ICT PRICE -? 7 SU ' PHONE: 454-8100
I Site Address Z-
Lot Bloc
!a
Name
m
C m Address
c City
Name
3 Address
p City
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent.
Gas Piping Outlets #
Other
BLDG.TYPE
Sec/Sub Res
A OND. C0. Mult
, . Comm. _
Other
Phone
WORK DESCRIPTION
New
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPUES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
M BTU
M BTU
M BTU
-?? M BTU
CFM
/
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
FEE
w i
S/C: ? SIGNATURE OF PERMITTEE
TOTAL:
FOR: CITY OF EAGAN
i
? CONTRACT PRICE
Site Address "
Lot Blo k Z_
m Name 1HOMPOLOLUMBING
? Address
c Ciry P'1TKA Phone 93-1-2521
_ Name W
c Address
p Ciry MPLS Phone 6an-3..?-
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
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
PERMIT tf ?/ S ??--
PLUMBING PERMIT RECEIPT It 7?%?? ?
CITY OF EAGAN Q
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: J? ZV. 1987
PHONE: 454-8100
BLDG. TYPE WORK DESCRIPTiON
Sec/Sub Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Ctoset - $3 00
? - ?
$
' Bath Tubs - $3.00 --
Lavatory - $3.00 ?
-'
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.40
Laundry Tray - $3.00 -
Floor Drains - $1.50 ' '?--
Water Heater - $1.50 -
Whirlpool - $3.00
Gas Piping Outlets - $1.50 - ? ?
(MiNIMUM - 1 PER PERMIT)
Softener - $5.00
Well - 510.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C:
?
GRANQ TOTAL: ' t'-
FpR gALE CITY OF F-AGAN ?`w n
130i4
? t • 3830 PAot Knob Road, P.O. Box 21-199, Eagan, MN 55121
' PHONE:454-8100 j
BUILDIWG PERMIT Receipt # To be used for '- '4 P I'P, X Est. Value $64, 000 Date ur:t-Efl}3i?K 29 19 66
Site Address ' 1612 CLFti1SdN DR Erect ? Occupancy R3
Lot 5 Block I Sec/Sub. TRAILS OF Remodel ? Zoning Pll
Parcel No. THOMAS L ARE Repeir ? Type of Const. V
Addition ? No. Stories
a
Name LJEW HOR I ZOIJ ;30YXS
Move
0 44
Length
Z
P
O
BOX
1367
A
Demolish
? 27
Depth
;
° .
.
ddress
City :•fPLS phone 420-3900 Int Impr.
Install ?
? Sq. Ft.
388
c~i a
W W
F W
?2
U ?
a=
t W
Assessment
Water & Sew Permit y • "%0
e 3-2.00
Surchar
.
P
li g
162.50
Pl
R
i
ce
o
Fire ew
an
ev
SAC 5 5.00
Eng. Water Conn. 500.00
Planner Water Meter 63.50
Council Road Unit 290.00
Bldg. Off. 12/29/$ Tr. PI. 156.00
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 ofEag?n Ordinaacps.
. "-'= .' -?.as?'?-',?i^ i.i
Signature of Permittee
A Building Permit is issued to: NEW HORI ZON HOMES
all work shall be done in accordance with ail applicable State o( Minneso
Var. Date
I Copie, U 0
Total ` y
on the express Condi6on that
Statutes and City of Eagan Ordinances.
r- ;
I ' I PermH Na I PsrmH Holder I De1e I TNOplw- 1t I
Finsl
Occ.
Frmp.
Dkp.
Site Address
Lot Block Sec/Sub
? Name
? Address
c City Phone
? Name
3 Address
O City Phone
FEES
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE
MINIMUM - COMM/INO FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOMD $1,000.00)
- $10.00
- 20.00
- .50
31GNATURE OF PERMITTEE
FOR: CITY OF EAGAN
PERMIT # =PLUMBING PERMIT RECEIPT #
CITY OF EAGAM a ?
3830 PILOT KNOB ROAD, EA(iAN, MN 55121 DATE:
PHONE: 4544100
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other
NO. FIXTURES TOTAL
Water Closet - $3.00 t
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bldet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
SoRener - $5.00
WeA - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL•
? N- wv iu
MECHANICAL PERMIT
RECEIPT # 7C/? 7
_ CITY (?EAGf4id
' • 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address `
Lot ? Blo
k ? S*
lS
b BLDG. TYPE WORK DESCRIPTION
c
? c
u
1• Res. v New
?E GW I K H G
A OND C0. Mult Add-on
Name
Address 8910
.
.
W N TWTTF 0 A E.
.
Comm. Repair ?
c City ` e
Other
FEES
? Name
? RES. HVAC 0-100 M BTU -$24.00
; Address ADDITIONAL 50 M BTU - 6.00
O C?N Phone (RES. HVACJNCLl1DES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS
MINIMUM
1 PER PERMI
(
-
n - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air M BTU " APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
Vent. CFM ? STATE SURCHARGE PEA PERMIT - .50
S/C
ADD
F PE
C
G
(
$50
I
RMIT PRI
E
OES
Gas Piping Outlets # ? BEYOND $1,000)
Other
FEE i
-
S/C: SIGNATURE OF PERMITTEE
TOTAL• `
FOR: CITY OF EAGAN
. o,.. .. , . . , .. . - .. . ' . . . . ' ' ., " , , .. . " • ' ' . . . , , . .,-.. . ..
? SEDGWICK HEATING & AIR GONDITIONING CO. ?78 ?
? HOUSE HEATING TEST REGORD /.. S, ,(3 /, /f??? ?
ADDR ESS 4 Cu= :tii ` r?.r i? RN Vg__ CITY C AC_fN td
OCCUPANT - OWNER jONwlo'(HJaN C'arziP,- ra
HEAT LOSS DATE HTG. INST,
SOLD BY INSTALLED BY
Electrical Work By Gas Line By - c!1 w, c-tfl-
TYPE OF HEAT GA _ FA?L_ HW_ STEAM SPACE HTR. UNIT HTR. OTHER_
GAS DESIGN CONVERSIO(U
MAKE +FZN V)?1T MAKE OF BURNER
Model 394GKlu.lo7.4bSo Model
Serial _ 40R!e A n 3$ SS Max
BTU Ratin
.
g
INPUT ??? b co MAKE OF FURNACE
Model -
CONTRO LS „
THERMOSTAT Heat Piug ?- Vent Size
Vaive SX 345 NSo)C- Q_ _ KIND OF LINER SIZE NONE
Limit- ST'v- nn c o Draft Hood _1?) FS ?s:?, r-?1 Regulator _?4
Limit Setting 21 s n° ? Filters Size Number T
Fan Setting t? o° ? Chimney Location Inside Outside
Pilot Type ??---IE_? ci *_ n e..1 L L Chimney Construction C-?SS r'3
Pilot Make ???'RK i? r?i ?t o2
Pilot Model
Pilot Timing !&L -!? r,??, ?v i"
L.W. Cut Off
Pressure 4i, C_ Perceni COZ /c,
Input CFH S o Percent O 2 ?o
Stack Temp.,:2 / S0 -E PercentC0 1'?ar-J Cr-
Smoke Bomb Wiring Q EC
Draft Test Tag vf_: S
T
Door Pressure Lighting Inst.
??L
Date Tested _ ? - ?- - <-?, I
Company Testing
Name of Tester - ? -? ? p- 'R b
Form 235
. GEO. SEDGWICK HTG. & AIR COND. CO.
HOUSE HEATING TEST RECORD
,
ADDRESS CITY
OCCUPANT? - ? OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY Electrical Work By Gas Line By - ?
TYPE OF HEAT GA_ FA= HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGIV CONVERSION
MAKE MAKE OF BURNER - - - -
Model Model --` _-
Serial ' Max. BTU Rating -----
INPUT MAKE OF FURNACE
CONTROLS
THERMOSTAT Heat Plug
Valve f -
Limit
Limit Setting -
Fan Setting =
Pilot Type t ? +
Pilot Make - -.'. ? •: : ? ?? . 4 0 _
Pilot Model J`1`,-
Pilot Timing 4
L.W. Cut Off
Pressure Percent C02
Input CFH Percent Oz
Stack Temp. -- Percent CO n
Model -"
Vent Size
KIND OF LINER SIZE NONE
Draft Hood 1 Regulator >
Filters Size Number +
Chimney Location Inside Outside
Chimney Construction ' `?
Smoke Bomb Wiring '
Draft Test Tag ?
Door Pressure Lighting Inst.
Date Tested
Company Testing
Name of Tester
Form 235
..r .. 711 .?G 1'7
O
SEDGWIHCK I CONDITIONING C
USE ETINGTSTRECORD
ADDRESS - CITY c? ' G4 rN
OCCUPANT_ ? OWNER
HEAT LOSS
SOLD BY
Electrical Work By
TYPE OF HEAT
MAKE
Filters Size Number ?
Chimney Location Inside Outside
Chimney Construction
Model Model
Serial Max. BTU Rating -
INPUT MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT Heat Plug Vent Size
Valve KIND OF LINER SIZE NONE
Limit - 4? Draft Hood Regulator
Limit Setting
Fan Setting
Pilot Type
Pilot Make j
Pilot Model
Pilot Timing • `. ? . , `
L.W. Cut Off
Pressure Percent C02 ? -
Input CFH Percent 0
2
Stack Temp. Percent CO -
DATE HTG. INST.
INSTALLED BY
Gas Line By -
GA_ FA= HW_ STEAM SPACE HTR. UNIT HTR. OTHER_
GAS QESIGN CONVERSION
MAKE OF BURNER - -`--
Smoke Bomb
Draft
Door Pressure '---
W iring
Test Tag
Lighting Inst.
Date Tested Lc " ti (o ' ? -7
Company Testing F'
Name of Tester i=;
Form 235
ADDRESS_
OCCUPANT
HEAT LOSS DATE HTG. INST
SOLD BY
Electrical Work By
INSTALLED BY_ ?- '
Gas Line By - ? ?
TYPE OF HEAT GA_ FA_ HW_ STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE ' ? • ?o.r, -?
. ?
Model
Serial ' INPUT
CQNTROLS
THERMOSTAT Heat Plug
Valve
Limit -
Limit Setting 1-? > C
Fan Setting
Pilot Type
Pilot Make
Pilot Model ?
Pilot Timing
L.W. Cut Off
Pressure Percent COZ
Input CFH Percent OZ
Stack Tamp. Percent CO
GEO. SEDGWICK HTG. & AIR COND. CO.
HOUSE HEATING TEST RECORD
CITY
OWNER
MAKE OF BURNER _
Model
Max. BTU Rating -
MAKE OF FURNACE
Model
Vent Size
KIND OF LINER S12E NONE
Draft Hood Regulator
Filters Size Number
Chimney Location Inside Outside
Chimney Construction
Smoke Bomb - ?- Wiring ?
Draft - Test Tag
Door Pre:sure Lighting Inst.
Date Tested
Company Teating
Name of Tester
Form 235
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
i (612) 681-4675
SITE ADDRESS:
, , I , , 0
';I; I.:rl I I.; I I II{tiMH1 A1,1
I PERMIT SUBTYP
E:,,,,
i1ji
+ ;ti t?? i ro ?,
t I IJ,.I
hltllr Ff i
? t,i roA i;r••: A:,t r'nhF,ii 1-1 ?;iwJ i i', ?,c (#i, I i;r ll iqt, tar?v E, c kiMriiaij s)rr r i F+ )ftl(:AI WFlkr
?
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
Permit No. Pertnit HoIdM' Date Telephone N
ELECTRIC
PWMBING 6' .
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMIN(3 -?yy
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATIN(3
GAS SVC
TEST .
INSUL Sz
GYP BOARD
FlREPLACE
FlREPLACE
AIR TEST
/)
? f , ,
FINAL PLBG ?? •'???'
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I. ?
BSMT FINAL
/
DECK FTG
DECK FINAL
I
? I
«. .? ,. .
CI'TY OF EAGAN WATER SERVICE PERMIT
3830 Pflct Knots Road
P.O. B±X 21'i99 ?j?` ? ?j PERMIT NO.: :^-^> -c`?
Eagan, MN 55121 ? ? DATE: 1--3 Q-E 7Zoning: 93 No. of Units: 4-pl nx
? Owner: tdew Horizon Homes
j Address:
? Site Addess: 1612Ii Clemson Drivr L6 B1 Trails of 'I'homas Lk
? Plumber. P i '
? Meter No.: Ep tion Gharge: 500. OQpd
Si2ev e dA.-?j ?y Z `?? "Asmt Deposit: 15. t101+d
I R9ader NO.: Q 3P `7?- A' ,??e • ' - - --?I iU?! 6Q?t?ne 10. d0pd
? I sgree to comply with tht &?P?ffr-t L E?ha?
Ordlnan es. M sc. Cha
I ? ? ' @T'i ?
' By Date Pald:
Date of Insp.: Insp.:-
? - ?(p -g7
c;: Y OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road ?i SSt)
P.O. Box 21199 PERMIT NO.:
Eagan, rWN 55121 DATE: 1- 30-87
Zoning: R3 No. of Units: '` nlex
Owner. New Rorizan Homes
11
Address:
SlteAddress: 16I215 Cle.maon Drive LG BI Trails of Thomas L?
Plumber. ThomPSOn Plnmbinr
12.-291-96 64454 100.00pd
?
cirv oF eaGaN ATER SERVICE PRMIT
?
3830 P'!ot Knob Road 0
P.O. Box. 21199 PERMIT NO.:
Eagan, MN 551?,1 ? ? DATE: -n, ex
Zaning: ' ? iv No. of Units:
ew orizon omes
Owner.
Address: 1612 emson r ve ,. ra s o. io*nas .c,-
Site Addess:
ompson
Plumber p ,
Meter No.: 7P 5 ? 9 U.
i .,
Size: "" L
Reader No.: ??° 7?? 3? TE1 FPI?n yRerrl
I egree to comply wfth the Ctty oft ' PtS?ucp
Ordinances. u u??fif
Total:
10/ gy Date
Date of I . Insp.:.
CITY OF EAGAN
3830 Pllot Knob Road
P.O. Box 21199
Esgan, MN 55121
Zoning: ^1
;•:a_w L'o
Ownar:
Address:
, r
Site Address: "
Plumber: _TFO-Mps
SEWER SERVICE PERMIT
PERMIT NO.: 9 $4 9
No. of Units:
er
I agree to comply with the City of Esgan Connection Charge: 4 7 5 • flaAe. ?
Drdlnancas. Account Deposit: 15. Cat2d- .
Permit Fee: 10.0012d
Surcharge: • ?n?
By Mlsc. Charges:
Date of Insp : Total:
Insp.: Date Pafd: '
I agree to comply wRh the City of Eayan
--
Connection Charge: 1=7 =- aL1120
Ordtnances. Account Deposit: ? ` - a?nd
Permit Fee: nord
Surcharge:
gy Misc. Charges:
Date of Insp.: TotaL•
Insp.: Date Paid:
a: _ L
.
LArY '°F`AaAM WATER SERVICE PERMIT
3830 Pllot nnob Road
P.O. 8ox 21199 30 -3?P32, PERMIT NO.: Eagan, MN 55121 DATE: 1-30-R7
i Zoning: . 93 No. of Unib: e?; _
j Owne? `,-?•. Tiarizen l7o=ar
Address:
Plumber:
Meter No.:
Size: 5
Reader No.: 0 d I I
1 aqree to compty wMh the dik?bf"&
Ordlnances. ? c ^ ? ? ?
? . ,r? 6. V?
Charge: 5pg. ggV4
PO?i .'v?pE?
EL€CfiW9?RS EiC' -? ?-
BY s?
Date of In .:
7-
CITY OF EAGAN . .
3830 Pllot Knob Road
P.O. Box 21199
Eaysn, MN 55121
Zoning: ' Owner. •'ow ?LOrixon rlome;
Address:
? Site Address: I61'' Clemgon Dr i,
Plumber: ThamFson PIu^1hinj
1? F,^454
I agree to comply wRh the City of Espan
Ordfnances.
BY
Date of Insp.:
Insp.:
SiteAddess: 1614 riowsepL.3 El-TraIls
Date
m
cmr oF EAGAN WATER SERVICE PERIVNT
3830 Pilot Knob Road '\ 8401
P.O. Box 11t?89 ?? PERMIT NO.:
Eagan, MN 55? ? ? DATE:
Zoning: No. of Units: -P ex
::ew .orizon Homes
Owner.
Address: emson r ve ra s of T mas Lk
Site Addess:
ompsoa um
Plumber. SOO.OOpd
Meter No.: ?k '? ??
ginB'r Con Charge: . 5_00pd
?Ivjv
siZe: Lrf ?blaa?t?
Reader No.:? O-p ??7? 7?L?E ED ?' 10. OOpd
i. . 50pd
1 agrsa to comply wRh !he QBQ"Rtar?qrye: 1 Sfi . 0?0? d? TP
' Ordina ea. ?
sMa Iwr 6'3:50p3 mete
/ tal:
Date Paid:
Oate of Insp.: IInsp.:
SEWER SERVICE PERMIT s o P io KEAGAN n b Road SEWER SERVICE PERMIT
PERMIT NO.: 9 551 P.O. BoX 21199 PERMIT NO.: 9552
DATE: 1-30 17 Eagan, MN 55121 DATE: 1--30--87
No. of Units: 4- Plex Zoning: P3 _ . No. of Units: - 4°plex
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Cherges: -
Total:
Date Paid
I agne to comply wkh !he CRy of Eagan
of Insp.:
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Total:
Date Paid:
140.OOpd
This
18 rt
?/s/8 7
7o 'I8'?
J,o"'°"'O° CO?"•`O' `'p1"^bO1 I hereby requast ioauection of above
? Owner electricel work inatelled et:
Str t dd ess, Ba
'
Lj: r Rou Ukroso
?
n
C
it?
ecUOn o. Townshlp Name or No. Range No. Couliry
Oc p n t IP
I NTI -
46
o-ve Phone Nn.
Powe
? upplie Address
al Contractor ICompany Name) , Contr tor's Li e?se !,?
V
Mailing A ?ress ontra tor r wner ak? I s
i tailat' n)
Aut ori ed at e( ontr wner Ma fng nstall ion) Phone Number
a ?
MINNESdTA S ATE RO F E THIS INSPECTION REQUEST WILL NOT
Gripqs-MidwaY Bldp. - Room N.191 BE ACCEPTEO 6Y THE S7ATE BOARD
1821 Univsrsitv Ave.. St. Peul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642•0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
111' See inatructions for completirp thif }orm on baek of yellow coay.
? "X" Be/ow Work Covered by This Request
0 EB-00001-05
i"G S/?/
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
R6C61VffD ) FROM
AMOUNT ? I
DOLLAR$
Thank You
6Y
- - 5? ''i i..? `
4Vhite-Payers CopY ?
Yellow-Posting Copy Pink-File Copy '
BLDG. PERMIT ti0.
--•
?----
(?
-./ (
'/_•9
, .--?-?
01-321C? ` ' Bldg. Permit
01-3422 Plan Check ?
01-3445 Surch. /r',dm. _
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Con
20-3868 Water Trm
20-3716 Water Met
20-2252 Acct. Dep
20-3713 Water Per-mit
20-3743 Sewer Perm
79-3866 Sewer Con:
11-3855 Park Ded.
TOTAL
I
[] CASH [-] CHECK
This request void ,?S/g?
18 months from
C 73264 /.? - - , ? 21 ' 41?- ,,, ? Z-,??..L ??o
1
ReqGest Date Fire No. ± Rouph-in Inspection
qu red?
e
[-]Ready No"?:koill Notity. Inspec-
C `? Yes ? N. tor When Ready
45or-censed Electrical Contractor I hereby request inspection ol above
? Owner electrical work installad et:
Str
1 t Address, 6 o Route No. ?
? V C
ection o. Township Name or No. ange o. County
Owc?pant (PRIN
,l/o k , Phone No.
Pow¢r Suppli Address
Elec cal Contracmr ICompany Name) Con?Ior's Li ense
iling A dress ontra o or Ow r a' Insta' ation)
Autho iz b-d Si S'MVM r ( nTr r?1w?
?q er k 1 1 ?one Number ?
MINNESOTA STATE BOARD OF ELECTRICITY
Grippa-Midwey Bldp. - Room N-791
1821 Univsreitv Ave., St. Paul, MN 65104
Phone (812) 642-0800
THIS INSPECTION REQUEST WILI NOT
BE ACCEPTEO BY THE STATE BOARD
UNLESS PROPER INSPECTION fEE IS
ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION ? EB-00001-05
/ Il, See instructions for comDlstinp this form on back o1 vellow copy.
C =4 X" BeJow Work Covered by This Requesf
6J-J na -- T....t ..4 n..:u:..., e....U....- w:..d Eauwment Wired
Water
N r Fae ServiceEntrsnceSize d Fae Feeders/Subfeeders N Fee Circuits
Uto200Am s 0 to30Am s Tt?3QAm
Above 200 qmpy 31 to 100 Amps 31 to 100 Affvs
Swimming Pool Above 100-Am s Above 100_Am s
Transformers Irrigation Booms Partial. Oth
Xfm
Signs Special inspection S
TOTAL F*/"r/Qi'
e?Y?H r k5 L? '?
FOR SALE T.H. CITY OF EAGAN ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN SS,2, N- 13016
-
' BUILDING PERMIT PHONE: 454-8100 Receipt#
To be used tor 1 OF 4 PLEX Est. Value $64,000 oate DECEMBER 29 19 6
1614B CLEMSON DR R3
SiteAddress Erect ? Occupancy PD
Lot 7 Block 1 Sec/Sub. TRAILS OF Remodel ? Zoning
Parcel No. THOMAS LAKE Repair ? 7ype ot Const V
Addition ? No.5lories 44
a Name NEW HORIZON HOMES Move ? Length
z P.O. BOX 1?367 Demolish ? Depth 27
a Address Intlmpr. ? Sq.Ft
c;tY MPLS phone 420-3900 i„stali ?
. o APProvals Fees
=
U U
<
?
U?
W W
f Z
U?
aw
a
Name SAME 534-7388 (MARTY)
Address ?ager # Assessment_
City Phone Wat6r & SeW.
Police -
nlame D_ R_ CRISWOLD Fire
nddress >> 975 PORTL.AND AVE GO Eng.
CiryR'V7T.I.F.phone $94-6287 Planner-
Council
Permit +' ?•""
Surcharge 32 • 00
Plan Review 162.50
SAC 575.00
Water Conn.500-00
Water Meter63,50
Road Unit 290.00
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off.1Z/29/8 Tr.PI. 156_00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and Ciry of Eagan Ordina es. APC Pafks
Var. Date Copies $
Signature ot PermitteeTo?l 2? 104 . 00
.141
A Building Permit is issued to: NEW HORI ZON HOMES on the express condition that
all work shall be done in accordance with all applica tate ot Min tes and Cily of Eagan Ordinances.
Building Ofticial
FOR SALE T.H. CITY OF EAGAN A' 13017
• 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?v ? ' PHONE: 454-8100 ?
BUILDING PERMIT Receipt#
7obeusedfor 1 OF 4 PLEX Est.vaIue $64,000 oate DECEMBER 29 ?$6
SiteAddress 1614 CLEMSON DR Erect 2f R3
lot 8 Block 1 Sec/Sub. TRAILS OF Remodel ? Zoning Occupancy PD
Parcel No. THOMAS LAKE Repair ? Type of Const. V
Addition ? No.Stories
s Name NEW HORIZON HOMES Move ? Len9th 44
3 ndaress P- O. BOX 1367 Demolish ? Depth 2 7
° ci MPLS 420-3900 Int.lmpr. ? Sq.Ft.
City Phone Install El
i o Name S?pR Approv:
$ ¢ Address ASSeSSment _
? City Phone Water R Sew.
FW Name D.R. GRISWOLD
xj5 Address 11975 PORTLAND AVE SO
iw Ciry B'VILLPPhone $94-6287
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 ?agan Ordinaycgs.
Signature oi
A Building Permit is issued to: NEW HORIZON HOMES
all work shall 6e done in accordance with all applicable State of M
Building Official w
Police -
Fire
Eng.
Planner-
Council-
Bldg. Off. 12,
APC
Permit y
Surcharge 32.0C
Plan Review 162.5(
SnC 575.0(
Water Conn. 500.0(
WaterMeter 63.5(
RoadUnit 290.0(
rc Pi. 156.0(
Var. Date Copies
Total $2.104.0(
on the express condition that
City of Eagan Ordinances.
FOR SALE T.H. CITY OF EAGAN A, - ?
3830 Pilot Knob Road PO Bo 21 199 Ea MN 55121 I v 13015
. I , . . x , gan,
PHONE: 454-8100 S
BUiLDING PERMIT Receipip
7obeusedlo. 1 OF 4 PLEX EstValue $64,000 pefe DECEMBER 29 ?y 6
SiteAddress 1612B CLEMSON DR E t IN p R3
Lot 6 elock 1 Sec/sub. TRAILS OF
Parcel No. THOMAS LAKE
Name NEW HORIZON HOMES
ndd.ess P• O. BOX 1367
Ciry MPLS phone 420-3900
o IName SAME 534-7388 (MARTY)
PAGER
$ a Address
? City Phone
twW Name D.R. GRISWOLD
-1
Address 11975 PORTLAND AVE SO
U
aw piry B'VILL$hone 894-6287
I hereby acknowledge that I have read this application and state that the
intormation is correct and agree to comply with all applicable State of
Minnesota Statutes and Ciry of E gan rdinanc s.
Signature of Permittee ?E???_ ??i ?
NEW HORIZON HOMES
rec ccupancy
Remodel ? Zoning pn
Repair ? Type of Const V
Addition ? No. Stories
Move ? Length 44
Demolish ? Depth 27
Int. Impr. ? Sq. Ft
Install ?
Assessment
water & Sew.
Police
Fire _
Planner
Council
BIdg.Off. 12 29 8
APC
Var. Date
Permit $ 325:00
Surcharge 32.00
Plan Review 162.50
SAC 575.00
Water Conn. 500.00
Water Meter 63. 50
Road Unit 290.00
Tr. PI. 156.00
Copies
r,,,,, 2,104.00
A Building Permit is issuetl to: on the express condition ihat
all work shall be done in accordance with all applicable St of Minnes?tutes and Ciry o( Eagan Ordinances.
Building OHicial i. T? _
FOR SALE T.A. CITY OF EAGAN
Np
13014
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, M N 5512,
-
+ PHONE: 454-8100
BUILDING PERMIT Receipt p
Tobeusedtor 1 OF 4 PLEX Est.Value $64,000 Date DECEMBER 29 ?y 86
Site Address 1612 CLEMSON DR Erect :n occupancy R3
Lot 5 Block 1 Sec/Sub. TRAILS OF Remodel ? Zoninq Pn
Parcel No. THOMAS LAKE Repair ? Type of Const. V
Addition ? No. Stories
a NEW HORIZON HOMES Move ?
Name Length 4
i Demolish ?
Address P• O. BOX 1367 I
I
? Depth 97
Ft
S
o nt.
mpr.
City MPLS Phone 420-3900 mstau ? .
q.
- SAME 534-7388 (MARTY) APProvals Feas
=U
?
Name
Address- PdqeT # qssessment
Phone
?W Name D.R. GRISWOLD
Address 11975 PORTLAND AVE SO
a W Ciry B' VILLEPhone 894-6287
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 Ciry of agan Ordinances.
Signalure of Permittee C?
A Building Permit is issued to: NEW HOR ZON HOMEy?
all work shall be done in accordance with all applicabtelState of M' nesc
Building Official
Water & Sew.
Police
Fire
Planner
Council
Bldg.On. 12/29/8
Var.
Permit $ 325.00
Surcharge 32.00
Plan Review 162.50
SAC 575.00
Water Conn. 5 0 0. 0 0
Water Meter 63.50
Road Unit 290.00
Tr. PI. 156.00
Copies??'?.1V4 UQ
Total
on the express condition that
and City oi Eagan Ordinances.
}--
Requ s[ Da e Fire N. ough-In Inspedion ReQUV
call ins
ector when reatl
)
V Inspec0on O[her T?an ugh-In
Now Will Nolify Inspector
? Read
? ? y
p
(
ou m? y
Yes ? No Date Reatly
I? licensetl conirector q<owner hereby request inspection of above efectrical work at:
r ?ioute No.J
Job A
(Sh et, e Ciry
??
?
l
i SUP41 /y
Seclion No. Township Name or No, pange No. County
Occu t(PRINTJ Phone No.
rr 1 om
Power Supplier Atltlress
Elect'cal ?ntractoe (Gompany Naree? ConUactor's License No_
/Ve D w
Mailing Ad ss (Convactor or Owner Making Installation)
vel
Author' d SlgnaWre [rdctor/Owner Meldqg Ustallation) Phona Number
`A cl `l ?
Z
-,
MINNESOTA STATE BOARO O?EiECTflICITP`i THIS INSPEGTION REpUEST WILL NOT
GrIgg4-Mitlway 61dg. " Room 5-128
1
11
M BE ACCEPTEO BV 7HE STATE BOARD
1821 Unlversity Ave., S[. Paul, MN 55104
ow ......
.
I UNLE55 PFOPER INSPECTION FEE IS
LN('I (1CFfl
REGIUEST FOR ELECTRICAL INSPECTIUIv ?'%t ee-ooaoi-os
01? See Insrcuctions for campleling Ihis form on back ol yellaw nupy i ? /?igi?!/
? n
I?e?e1? "X" Below Work Covered by This Request "??
New Ad Rep. Type of Building AppGances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Builtling Dryer Load Management
Comm./Indushial Furnace Other (Specify)
Farm Air Cond+tioner
Other(speciiy) Conlraotors fiemij5m - rils
Compute Inspectron Fee Belaw.
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
9wimming Pool 0 m 200 Amps G to 100 Amps
Transformers Above 200 Amps ove 10 Amps
Signs insPeomrs usP (Drq: ' TOT/
!L
?
Irrigation Booms /
)
T
v
Special Inspection
Alarm/Communication THIS INSTAILATION E O RFD PISCONNECTED IF PiOT
Other Fee COMPLETED WITHI
I, the ElecUical Inspector, hereby
tif
th
t th
i
b Roc9ny?
cer
y
a
e a
ove
nspection has been made. Final
OFFICE USE ONLY
This request voitl 18 months from
This reques[ vald _?/:5
18 moaths Irom f
J ?? .
? 73265z, ;,?, ?•i?er v ?6a.?-no/i1.-lbi.??
HeQ} I?est Uale Fire No, ,
?. ?HOUp?-in InspecUon
equ1
'
?ReatlY No?Vill Notity Inpec-
I ; ?
es
No [or When Readv
--MLicensed Ele[vical Contrector 1 hereby m0uest inspaclion oi ebove
? Owner electrical work instalied at:
Street Adtlress, Boa or Route No. Ci
eMmn o. Town ip Name or o. Hange Na, Counly
Oc upam IPflINTI ,/' .
! I
// Le Phone No.
Po Sup01i r
? Address
EI ct! Contractor ICompany Namel
?? _ T Cnn actor's L ens N //i ?j
? l?
Mailing AtlJregs fC tr acto or O ne, Ma -in iailati nI
U
Aut orized S? va ?yner a i
\?f ?s P?one Number ?°-
`J
MlNNESOTA 5T4TE BOAflD OF ELECTPICIiY
Crigga-Midway e1de. - paom N.191
1821 UniveraitV Ave.. 5t. Paul, MN 56104
Phone (612) 642-0800
THIS INSPECTION REQUEST WIIL NOT
BE ACGEP7E0 9Y iHE STATE 6ppRD
UNLE55 PROPER INSPECTION fEE IS
ENCLOSEO.
;Z/S/S 7 REQUESi FOR EtEC7RfCAL INSPECTION ryEs-o(o?oopi-o)s
- ' See instmetions br Completieq this torm on beck oi yellow copy.
r, 5 "X'" Below Work Covered by 7hrs Request
Rdd H.P. Type ol Building Appliancee Wirea Equipment Wired
Home Ranye Temporary Service
F.plex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Pumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Othe. peci v ihoe ISnacitvI
I P,! S(ICGI Y OfM1C! DIhmr
M Fee ServiceEntrance5ize p Fee Fenders/SUbieeders p Fee Circuits
0 to 200 qm s 0 to 30 Am s 0 tn 30 Am s
Above 200 qmps, 31 to 100 qinps 31 to 100 A s
SwirtNningPool Above iD0-AmPS Above 100?Am s
Transformers Irrigation Booms Partial-"Other Fee
Signs Special InspeCtion
' --?
emarks 4 8 TOTAL FE?/
Rough-in Date V?
I, tha Elecvical
//? ( Inspecloq hgrab
r, y
Final
r?° cartiiythetthaabova
lnapection has heen
f inede.
41? City of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2008 RESIDENTIAL PLUMBING
---------,
?
For OHice Use ?'+ I
I Permil#:
-,
?
? Permil Fee:
D
R
i
d
ate
ece
ve
:
I ?
? Stafi:
RMIT APPLICATION
Date: . ? U (] Site Address: 1 L? I q l_ -l.C
7enant: Sufte#:
RESIDENT / OWNER Name: ? V 1 l LUI PhonJQ? j -Q-
0
Address / City / Zip: llmm JT-
CONTRACTOR Name: 4 ,?? lfo nse#: [p u M
Address:
?
City: SlaleA4)? . Zip:a l -
Phone.-?)UIL+tC-l Contact Person?-
TYPE OF WORK _ New )OReplacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Descri tion o1 work:
PERMIT TYPE RESIDENTIAL
_ Water Heater , '?CWater Soflener
- Lawn Irrigalion Add Plumbing Fixtures
(_ FPZ /_ PVB) (__ Main _ Lower Level)
Seplic System _ Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Hea?er, Water Softener, or Nlater Heaier and Softaner (includes $.SG 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 7urnaround (add $136.00 it a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes Counly fee and $.50 Slale Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
i nereoy acKnowieoge Inat Irns imormallon is complete antl accurate; that the work will be in confonnance with Ihe ordinances and codes of ihe City o1
Eagan; that I undersland lhis is nol a permil, bui only an application for a permil, and work is not to starl withoul a permil; Ihal the work will be in
accord nce with Ihe a ove/\plan in ihe case of work which requires a review and approval la
l
X
X
?
Applicant's Printed Name Ap cant's Signature ? MAR 1 2 2008
FOR OFFICE USE
Revlewed By:
Date:
Required Inspectlons: _Under Ground _ROUgh-In _Air Test _Gas Test
? vCi 2007 RESIDENTIAI, BLIILDING PERMiT APPLICATION
City Of Eagao
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651fi75-5675 FAX # 651-675-5694
Nea Cofsaudn Resmmraft .
3 reg'alened sksurveys showirg s4 R of bL s9. ftof houM mM al raofed ms
(20%mazimum M camFsge a0awed)
i Sob Repmt'rfpraposed 6in"Mhg is robe qaced on asWr6ea sod
2 apies of plan showng heam 6 weidow sizes; Ppued famd design. ek.
1 sd dEnergy CaRpdetians
3 mpie.g ot Tree Preseria6an Plan if bt Platted aReri/1183
Rim Jast Datml Optlons seiection sheet (buklngs with 3 w Icgs uniLS)
hSnnegexo mechenical vanWation fwm
RenoddlRwav Remeremeds
2 mM of Plen alwwia9 footio9s• besms,jasls
1 $e[ of EaM Calale6m for haefed adfAm
1 steswvay for additians & dodcs
Ad6Ear - 6dCafe r/ on-gle sqft aysfern
? 34c. Z6
Ofice Use Onlv
Certof5uroeyRecd - _Y _N
Soils Repat _Y _N
Trea Pres Plan Reod _Y _ H;
ireePrasRequired _Y _N
On-&'teSe* Syslem . -Y _N
Pians are considered pubGc information unless vou state thev are trade secret and the reason.
tf
Date _L /(? ?l _O? q
Constroction Cost v' Q, d 0 tl'---
SiteAddress /-L/.f' Unit/Ste #
G?en.. .J 1
Description af Work 1!? Rb o ?/ ? v?'? l l??]?F L: ?
MeHi-Family Bldg k?-'Y _ N Firepiace(s) _ 0_ 1 _ 2
Properly Owner o n. cA L<!C c Telep6one #((e. J!) L 4 S- ?? O U
Contractor /i?/ ,
-
Address . ? . rj)( ? cih' ?GCr7lISL1 _'__r?e
State Zip ?7:3:7 Telephone # (994 7 3? ?/? d
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NE1fB BUILDING
- Minnesota Rulgs 7674 Cateeorv t Minnesota Avles 7672
Enel'gy COde C8t2gory . Residentlal VenUiation Cafegory 1 Worksheet • New Enetgy Code Wo[ksheet
(d submission type) Submitted Stifirrdtted
• Energy Envelope Calculadons SubmiUed
In the lasi 12 months, has the Ci1y of Eagan issued a permit for a similar plan based on a masfer plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Conhactor
Sewer/Water Conhactor
Telephone #(
Tetephone # (
Telephone # (
for a Residential Building Permit and acknowledge that the information is complete
,
that the work wiil be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to sM without a
permit; that the wark will be in accordance with the approved plan in the case of work which requires a review and
approval ofplans.
?} G'?"uar l?s?trsJ !/.?e,J .T,sC_
S7 P .. r[ 'Es- Lr? °L
ApplicanYs Printed Name 0.2 y pplicanYs 5ignature
PLUMBING (RESIDENTIAI.)
J a Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when pemuts are required for each unit
DateA-/615/ 6
I
Site Address
i0 l ? Unit #
Pro
ert
Owner ?T`C/ ?"? ??1 f
Tele
hone #(6v) 053'-
w]2
p
y p -
ContracYor
3670 DODD ROAD
address city
(651) ,365 1340
ZiP
State Telephone # ( )
The Applicant is _ Owner
Contractor _ Other
Y
5eptic System New _ Refurbished Submit 2 sefs of plans and MPC license . $ 100.00
Includes County fee. Additional consultant fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fiMures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.00)
Other,
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener x Water heater $ 15.00
replacement _ additional
$ ?
State Surchar
ge f ?r-
r jS--
T°tal DEC 3; 2003 $
I hereby apply for a Residenrial Plumbing Perxnit and aclmowledge that the ' ormahon is complete and ccurate; that the worx wm
be in conformance with the ordinances and codes of the Ciry of Eagan and the Plwnbing Codes; t t I understand this is not a
permit, but only an application for a permit, and work is not to start without a peri ; ork' be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
?SD I?P (6,4 0-2 b -
Applicant's Printed Name Applicant's Signature
COMMERCIAL
2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4675
qci. a?
Foundation Onl New Construction Interior Im rovement
. SWctural Plans (2) sets • Architectural Plans (2) sets • Arohitectural Plans (2) sets
• Civil Plans (2) • SWdu21 Plans (2) • CodeAnalysis (1) "
• Certlfipte of Survey (1) • Clvll Plans (2) • Project Specs (1)
• Code Malysis (1) " . Landspping Plans (2) • Key Plan (1)
• ProJeclSpecs (1) • CodeAnalysis (1)" • Master Exit Plan (1)
• Spec. Insp. & Testlng Schedule " • Certificate of Survey (i) • Energy Calculations (1) not always"
• Solls Repart (1) . Spec. Insp. & Testing Schedule (i) " • Elec. Power & Lighting Fortn (1) not always"
• Meter size must be established . Meter size must be established • Meter size must be established - if applicable
• Project5pecs (1)
1 • EnergyCalculations (1) "• d
! • Electric Power & Lighting Form (7)
1 • Master Exit Plan (i) 1
1 • Emergency Response Site Plan (7)
1 • SoilsRepoR (1) 1
• MCIES SAC detertnination letter • MC/E5 SAC determination IeKer • MClES SAC determination letter
call 657-602-1000 ca11 651-6 02-1 000 ca11651-602-1000
Food & beverage or lodging facilities - submit plan W MN Department of Health. Call 651-215-0700 for detafls.
Contact Building Inspections for sample.
Permit for new buildings or addltions will not be processed without Emergency Response Site Plan. Ask Building Inspections for requirements.
DATE: ?S ??R_ NEW _ REMODEL CONSTRI?TION COST: ? V
SITE ADDRESS:
TENANT NAME:
c
SUITE #:
FORMER TENANT NAME. IF APPLICABLE-
DESCRIPTION OF WOF
PROPERTY
OWNER
Name:
Ciry: ft'l? State:
Conipany: ? (A V
CONTRACTOR
Sheet Address:
ciry:
ARCHITECT/
ENGINEER Company:
Name:
Street Address:
City:
Licensed plumber Instaliing new sewerlwater
SYate: Zip: ( c)
Phone #: L_
Registra6on #:
State:
Phone #: (
I hereby acknowledge that I have read this application, state that the information is corred, and agree to compl t II applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
Updated 7/02
Zip:
Phone#: (_(6--1 ) _?)VJ `14Up
75865 THE TRAILS OF THOMAS LAKE
CLEMSON CIRCLE
4300/ 10 75865 24002 (4-PLEX)
4300B/ 230 02
4301/ 210 02
4301B 220 02
4302/ 10 75865 250 02 (4-PLEX)
4302B/ 260 02
4304/ 280 02
4304B 270 02
4303/ 10 75865 200 02 (4-PLEX)
4303B/ 190 02
4305/ 170 02
4305B 180 02
4306/ 10 75865 290 02 (4-PLEX)
4306B/ 300 02
4308/ 320 02
4308B 310 02
4307/ 10 75865 160 02 (4-PLEX)
4307B/ 150 02
4309/ 130 02
4309B 140 02
4310/ 10 75865 330 02 (4-PLEX)
4310B/ 340 02
4312/ 360 02
4312B 350 02
4311/ 10 75865 120 02 (4-PLEX)
4311B/ I 10 02
4313/ 090 02
4313B 100 02
4314/ 10 75865 370 02 (4-PLEX)
4314B/ 380 02
-4316/ -
400 02
? 4316B
- 390 02
--
4415/ 10 75865 080 02 (4-PLEX)
4315B/ 07002
4317/ 05002
4317B 060 02
4318/ 10 75865 410 02 (1/2 OF 4-PLEX - OTHER 1/2 IS 1613/13B CLEMSON DR.)
4318B 10 75865 420 02
4319 10 75865 040 02 (1/2 OF 4-PLEX - OTHER 1/2 IS 1617/17B CLEMSON DR.)
3
??-
1986 BIIILDII?G PBAMLT iPPLICATIOH - CITY OF S9G9N
BiORE: 9TJ. COHTRACYOSS MQST BE LICENSED {iITH THE CITY OF EAGAN
SIAGLE F9MIILY DitELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATE5 OF SURVEY, 1 SET OF ENERGY CALCULATION
MOLTIPLfi DiiELLIRGS - HFSIDENTIAL RENTAL U?iITS FOR SALS OAITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SORBEY - CHECB iiITH HLDG. DEPT.,
1 SET OF BNERGY CALCULATIONS
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTIIRAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
EI3ERGY CALCULATIO145,
$2,000 LANDSCAPE HOND
uN I r 'i9 64,CC)0
To Be Used For: ? Valuation: Date: ???? 1Slo
Site Address AJ?
Lot '?' Block g?Ll
PareellSuh
Owner
,
Address
City/Zip Code
Phone
Contractor EUY Riznu 1"hM
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone S
Erect
Remodel
Repalr
Addition
Move
Demolish
Int.Impr.
Install
Occupaney
Zoning
Type of Const
# of Stories
Length
Depth
Sq Ft
APPROV9IS FEES
Assessments Permit
Watec/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off Treatment P1
APC Parks
Pariance Copies
TOTI[.
NOTE: ADDRESSSS FOR CORNER LOTS - CONTRACTOR/HOIiEOHNEH Mi15T DESIGA9Tfi pHICH ADDRESS
IS DSSIRED. NO CH9PGSS WILL BS ALLOWED OHCE BQILDING PERMIT IS ISSQSD.
1986 BDILDIPG PSRIffT APPLICATIOH - CITY OF EAGA9
NOTS: ALL COPTRACTORS M[TST BE LICENSED NITH THS CITY OF EAGAN
SIBGLE FAMIII.Y Di1EI.LIAGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 7 SET OF ENERGY CALCULATIONS,
HUI,TIPLS DWELLINGS - HESIDIIi'PIAL RENT6L UNITS FOH SALE IINITS V
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SUROEY - CHECg fiITH BLDG. DSPT.,
7 SET OF SNERGY CALCULATIONS
COMIllERC7At;
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF $PECIFICATIONS AND 7 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
C..f N 1 T- .1c) (?24 j ODO
To Be Used For: + Valuation: ?????
6c..er?sou
Site Address ??? Ag pfz. OFFICE II?
Lot 41? Block 'Y? I ? Ereet _
Pareel/Sub
Owner ?
Address
Remodel _
Repair _
Addition _
Move _
Demolish _
Int.impr. _
Install _
CitylZip Code
Phone l ?iZ2 ?-,,aj?G?j
Contractor IVEW ?50 7.nN OMF
Address Z? ?d_?Z
City/Zip Code
Phone
Arch.fEngr. ,
Address ??
APPROVAL3
Date: ?e?i?iJ?LO
Occupaney
Zoning
Type of Const
# of Stories
Length
Depth
Sq Ft
Assessments Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off Treatment P1
APC Parks
Variance Copies
TOTAI.
City/Zip Code
Phone #
NOTE: ADDRfiSSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNEH MQST DESIGNATE AHICH ADDRESS
IS DfiSIRSD. NO CHANGES WILL BS ALLOHSD ONCE BOILDZNG PERMI3 IS ISSIIED.
1986 BUILDING PBAMIT APPLICATIOH - CITY OF SAGAN
NOTE: ALL CONTRACTOBS MUST BE LICENSSD {TITH THE CITY OF EAG9N
SINGLS F9MILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLE DW6LLIHGS - HESIDENRI9L RENTAL DNIYS FOR S9LS DNITS ;
ZNCLUDE 2 SETS OF PLANS, CERTIFICATS OF SOR9EY - CHECg flITH BLDG. DBPT.,
1 SET OF ENERGY CALCULATIONS
CONAIERCIer:
INCLUDE 2 SETS OF ARCHITECTURAL
1 SET OF SPECIFICATIONS AND 1
ENERGY CALCULATIONS,
$2,000 LANDSCAPE HOND
I I
& STRUCTURAL PLANS,
SET OF
.
To Be Used For: ? Valuation:
S3te Address /16pAy6C.EM5o" DP_,
Lot ? Block ?1 ?
Parcel/Sub
Owner
Address,??/?,?a?'
City/Zip Code
Phone
Contraetor NEW ('(0 lanht ?MES
Address '?
City/Zip Code
Phone
Arch./Engr. Address
City/Zip COde,?/s????? ? .,
Phone ? ???
? Date:
Erect
Remodel
Repalr
Addition
Move
DemoLish
Int.Impr.
Install
Occupancy
Zoning
Type of Const
U of Stories
Length
Depth
Sq Ft
APPROVAIS FEFS
Assessments Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg OfF Treatment P1
APC Parks
Varianee Copies
'IO'PAI.
NOTE: ADDaESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNE9 MIIST DESIGN9TE WHICB ADDRBSS
IS DESIRfiD. NO CHAAGES iIILL BE ALLOWED ONCE BQILDING PERMIT IS ISSIIED.
1986 BDILDING PERMIT APPLICARZON - CITY OF EAGAN
NOTS: ALL COHTRACIORS M[JST B6 LICENSED HITH THB CITY OF EAGAH
SINGLE F6FIII,Y DWELLIAGS
INCLUDE 2 SETS OE PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MULTIPI,S DHEI,LINGS - RESIDENTIAG RENTAL T)NITS FOR SALfi UNITS ?
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRVEY - CHECg WITH BLDG. DSPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
t SET OF SPECIFICATIONS AND 1
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BON?
UutT `H
& STRUCTURAL PLANS,
SET OF
To Be Used For: 9?51E,.v7/RL Valuation:
/ CC,Et?X:u
Site Address ?(p?y ,B tJR.
Lot J, Block 40-? ?
Pareel/Sub
Owner
Address ??/edt?6 ??? ?
City/Zip Code _
Phone y?0- -;F91Jp
Contractor -NFyy NORi7nN f'bOMtEc
Address /16;;;7
City/Zip Code
Phone 7?O -
Areh./Engr.
Address
City/Zip Code
Phone 4
64,cz?o
-(?- Date:
Ereet
Remodel
Repair
Addition
Move
Demolish
Int.Impr.
Install
Oecupancy
Zoning
Type of Const
q of Stories
Length
Depth
Sq Ft
aPpaovAC.s FEES
Assessments Permit
Water/Sewer Sureharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Couneil Road Unit
Bldg Off Treatment P1
APC Parks
Variance Copies
1Y)TA[.
NOTE: 6DDRSSSES FOR CORNER LOTS - CONTAACTOR/HOHEOfINER MIIST DESIGNATS WHICH ADDRBSS
IS DESIRED. NO CHANGES SiILL BS ALLO?lED OHCE BOILDING PERMIT IS ISSIIED.
L'
•? Ff?,?,^'.'r?ys_ j"?,,,,r10.$?1rqi?'?_ ?A""?? ??
?.,..
"HEATLOSSCALCULATIONS HEATING&AIR CONDITIONING CO.
fV c?t? 2c?,?5?
MINNEAPOLIS. MINN.
Weatherstrips A.S.H.V.E. Canslruction No. Insulation
NTindows Doors Guide ReTerence Out. Wal1 Int. Wall Ceiling Root Flovr Kind How Applied
Ves-No Yes-Na 79 +
FI.?^?Ylui?(?? ,_pfloom Leng[h 7, 2, Width Height FI. (`(,fl??}-?(? Q?tr) Roan Length ??/,c -W:9N+ Heighl
YJi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea
ryo Witlth
of anv He?pht
ot Dane No. of
li his lineal tL
of creck A?aa
sp. fl.
N?' W,d?p
of ane Ha.qhl
ana
of Nn. ol
h hts L'oeal 0.
af crack ?1rea
sa. fl•
2. ? y
I'•'t 1 1 2- 1 (
.?lP Z 1-7
? ? OF. ?y
' 'l
Coef 8tu Coef Btu
In(iltretipn I --? 3 Inliltration
Giess cies5 S
Exp.wall 1 Exp.wall ?o :K °i.
Netexp.wall 9.1 9` Netexp.wall Ir? `?-? ??(f
y'fifwdFh 4U+" 1 u it'r 22,2 Int. well
Ceiling Ceiling ?.'.?(p 1?5 1?
Floor Floor
7ota1 Btu. 7 5'1 Total Btu.
Raquired sq. ft. E.D.R. or sq, ins. W.A. Leader area Required sq. It. E.D.R. or sq. ins. W.A. Leader area
FL Room Length I.?j Width Height ":? FI. ?•?.? ..?"?.»pkf?ctom Length I 5 Width I?J Heiyht %"'
?, ..
Wi ndows a nd Doors- Cracka ge and Ar ea Wi ndows a nd Doors- Cracka ge and Ar ea
No. Widm
of ane Heiqh[
of ane No* of
li hlg lmeai It.
of crack Area
'+4. 1t.
No' y????h
of ana HoiqM
?? ane No. ul
?? hts Linea? tl.
of c?acM Aree
so. f?.
,
2? t 2 ? 1 ,_.
Coef Btu Coef Btu
Infiltr3tion ? l Z?qa Infiltration
ciass ??I cit 5C) Glass 1 ) .?.?.)
Exp. wal I Exp. wall 12- 7+ T.
Netexp.wall Netexp.wall J ? '-??? 3?<
Int, wall Int. wall
Ceiling 2 ,5 CeilinQ l?t.? .:?•`,1 ??S
Floar Floor E?-? /1 ?'f O ?)
Total 8tu. S3 Tutal Btu. 3??}
Required sq. ft E.D.H. or sq. ins. W.A. Leader area Required sq. ft. E.D.R, or sq. ins. W.A. Leader area
l FI. `,,'.T -y c i Room length ??!. Witlth Height Room Length ?('Width •?? Heigbt "A
Windows and Doors-Crackage and Area Wi ndows a nd Doors -Cracka ge and Ar ea
N?' Witlrn
of ane Heiqht
of pane No. ul
hiihas Lineal h.
ol ttack A:ea
594.
NO' Nvnni
of ane H. pi?l
ut anx Nn. ol
h his Uneal R.
of cfack Area
aV. tt•
Coe! Btu Coef 8tu
4ntiltration Inliltrntion
Glass Glass
Exp. wall Exp. wall
Ne[ exp. wall Net enp. wall
int, wall Int, wnll
Ceilin9 I.?' ).`-i 2 t? Ceiling
?
Ploor "_.Flnor
Tutal Btu. Tota1 8tu.
RequireJ sq. ft. E.D.F. or sy. ins. W,A. Leader area t Q Rvqoired sq. ft. E.D.R. or sq. ins. W.A. Leader area
?HEAT LOSS CALCULATIONS 56s Se4o&4 MINNEAPOLIS, MINN.
HEATING&AIR CONDITIONING CO.
Weather5trips A.S.H.V.E. Construction No. In6ulation
Windows Doors Guide
Reference Out. Wall Int. Wall Ceiling Roof Floor Kird HowApplied
Ves-No Yes-No 19
^
.
Room Length `C) Width Height F1, Roqn Langth Width Height
VJi ndnws a nd Doors- Cracka ge and Ar ea Windows a nd Doors- Cracka ge and Are a _
ryo W?A,h
ol ane HeipM1t
ol Dane No. 0f
1i hls Lineal 11.
of crack Aien
sq. it.
NO' Wid,h
ol ane NmpM1l
ol ane Nn. o1
li hts Lineal It.
of crack Area
s9• ???
2
CoeT Btu Coet Btu
Infiltreti0n 7(p(] Infikration
Glass ( '-"?ry ?`fJ Glass
Exp. wall Exp, wall
Net exp. wall ( 2? Net exp. wall
- Int. wall Int. well
Ceiling - Ceiling
Floor Floor
Total 8tu. 3?, Total Btu.
Required sq. it. E.D.R. or sa, ins. W.A. Leader erea R9quired sq. ft. E.D.R. or sq. ins. W.A. leader area
? FI. Width 11 Height FI. Room Length Width Haiyht
Nlindows and Doors-Crackage and Area Wi ndows a nd Doors- Cracka ge and Ar ea
No. Witlth
ol dne Haipht
o} ane No, of
li h[9 Lmeel fl.
of crack 4rea
s4. Ot.
N°' WiNh
ol ane Ha"qM
nl ana No. of
b hls lmaal iL
ol crack Area
sO. I1.
r 9 ?t
Coef Btu Coef Btu
Infiltretion 2223 Infiltration
Glass QQ(? Glass
Exp, wall Exp. wall
Net axp. w II ?.?2 41.1 11 Net exp. wall
IdL.wall ( Z -7U .2.2 Int. wnll
Ceiling Ceilinp
Floor 'l_?J? I? 42 •5 ? j Floor
Total B[u. To[al Btw
Required sq. tt. E.D.H. or sq. ins. W.A. Leader are. Required sq. It. E.D.R. or sq. ins. W.A. Leader area
FI.R i.?,2,f .,r RgOoom Length 13 Width -f Height FI. Aoom Length Width Height
YJindows a nd Doors-Crackage and Area W indows a nd Doors -Cracka ge and Ar ea
NO' yyidrn
al ana Helqht
or owne No. 01
li hn Lmeal f[.
ol creck Area
sa. h.
NO' W.q?n
oh xne ryaGhl
ui pxne No, nl
li nls l?neal fl.
of crack Area
eq. fl.
Coef Btu Cae( Btv
Infiltration Infiltration
Glass Glass
Exp. wall Exp. wall •
Ne7 exp. wall 7?11b Net exp. wall
'
Int. wall Int. wall
Caifng C.eiling
---
Floor -rio(N ----
Tutal Btu. Total Btu.
AequireJ sq, ft. E.D.R. or sq. ins. W.A. Leadnr area Rtiquired sq. It. E.D.R. or sq. ins. W.A. Leader area
? CITY OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE:
Eagan, Minnesota 55122-1897 Permit Numher:
(612) 681-4675 Datelssued:
SITE ADDRESS:
1610. CLI=MSOIV DR
IQT: 8 BLOCK: 1
7iik. Tf2RIL5 UF 'i"I10MRS LAKE
P.2.N.: 10-75865-080-01
DESCRIPTION:
Type BASEMENT FINTSH
9Ulkdlhg Oerk Type flLTERA7TON
&? ?ry
. . .. - .... ?
+ §a
cit r??
?•-
?f
Orzo 444 ll
io/'?s/?P5
BUTLDTN6
026610
10(24Ja5
c
'xr g
-.,
REMARKS:
A SEPFlftATE PERMT7 la F?ERUSFtGD FOR ANY PI_UMB,IfdG tJR EL.E[:TF2,ICAL WORK'
FEE SUMMARY:
Bese Fee $35.00
Surcharge
Tota1 Fee $35.50
CONTRACTOR: OWNER: - Appricant -
SNxFFTM MURIEL
1614 CLEMSQN QR
EA(iAN MN 55122
(612)452-4975
I horeby aolxn-dwledge thet -T have °rojmd this tnal?, The
'infQrrtr6tko-i1 Is correct an-d agY.0e tca ?ar'ply with a1l' '$:tste of.?n,.
<. ,
`StatutgsandCity afi.Eat?an Qrcfanaarces.«'_
_ . _. .. _. , =
APPLICANUPERMITEE SIGNA RE ISSUED B SI ? RF I-
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B U I L D I N G
3830 Pilot Knob Road Permit Number. 026610
Eagan, Minnesota 55122-1897 Date Issued: 10 / 2 4/ 9 5
(612) 681-4675
SITE ADDRESS: ' LOr: g B L 0 C K: 1 APPLICANT:
1614 CLEMSON DR SNIFFIN MURIGL
THE TRAILS OF THOMAS LAKE (612) 452-4975
PERMIT SUBTYPE: TYPE OF WORK:
BFtSEMENT FINISH ALTERRTION
INSPECTION
FRAMING „ •
INSUlA7I0N „
ROUGH IN PLBG FINAL
REMAftKS: A SEPARATE PEftMTl" IS FiEQUIRECI FOR ANY I'LUMBING OR ELECTRICAL WOKK
F . . .. . . .. . . _
L ?
. ?
r
. ,-
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPUCATION (RESIDENTIAL)
681-4675
New Censhur2ion Reouirements RemodeVReoair ReauiremeMs
? 3 regiatered atte wnays ? 2 copies of Plen
? 2 wpies of plans (Indude beam & window saeg; poured fid. design; etc.) ? 2 sRe surveys (exterior atlditions 8 decks)
* I ener9Y calc+latiom ? t energy calwlaGons for heatetl addttions PI Vwp
? 3 topka of tree preservation plen ff loi platted after 711l93
mquire d: _ Yes _ No Z C? ??.? roek
DATE: L1 c+ I 1- 4\ CONSTRUCTION COST:
DESCRIPTION OF WORK: I?{Aa Flfc (?ou
STREET ADDRESS: C l2 rn?-r?'"? ?d'i •
LOT ? BLOCK I_ SUBD./P.I.D. ?-tild
PROPERTY
owNea
CONTRACTOR
ARCHITECT!
ENGINEER
Name: S?; F?i'? ? u2ie1
w. y w? U+rh
i
Street Address? L?? h'?'? S? 1-1
r
Phone #: 'LS Z `4q7-? S
City: G5tate: 1?j Zip: '7 S 1 Z?-
Company: ?jPhone #:
Street Address:
City: State:
Company: LA +v19-
Name:
License M
Zip.
Phone #•
Registration #•
Street Address•
City:
Sewer & water licensed plumber:
change are requested once pertnit is issued.
I hereby aGmowiedge that I have read this application and state that
appGCable State of Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No
State:
Zip:
Penatty applies when address change and lot
is correCt and agree to comply with alt
?
? QCT i 7 1995 ;
I ?
CfTY USE ONLY
L ? BL I RECEIPT #: ?
SUBD. DATE:
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681 -4675
Please complete for: ? single iamily dweliings
? townhomes and condos when permits are required for each unit
FIXTURES
Shower
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot Tub/Spa
Water Heater
Floor Drain
Gas Piping Outlet ' minimum -1
Rough Openings
Water 5oftener
Private Disposai " Dakota Cty. lieense
(new and refurbished systems)
U.G. Sprinkler " home under wnst.
Alterations ' to exisUng
Water Turn Around
EACH ?Q TOTAL
3.00 x =
3.00 x =
3.00 x = 3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
1.50 x =
5.00 x =
50.00 =
3.00
20.00
20.00
STATE SURCHARGE
TOTAL
= a??
.50
s?
?-
SITE ADDRESS: ?? 1 'f CI e?C,-)'^ `J'c
OWNER NAME: q) l) 2; L? (Z Y1 ), CC-, n
INSTALLER
STREET ADDRESS:
CITY: 'FCASTATE: MY'\ ZIP: SS )72
PHONE #: ( ?c ) 1 ) ``}S
D ? 1. ,--------__
ST R10If1'f
PERMIT# "!'/ '! Ll RECEIPT DATE: ? A
KSIDEIVTIAL PLIJMBINfi PERMIT APPLICATION
crrY o? ?raALN
3$30 PILOT HNOB [{D
EAs,ax, M?v 55122
651-6e1-4675
Please complete for:
SITE ADDRESS:
OWNER NAMt: :
? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for inigation system
( b r c? aa,? E)
(f^?
INSTALLER NAME:
STREET ADDRES '
?
crrv:
Place a check mark next to the aermit work tvue
STATE: ZIP: ?3 l
New residential dwelling unit under construction and not owner/occupied $ 90.00
Add-on, modification or alteration to existinq dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• waterturnaround
v L??Y ???`? ?`
f
k
?
N
t
ure o
wor
:
y
a
•b ?
Septic Sys.em, re,dhefurbished - $ 225.00
• includes County & Consulting Inspector fees
. requires MPC license
State Surcharge $ 50
? r
TOtal •
Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I here6y acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City ot Eagan ordinances.
It is the applicanYs responsibility to notify the property owner that the Ciry of Eagan assumes no liability for any damaq s caused by the Ciry during its
normal operational and maintenance activities to the facilities constructed under this permit within ?t property/ " ht- - ay/easement.
SIGNATURE OF PERMITTEE
TELEPHONE #: ??/ 3 g,
?,s?:e,: CoDE)
TELEPHONE#: 9Sa" 0 8qS V93
(AREA CODE)
Updated 1101
,
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
P1CYJ'S': PA3dKENr OF kEE AT 7.IM pg
APPLICATTON DOES NOT CONST1=1
APPROVAL OF PERhIIT.
INSPncizotv oF sEWmt r,rro/ox vuXEE
?? T?.TATTONS WII.L NCYP BE SC}HMD-
tJLID UNfIL PERMIT HAS BEEN
APPRWID.
1) PROPERTY ADDRESS: IVJI "'-
LEGAL DESCRIPTION: E7j ? TL •-
, Lot B ock Subdivision or Tax Parcel ID
IF EXISTING SPRC'C.'1TJRE, DATE OF ORIGINAL BL'ILDING PERMIT ISSL'ANCE: . -'
i
PRF'.SEIVP ZANING/PROPOSID USE: (hbn Year)
Cl CObVERCIAL/RElAIL/OFFICE
r7 IAIDCSTRIAL
[D INSTITL'TIONAL/GpVE?fIMg,'D7T
? R-1 SINGLE FAMILY
? R-2 DUPI,FJ{ (7top 0nits)
? R-3 TOWNHOUSE (Three + Units) ( thiits)
Q R-4 APARTR7EN'P/COAIDOMINIL11 ( Units )
2) ?
N11N1E:
ADDRESS:
CITY, STATE, ZIP:
. PHONE:
3) • u 7l•
For
City Use
NAME' ? ?LA?1/jPAV77 - P1umUers License:
AonREss:? ? Active
CITY, STATE, 2IP: ?--1 ??d
Not recorded
PHONE: Z Z MASTER LICENSE#
Staff Intial
NP.ME:
4) • a . ,
_ ADDRESS: .
CITY. STATE, ZIP:
PHONE: .5) vF5 r • r•
11
? CONNECrSON 7O CITY SEWE[t Q5 CO[aIEX,TION TO CITY WATER Q OTf-IER_
6) ?? ..• r ? PLEASE F30LD APPROVID PERMIT FC)R PICK-OP BY ONE OF ABOVE ----
PLEASE MAII, ApPROVID PERMIT 70 1. 2. 04. ABOVE
/ ?? ?,? (Circle one)
7) r. r u• - ??%1
FOR CITY USE ONLY Y
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ /o-?;'D
$ $ j0-S-2)
SEWER PERMIT (INCLCDE SURCHARGE)
WATER PERMIT (INCLL'DE SL'RCHARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLODE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCODNT DEPOSIT - SEWER
$ $ 15, J ? ACCOGNT DEPOSIT - WATER
S J jJ O CI-?) $ WAC
$ $ SAC
$ $ TRLNK WATER ASSESSMENT
$ $ TRCNK SEWER ASSESSMENT
$ $ " LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERAL BENEFIT/TRLiNK WATER
$ ? d U $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PL'BLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MDST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWI[VG ?ONDITIONS:
APPROVED BY;
TITLE:
DATE:
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTlON
F NOT6: PAYMFTTP OF PEE AT TIME pg
F APPLicAaiorr mEs rxrr amzTricm
t APPROVAL OF PFRMIT.
?
F IIMPDCTION OF SUR ADID/Ct FIIOFR
? IelsrAr.ramroNg WiLL NUT HE SQHm--
F ULE7) UNfIL PERMffT AAS
i APPR(7VFD.
1) pROPERTY ADDRESS:
LEGAL DESCRIPTION:
. .--"a.wc,ciouna1.vision or Tax Parcel ID #)
IF E7QSTING STRC'Cit1RE, DATE OF ORIGZNAL B[JILUING.PERMIT ISSCANCE: '
PRESBNfl' ZANING/PROPOSID L'SE: Mon ?
? COhMUCIAI+/REIkII./OFF'ICE
? 2ML'ST'f2IAL
? INSTITS,*PIONAL/=MMEW
2) ?
NAME:
ADDRESS:
CITY. STATE, ZIP:
PHONE:
3) • . ?•
NAME:
ADDRFSS:
CITY. STATE, ZIP:
PHONE:
? R-1 SINGLE FAPffI,y
?J R-2 DC?PLEX (1MO Lhits)
0 R-3 TDWNiOUSE (Three + Units) ( C?nits)
[v?' R-4 APARTTIENTP/COAIDOAIZNI[JM Units )
MASTTER LZCENSE#
ritimioers l.Icense:
Active
Expired
Not recorded
Staff IniUlal
4) ?lk« • i?•
tvAME: Y2 )11 013 ? rZ
. ADDxEss: '
CITY, Si'ATE, 2IP:
PH0NE: .
5) ? v r• •?• : o • ar - y? •
?? CONNECTZON TO CITY SEWII2 COIa7FX.TION 1U CITY WATER Q OTI-IER ' .
6) ? • • r ? PLFI+SE HOLD APPROVF9 PEE2NIIT FY)R PICK-C'P BY ONE OF ABWE __.__. ..--
[a PLEASE MAIL APPROVID PERMIT TO 1, 2,? 4. ABOVE
l? ??,,? (Circle one) 1
7) ?,l?V.t?A? a .z,?. h7. en
/'
FOR CITY USE ONLY
. _ ,.
PERMIT # ISSC'ED
9:3 99
Pd w/Bldg. Permit FEES:
$ $_ IO '??• SEWER PERMIT (ZNCLUDE SURCHARGE)
$ WATER PERMIT (INCLODE SURCHARGE)
$ ? ? S o $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLPDE CORPORATION STOP)
$ $ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ $ / 57, ACCOONT DEPOSIT - WATER
$ 57) rJ - D-Z% $ . WAC
$ J? S?D U $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFZT/TRUNK WATER
$ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ .GJ// (J (1 TOTAL ,
v S -76 Z
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PC'BLIC RIGHT OF WAY?
r--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" ML?ST BE ISSL'ED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: ? 13/J ? ??
CfTY OF EAGAN `
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
NOT6: PAYMENT OF EEE AT 'PIME OF
???w DOES NOr CONSTITM
APPROVAL OF PERMIT.
nvsrnc.'riorr oF MM ArID/Ot HUM :
TTlSTA7.TATTQN$ WSLL NCYT $E $CHED-- -
ULID ONP.II. PIItMIT HAS BEET7 ;
APPRdVID. '
Please Print
1) PROPERTY ADDRESS; CZL22a?
LEGAI, DESCRIPTION: 7 / T(-- "-
Lot Block Subdlvision or Tax Parcel TD )
IF EXISTING STRCCi[IltE, DATE OF ORIGINAL BqILDING PERMIT ISSCANCE:
?
-
PRFSENT ZONING/PROPOSfD LTSE: (Nbn Year
? C?+'?RCIAL/Rh'I'AIL/OFFICE n R-1 SINGI,E FAMILY
1-7 IDIDCSTRIAL Q` R-2 DI7PLEX (7tao Onits)
? INSTIZL;TIONAL/GOVIItNMENT ? R-3 TOPINFIOUSE (Three + Units) ( Units)
? R-4 APARTMEDIT/CONIDOMINIC'M { Units )
2) ?
D1AME:
ADDRE55:
CITY. STATE, ZIP:
PHONE:
3) u r ?• ?. ?i?/lL ?
?
ADDRFSS:
i CITY. STATE. ZIP:Afik& M% V i JS'7'7?
PxorE:2> ?2 0-1 rA= LzcErrss#
4) •?• • ?.,?.i?:
NAME:??? ? Z.
_ ADDRESS: •
CITY, Si'ATE, ZIP:
PHONE: •
Active
E?cPis'ed
Not recorded
sta Initiat
-5) r v ?•? r• • ?• : a ?
? CONNECTION T0 CITY SEWEFt ? COMB.`TION 20 CITY WATER 0MER '
6) ? Y• Y" ? i- ? PLEASE HOLD APPROVEED PERMIT FOR PICK-UP BY ONE OF AH(7VE
PLEASE MAIL APPROVID PERMIT TO 1, 2.,3 4. ABOVE
(Circ2e one) n
7) VLIr n u• -
FOR C1TY USE ONLY
e :M1
PERMIT # ISSL'ED
.9 d f
Pd w/Bldg. Permit FEES:
$ $ f0 -S'D SEWER PERMIT (INCLDDE SURCHARGE)
$ WATER PERMIT (INCLUDE SORCHARGE)
+S 6 -? 7?0 $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOL'NT DEPOSIT - WATER
$ t?)Z9 O, U O $ WAC
U Z)
$ ?7 S
. $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ ' LATERAL BENEFIT/TRONK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ 2,'U` C? $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
S I2-?7 y S? $ 6-1-6 TOTAL
?vSv_ 6
RECEIPT # RECEZPT
DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PC'BLIC RIGHT OF WAY?
Q YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MLST BE
DIVISION
LIST ISSL'ED BY THE ENGINEERING
AS A CO
DITION
. .
N
SUBJECT TO THE FOLL OWING LbNDITIONS:
APPROVED BY:
TITLE:
DATE : O ,
?
p _
E
s
3
1
L ______ , i
3123', , .204 /i
Z--- 2
Use BLUE or BLACK Ink
For Office Use
I ~j I
nj Permit
t City of EI Permit Fee:
3830 Pilot Knob Road I I f j
.9
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I
I Staff:
Fax: (651) 675-5694
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3 Site Address: o? 1,3 & IM 1 C 1eAs~ Y1e Unit
Name: / I / _LLOILAO-S 4)~ Phone: Co.1a 7L/-7 -IS cat' /
Resident/
Owner Address / City / Zip: )30UC
Applicant is: Owner Contractor
T tf/ ei 5Jjjjvi
Description ofwork: e T ml Jr PDOC ;,~ff!J~e f /A?
Ype of Work
-i
S d~
ConstructionCost: 1,~
i Company: " Contact:
C13 q:), i_i r✓, C mte,, N 6 icy l
Address: City:
Contractor i
Yk1✓1
State: Zip' Phone:
-ticense # - ea e i icate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I9+J < P dJ /Y r
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 they are trade secrets.
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.aopherstateonecall.ora
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 ate Building C de must be completed within 180
days of permit issuance.
x 1sl~ S x
Applicant's Printed Name Ap cant's Signature
Page 1 of 3