1371 Cleome Lane
Use BLUE or BLACK Ink
For Office Use
P in
~U T n j Permit#: ~~1 xN mt.
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Permit Fee:- ry
3830 Pilot Knob Road
Eagan MN 55122 j Date Receiyqd:
j
Phone: (651) 675-5675 1 i
Fax: (651) 675-5694 1 Staff: I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: l `I o Site Address: C~ U m e L0.)
Tenant: Suite
RESIDENT/OWNER Name: Ta V i S - L a d Phone: COI
Address / City / Zip: rte. L o-yN-Q . ~Q e 1l
Applicant is: Owner YContractor
TYPE OF WORK Descr ption o wo k: ~p `~~4 r~c~ 07 vJ5 ~r-~ e 1C 1 5-~ i r~~ Q ~2 n'~ r~ e~ S
Construction Cost: LP l Multi-Family Building: (Yes / No 1
CONTRACTOR Name: kQeY1.c~~w CQr-.o e-n s License aC) ~D L4 [
Address: 990 Lone Oc k f?Q, # 111V City: ea cxn
State: VJ Zip: 5ED I Phone: t a , c b c~
Contact: 1 0.r C~ _:yo Email
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Ir the ast 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
j Y3s No If yes, date and address of master plan:
Liceneed Plumber: Phone:
Mechanical Contractor: Phone:
Sawer & Water Contractor: Phone:
MOTE: Plans and supporting documents that you submit are considered to be public information. Portions 0l
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 flours before trou intend to dig to receive locates of underground utilities. www.popherstateonecall.orq
thereby acknowledge that this information incomplete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; 1hat 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.
0
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Applicant's Printed Name Applicant's Si ure
Page 1 of 2
vaLtirE of y?cnM WATER SERVICE PERMIT
3795 Pilot Knob Raad PERMIT NO.: _ 1725
Eogan,MN 55172 ' DATE: _5/12I7$
Zoning: Rl No. of Units: 1
Owner: milgpn ronstnwtiOn
Address:
Site Address: Lane 2782 WRII
Plumber. PEt9t&=
w ?:
Meter No.:
Size:
?41' ?F c? / Connection Charge:
Reader No.:LvZ ZZ !?zg?7
1 agrea comply with fhe Village of Eogon
Ordia.
/
By r
Date of insp.:
Account Deposit .
Permit Fee: 10.00 pd
Surcharge: .50 pd
Misc Chazge 60s: .00 meter - pcl
Total:
Date Paid: t
Insp.:
VILLdBE fli (SAGAN
3795 Pilot Knob Rood
eagon, MN 551$4
Loning: Rl
SEWER SERVICE PERMIT
PERMIT NO.: 2487
DATE: 5 1
No. of Units:
:)wner: Tilsen Construction
Address:
>ice Address: 1371 Cleome Lane L27B2 WRII
?Wmber: Peters -Bey-ROC '
aqree to comply w{f6 fhe Villaga ei Eayan
Jrdinoncea.
3y:
)ate af Insp.:
nsp.: -
Connection Chazge425.00 pd
Account Deposit:
Permit Fee: 10.00 pdSurcharge: • 50 pd
Misc. Charges:
Total:
Date Paid:
CITY OF EAGAN Remarks
Addition Wilderness Run 2nd Addition Lot 27 Rik 2 Parcel 10 84351 270 02
Owner .'? i ?IL - 11CIdl-,I ' Street 1371 Cleome Ln. State Eaqan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK aa? 1973 $175. 00 $8. 75 20 PAID
SEWER LATERAL
WATERMAI N
WATER LATERAL
WATEA AREA
STORM SEW TFiK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $320. 00 13072 3-28-75
BUILDING PER. #3534 3072 3-28-75
sa,c 13072 3-28-75
PARK
I
?v ?'y35i ,?-1(} o?-
G??/?. ?
PERMIT NO.: SFiA
The City of Eagan hereby grants to rp„jA H petPrs ro_
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
of
a vr.rrnj3rur. Permit for: (Owner) m;is n nonq-n,vtio„ Co.
1'_°J--`_---•e--'-; Q?,? . ?
at iz7C-ici= ,? , pursuant to application dated 6/2/75
Fee Paid: g40.00 dated this Sth day of T„nye 2,19 75•
1.00 s/c
Mechanical Permits:
Building Inspector
Bid Total:
?7- ?--?
,
CI'Z'Y OF FAI1N
3795 Pilot Kncb Road
Eagan, Tv'Iinnesota 55122
PEStNST NO.: 705
--
The City of Eagan hereby grants to Neil & Hubbard
ef St. Paul
a rcFamzxG Permit for: (Owner) Tilsen tiomea Lnc
1374-1378-1384 Amaryllis, 371 Cleome, 1342 Cosraoe, 4378 Dunrov&n, and
at 11371 Svensk rana , pursuant to application dated 7/15/75
Fee Paid: $140.00 dated this 21 day of Julv , 19 75
3.50 s/c
Building Inspector
Meehanical Permits:
Bid Total:
?
CITY of EAGAN
I
BUILDING PERMIT
DESCAIPTIOIQ
. i.
N2 3534
3795 PiloY Knob Aoad
Eagan, MinnesoYa 35122
954-6300
Dals ......3.:-.7S ..........
6lozies1 To Be Usad For Fronf Daplh Heigh! Eal. Coc! asmi! Fae Asmarks
I ?
........... -----------.J?::.-......?..f.°'e?c:-t----,--- .................... per ........----.------.N:`::...?......?-.?.,-'?--:?.---....................._....
Mayor ? BuAdinInapector
This pezmit does nof aulhori:e tha use ot afreeis, roads, alleps or sidewelks por does it qiva !he owner os his agan!
!he sigh! !o eseala anp situation which is a nuisance os whieh presents a haserd fo !he health, safely, eoavenianes aad
ganeral welfara !o enyona in She eommunilp.
TFIIS PERMST MUST BE „PT ON THEC? PREMISE WHILE THE WORK IS IN PROG ES$.
This ia locerrifY• !hal ...................-!:?-. ? .-.-_.hasparmission !o areet a.., ? ? '
"""' ...................." '"' ........ ...... ?......................_upon
the above desczibed pcemise subjeet !o ihe pxovisions of all applicable Ordinances for fhe Ci! of Eegen.
? 7*q/ 6
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
?41
New Constmction Reauiremenb RemodeVReoair Raauirements Ofiice Use Onlv
3 registered sita surveys showing sq. ft of lat, sq. ft, of house; and ?II roofed areas 2 apies of plan Cert of Survey Recd _ Y _ N
(20%maximum bt coverage allowed) 7 set of Energy Calculalions for heated addftions Tree P2s Plan Reod _ Y _ N,
2 copies of plan showing beam & window sizes; poured found desgn, etc. 1 site survey foraddiUons & decks Trae Pres Required _Y _ N
1 set of Energy Calculations Addffion - irMfcate 8on-sife sepfic sysfem On-site Septlc $ystem ,. _Y _ N
3 copies o(Trae Preservalion Plan if lol platted after 711193
Rim Jaist Oehail Options selection sheet (buildings with 3 or less units)
Date _'1/ /?/ OS
SiteAddress 1371 Construction Cost ? l 731 y 9
LANF Unit/Ste #
Description af Work _JEC K
Multi-Family Bldg _ Y X N Fireplace(s) X 0_ 1 _ 2
PropertyOwner ??25 + AN5' /- lAnJSl--i? Telephone#(6S/) -3S0C?
Contractor
Address
State
Zip City
Telephone # ( )
COMPLETE THIS AREA ONLY IF
A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan8
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_X N If so, 25% plan review
Telephone #(
Telephone # (
Telephone # ( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in acwrdance with the approved plan in the case of work which requires a review and
approval of plans. ? I
C 1lezs i-!A ^)SF,J ( ?9,
ApplicanYsPrintedName Appicant'sSignature ji ApR 0 4 20135
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 76-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
0 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex p 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? OB 04-plex ? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous
Work Types
?p 31 New ? 35 Int Improvement ? 38 Demolish Interior O 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement 'Demolition (Entlre Bldg) - Give PCA handout to applicant
Valuatlon ? D??d? ~ Occupancy lz"3 MCES System
Census Code ? Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width ?
REQUIRED INSPECTIONS
Footings(new bldg) FinaVC.O.
Footings (deck) ? FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Poo] _ Ftgs _ AidGas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Br ick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
Insulation
- Retaining Wall
-
Approved By?: iI
--------- -------°-------------=
- -- Building Inspector
-------------------------------------------- ------- ------- ----------- -------------
- ------- ------------ ----
Base Fee / G„U L
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total ?
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F?LQ1 ILAN M" Se-- 0 s /Uf4ap
.? c4IAgeO-A-
MASTER CARD
Permit
No. I
Issued Issued To
Con}rac}or Owner
BUILDING
PLUMBING 3
JI_f ^-
!
CESSPOOL - SEPTIC TANK
WELL
ELKTRICAL
HEATING
GAS INSTALLING ?, ?? ? ?-
-_?
SANITARY SEWER I
OTHER I
OTHER I ?
Items Approved
(Initial)
Da}e
Remarks
Distan[e From Well
FOOTING ? SEPTIC
FOUNDATION ` ?. 7- CESSPOOL
FRAMING TILE FIELD FT.
FINAL ?
EI_ECTRICAL I
HEAiING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
ORAINFlELD
PIUMBING ?- ?
WELL
SANITARY SEWER
Violations No}ed
on 8ack
COMMENTS:
STRUCTURE AND
IAND USED AS .0,
-'7_-_
RESIDENTIAL
BUILDING PERMIT APPLICATION
cirr oF eacan
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConsWCNon Reauiramenb
. 3 registemd site surveys shaxing sq. k of loG sq. ft. of house; aM all raofed amas
(20% mazimum lot coverage allowed)
. 2 copies of plan showing beam 8 windax s¢es; poured found desgn, etc.)
• lselofEnergyCalculatbns
• 3 copies of Tree Preservation Ran if lot platted afier 711/93
. Rim Joist Detail Options selection shcet (bldgs wAh 3 or less unAS)
DATE K - l y - 6 ?--
113-?I?
RemodeUReoair ReauiremeMs
. 2 cropies o( plan
• 1 set of Energy CalcWatians for heated additions
• 1 site survey Por exterior additions & decks
. Indiwte ithome served by septic system (oraddNons
U
VALUATION !1?0 0 ?
SITE ADDRESS 1 3 7/ C'_),P tti Mg- L.r1 MULTI-FAMILY BLDG _Y _ N
TYPE OF WORK IzP l20010-- FIREPLACE(S) _ 0_ 1 _ 2
APPLICANT .f)et- v; C.p-S Of /vr?D IS
STREETADDRESS /6 SS c?p?/i?iS A-?? CITY u,o%IUnA/? STATE??ZIPSS1
TELEPHONE# 6Q_5.21-3337CELLPHONE# /S/?o??S- 3SIS FAX# l/:?-So71- c'la?A
PROPERTYOWNER D14-4- H'A-hSDt-\ _TELEPHONE#
---------°---------°-------------------------------------------------'--°-°----------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUtLDINGS ONLY
Energy Code Category _ MINNESOTA RliLES 7670 CATliGORY I MINNIS(Yl'A RiJI.FS 7(i72
(J submission qpe) • Residential VenGlation Category 1 Worksheet Submitted • New Energy Code Worksheet Su6mitted
• Energy Envelope Caiculations Submitted
Plumbing Contractor: _ _ Phone #
Plumbing system includes _ Water Softcncr _ Lawn Sprinkler Fee: $90.00
Water Heatcr No. oC R.I. Baihs
No. oF Baths
Mechanical Contractor: Phooe #
Mcchaniril sys[em includes: _ Air Conditioning Fce: $70.00
_ Heat Recovery System
Sewer/Water CoMractor. Phone #
°-----°-------°-------°-------------------------------------------------------°---°---------------------------------
i hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
5lgnature of Appi(cant
orrrcr; t1sL oNLY
JUN 1 ; 2002
Certificates of Survey Received _ Tree Preseroation Plan Received _ Ndt Required _?
lo:, ed 4/02
zoos RESIDENTIAL PLUMBING PeRmiT aaPLicarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
oate ,__4-/ -t-Z ! 66
site street Adaress 1.3 71 C(epwAe. i? 0,s r,?\ unit #
Property Owner I-We- ? "n510"ti Telephone # ( iSf ) ?Sy -3SP.?
Contractor I o,?C ? C Telephone # {651) 43 - 7011
Address tcU,SC'""c?.??-r ?fi'.1d. City ('h<-Mihlt'C?l State/uxu Zip 55oa
The Applicarrt is: _ Owner ?N Contractor _Other
i Septic System _ New _ Refurbished Submit 2 sets of pfans and MPC license Includes County fee
$ 100.00 ?
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. !f you are insfalling onlv a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
I
?
_Septic System Abandonment ??
rr ?
T
_Water Turnaround (add $130.00 if a 5/8" meter is required) 0,
7
_Other.
?
_ Water Softener Water Heater $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuiid $ 30.00
State Surcharge $ .50
Total $ I5: 50
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is compiete and accurate; that the
work wiil 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 pertnit, 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.
A ,,r k ; uR;e_+? AtA ? '
ApplicanYs PriMed Name ApplicanYs Signature
2/17/13 02:07PM CST DDR Mechanical -> Permits
411/11° City of Ratan
9830 Pilot Knob Road
Eagan MN 65122
Phone: (651) 676-6675
Fax: (851) 875-5894
6516755694 Pg 2/2
Use BLUE or BLACK Ink
For OMce Use
Permit fit: 'I 1977 I
Permlt Fee: (v0.°)
Oats Received: 10-11 7/ r
Stat:
1
2013 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: r-111 site Address: I' 1-1 i _IQ C me t(5-1"
Tenant:
Resident/Owner
Suite it:
Name: _ Phone:
Address / City / Zip:
NameT Q 'me Gn0.4' 1 C Q-, License 5: (M Sa4
Address: 6 L1 o ^ ►'
91-7 5 City: J of th.gw"'�
l
Contractor v
State: "MN ,,. Zip:5 ,2,� Phone: C15 -)S) - 3530 '.8(t) - 9 b 5.374
Contact: "ibt?,i'arn t"N Email: 6'e'rui(2-.6afrne CAA ex"; CO . CvVW"N
New $Replacement Additional Alteration Demolition
Type of Work Description of work:\Gc�ny i'tc-� ()sat g09FLA-plc,. (-e•
NOTE: Roof mounted and ground mounted mechanical equipment Is required to be screened by City
Code. Please contact the Meohanioal Inspector for Information on permitted screening methods.
Permlt Type
RESIDENTIAL FEES
RESIDENTIAL
Furnace
_ Alr Conditioner
Alr Exchanger
•_._. Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under/Above ground Tank t_ into/ _ Remove)
$60.00 minimum, Add or alteration to an existing unit (Includes $5.00 State Surcharge)
$100.00 Residential New (includes 55.00 State Surcharge) = $ TOTAL FEE
COMMERCIAL FEES
$66.00 permit Fes Minimum
$70.00 Underground tank installation/removal
•if contract value Is LESS than 510,010, Surcharge = 55.00
"If contract value is GREATER than 510,010, Surcharge • Contract Value x $0.0005
mlf the project valuation Is over $1 million, please call for Surcharge
Contract Value 5 x .01
. 5
=5
- 5
Permit Fes
Surcharge"
TOTAL FEE
I hereby acknowledge that this Information le complete and accurate; that thew k will be In oonformanoe with the ordinances end codes of the City of
Eagan: that 1 understand this Is not a permit, but only en application for a permit. and work le not to sten without a permit; that the work wilt be In accordance
with the approved plan in the case of work which requires a review and approval of plans.
x D iVN.E ESA -
Applicant's Printed Name
Applicant's Signature
FOR OFFICE USE
Required lnspeotlons: Reviewed By: Date:.,....,,
Underground Rough In Alr Test Gas Service Test In -floor Heat Final HVAC Screening