1956 Covington Lane
.1►'
Use BLUE or BLACK Ink
I For Office Use I
I I
(~~a I Perm it
i
City U an
S4-
Permit Fee: Z
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 LA Site Address: 1ISi IS& G_ ~aJ 1~ 7
Tenant: Suite
RESIDENT / OWNER Name: Ot z- Phone: (~f
Address / City / Zip: (-AA,
Applicant is: Owner Contractor
TYPE OF WORK Description of work: W13
C.t>
Construction Cost: - i l~t.X3 Multi-Family Building: (Yes / No
CONTRACTOR Name: License LOn
D~ Address: l 1l5 City: ~AJ
State: .A,4,-) Zip: !~-01 1~ Phone: - z
Contact: Email:
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:
License Plumber: Phone:
Mechanical Contractor: Phone:
Sewer Mater 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) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orci
I hereby acknowledge that this information is complete and accurate; that the work will be in conform ce 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 i 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 approv I o
x } x
Applicant's 'Printed Name Applic 's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
_ 01 of _ Plex _ Lower Level _ Pool _ Miscellaneous
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~0~a &.0 Occupancy MCES System
Plan Review Code Edition J.'"? SAC Units -
(25%_ 100%_0' Zoning PD City Water
Census Code 391 Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: 7,47- , Building Inspector
dy
Z0'* 3 q Lb
RESIDENTIAL FE / -70 ~ 64)
Base Fee
Surcharge
Plan Review ?
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
WOW VI OLMVI~ 1111%
For Office Use I non
Permit
City of EaRa I _ 1
Permit
3830 Pilot Knob Road Q r I Fee.
Eagan MN 55122 I 1
I Date Received: 1
Phone: (651) 675-5675 1
Fax: (651) 675-5694 i staff: - I
2011 MECHANICAL PERMIT APPLICATION
Date: Site Address: Z~FS 6 t4O y n j1 m 611-1
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address /City /Zip: /MSG Co 1/,'Il 4, L N
CONTRACTOR Name: r0 hz_s 5 i o~1 l~l-/ ~~r141~r'c~t- &_-fVt-5 License
Address: City:D K h l / o
State: ' `I Zip: S S 3 L d Phone: Cs Q_ 66-Y--1101
Contact: Email:
TYPE OF WORK New Replacement -C Additional Alteration Demolition
Description of work: Neil
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
_ Heat Pump _ Under / Above ground Tank Install / _ Remove)
" When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
TOTAL FEE
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.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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 rm.t; that the work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
x l Po YJ X_
Applicants Printed Name Ap ~ffs S nature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground _ Rough In Air Test -Gas Service Test -in-floor Heat -Final
Exterior HVAC Screening Inspection
vac a~ v1 12 JivIn 111n
`For Office Use I
1 I
¢ I Permit C-"~ X 25 l
City of Eapn
i Permit Fee: I
3830 Pilot Knob Road l
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 1
Staff:
Fax: (651) 675-5694
2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: SiteAddress• / ~S~y LDf%/gig ~S1a GN
Tenant: Suite
RESIDENT / OWNER Name: ~i Phone:
Address /City / Zip: c'v/!fi`n Al
CONTRACTOR Name: sSiavrrrl 'k c~Ijj&/gdd License
Address: 490 L W, y 4.1 a City: ,*'a - " is
State: Zip: J2 L>- Phone: 64 ~i S~-1lo /
Contact: Email:
TYPE OF WORK New JO Replacement - Repair Rebuild Modify Space Work in R.O.W.
Description of work: tA-P-e- lit'- o 46 L~ fb~
PERMIT TYPE RESIDENTIAL I aXj +1.1 b, Vc~a
Water Heater Water Softener
Lawn Irrigation RPZ / PVB) 7X- Add Plumbing Fixtures Main Lower Level)
Septic System ( Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tumaround* (includes $5.00 State Surcharge)
*Water Tumaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
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.
1 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 l 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 aprot plan in the case of work which requires a review and approval ox~ .J x
Applicants Printed Name A ant's `gn ure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground .Rough-In -Air Test _ Gas Test Final
CITY OF EAGAN N2 10232
3830 Pilot Krrob Road, P.O. Box 21-199, Eagan, MN 55121
PNONE: 4548100 OAe?6
i
BUILDING PERMIT Receipt #
T. ba „"d fm SF DWG/GAR Est. Volue $57,000 Date MAY 16 ly SS
SiteAddren 1956 COVINGTON LN
Lo< 5 ei«k 3 S1c/Sub. BERKSAIRE PONDS
Parcel No.
Ereet EX occupency R3
Remodal ? Zoning RI
Repelr ? Type of Cons[. CJ
Enlerge ? No. Stories
Move 0 Lengtn 36
Oemolish 11 Depth 46
Grade ? SQ. Ft.
Install O
Aoorovols fon
W nlame RSM HOMES
? Addrms 6 UPPER GUTHRIE CT
City APPLE VAL phone 435-8868
p Name SAME
?u
Addreu
? City Phone
Neme _
Addresa
City _
Phone
I hercby xknowledps tMt 1 Mw rey?s ov ication and stare that
tha inlormotion is correct and lr to c I ith o?17a0plicable
Stcro of Minnesota Statutes ? Ordin cas.
Slpmtun of PermiM
A Buildlnq Permit ia issuad to: RSM HOMES
all work thall be done in ettordonce with all oppll la State of i?
Buildtrq Offieiol
Assessment
Water 3 Sew.
Police
fIro
En0•
Planner
Countll
BIdg.Off. S 13 85
APC
rVar. Date
Permit +ti 304 _ 00
Surchorqa 28 _ S Q
Plan Review 1 57 !10
,AC 525_00
WaterConn. 5 .a0
Wmer Meter 6-4- ? 0
Road Unir 28n nQ
T.P. 132.00
Copy .50
Total $1,985.0
_ on the axproq conditlon thoi
cnd City of Eapan Ordironeas.
? ,- - CITY OF EAGAN • ri
3830 Pilot Knob Rosd, P O Box 21-199 Esgan, MN 55121
PHONE:454-8100 BUILDING rERMIT Receipf #
?
r. L. .ud ie. Esr_ value ' 5 7, u i: '; pare L , 19
„4
6
'``. 1 V (liN
Eroct 12,
OCCUpsnCy
' -
Site Addr6n
l
R
d
? ri
Zonin
Lot
Block
? "
/Sub ema
e g , i
`
.
Rspair
?
T
ype of Const.
Pareel No.
?
Enla?ge No.5torias
Move ? Length
W Name Demolish ? Depth
? Addrss s ' Grede ? Sq. Ft.
City ,. . 1
Phone Inatall ?
i here6y acknowiedpe thot I hove road this opplication and state thot
the informofion is corcect ond ogree to comply with oll opplicaW
Stott of Minnesoto Statutas,ond City of EoQan Ordinonus.
Sipnoturc of Pemwtta • . .
;
A 8ulldinq P•nnit Is iuued ro:
oll work sholl be dorn in oaordanct with oll oppliopble State of Mir
Buildinp Ofllcfol
Assessment
Water & Srw.
Poliu
Fin
En0•
Bldg. Off.
APC
Var. Date
Permit -
Surchorya
Plmi Review
SAC
Wuter Conn. Water Meter
?
Rocd Unit
-- ? -t v
an fM sxpnss canditlon thot
tutas and Gty of Eoqan Ordinonces.
' Pamk No. Pwmlt Holdw Dab T?1? hons ?
Plumbiny q-? ("66
H.VA.C.
ENetrie ,
7 ^? cJ
??? 17 I -` i4- 7 ? (? ? ? •
I r'• v
Soiteeer
Inwection Date Insp. Oehe?
Footinyt
Foundation
Fnminy
Roofinq
Rouyh Plbp.
Rouyh HVAC
Inwlstion ?
A"l .111$7 -4
F{nal Plbp. T_ <.!
Final HVAC
Fin.l 7.?P
Grt/Ooc. C-o
wanr Dowibe Location:
MIIeII
SewAr
Pr. Difp.
MECHANICAL PERMIT
CITY OF EAGAN
3830 PILOT KN08 ROAD, EAGAN, MN 55121
PERMIT #
FiECEIPT #
DATE:
Site Address " gLDG. TYPE WORK DESCRIPTION
Lot Block ? _ Sec/Sub ' -
Res. ? New
;i5 Name Mult Add-on ?% ^
? Address `? ? ,' - ? Comm. Repair
c City Phone ' Other
Name T & ? FEES
?
3 Address RES. HVAC 0-100 M BTU - $24.00
p City PhOne A
B
U
I 6DQ
?- ADD
ON A
R COND.
O
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 .?u MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU STATE SURCHAFiGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Vent CFM BEYOND $1,000.00)
Gas Piping Outtets #
Other
FEE ?
?
SIU`NATURE OF PERMITTEE
S/C: ,
TOTAL• '' • -'`
FOR: CITY OF EAGAN
?__
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN "O.OC' •
Fee
FrN in numbered spaces S/C .50
Type or Prini legibly Tot. 20. 50
,
1. Date 2. Instaliation Cost 0r. (;r•
3. Job Address 10$6 CoviriFtOn Lot ? Blk. ? TFect
9>
4. Owner A -- ? ? -
5. Contractor - Y ??• .,._:LT Phone -"5-F1-67
6. Address /-(?37 Chica??0
7. City . "?Z"'• State Zip
8. Building Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New Q Add ? Alter ? Repair ?
10. Describe in:- '1 .1 gas forced eir ft1Ame1 Type ?t g^s
11.
No.
1 Equipment 8TU - M. Ea.
Forced Air 75,OGC- No. Equipment CFM
H
Ai
dli
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
? Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Ffnal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt PLUMBING PERMIT Pennit No.
CITY OF EAGAN '
, Fee .
Fill in numbered spaces S/C -
Type or Print /egiWy TcvL .
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner '? r• 3'? j/?
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential L? Commercial O Institutional O
9. Work Description: New Cl Add ? Alter O Repair 0
10. Describe
I 11.
No.
? Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
/ Lavatory Softner
` Shower Well
Kitchen Sink
Urinal/Bidet Other "
? Laundry Tray
? Floor Drains
Drinking Ftn.
/ Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
Comply with all ordinances and codes governing this type of work.
Signed : for
Rouph Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition BERKSHIRE PONDS Lot
Owner
Street 1956 CovingtQn L.ane
10 13750 050 03
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. ?L-sq 1982 239.09 23.91 10 143-49 Ci010 8- -$
STREETRESTQR. B 1 115.55 U010 43 8-5-85
GRADIfVG
SANSEWTRUNK E57 1982 176.04 11.74 15 129.12 C010543 8~5-85
SEWER LATERAL ,; 1982 57,24 3.82 15 42.00 C010 -5- 5
* Sewer Lateral 9,13 1985 7,88 28.5 399.36 CO10 3 8-5-85
WATERMAIN 1982 46.09 _
3.07 15 33.81 C010543 $-5-$5
* WATER LATERAL
WATER AREA 1982 176.04 11.74 1 15 12 .12 C010 8- -$
ST4RM5EWTRK 1985 385-03 95 35 359•37 C010543 8-5-85
STORM SEW LAT
ClJRB & GlJTTER '
SIDEWALK
STREET LIGHT
WATER CONN. 500OO rr u
BUILDING PER.
5AC
PARK
CITY OF E:>GAN WArER SERVICE PERMIT
3830 Pilot Knob Roed
P.'O. Box 27199 PERMIT NO.:
Eagan, MN 55121
Zoninp:
No. it; ts:
Owrwr:
Address:
51te llddrcss: ].`.%56 Cc fnntnr• Lane [:5 13 3''r'?r
Plumber:
Meter No.: S ? Connection Chor Siu: ?'? ??
.? IY) Acoount Deposit:
Reader No.: ? Permit Fee:
1 pne fo oomPlf !w Cih *F gegon Su?cha?ye: . i,j
Misc. Chorfles: 132. OOrd ?? CTotal:
eY Dote Poid:
Date of Insp.: , f/.-3 1 Q' - I.m, •
CITY OF EAGAN • SEyyER SERVICE PERMR
3830 Pilot Knob Road -,, 'I
P. 0. Box 21199 PERMIT NO.: ''
Eegan, MN 55121 p,,TE; 377
` Zoninp: I` 1 No. of Units:
Owner R5M 1?omes
Address:
Slte Addr
Plumber.
I M- !o eMwplj wa 1Mt CNq of 16pm
Ordinenaa.
Connection Charge: 425.00pd
Aaco,x,t pepowe; 15.00 nd
permit Fee; _ 10.00 od
SurcFwrpe: .50 nd
Mise. Choe+pax
Totol;
Bv
DcM of Insp.:
This refyuest void
16 months Irom . t
3 8 5 3 2 ?
?--
Request1 Date
q
7
-
?
?
Fire No.
Rouph-in Inspecnon
Required? _ TC
leady Now pwi ii Notify Insqec-
-G 1
t
1
1 ?Yes [?Mo [or When Ready
? xcensed Electrical Contractor I hereby request inspection of above
? Owner electrical wwk installed at:
Street Address, Box or Route No.
1956 Ca .in a n CitV
E=aa
ection o. 7ownship Name or No. Ranpe o. Cour y
OccuGant (PRINT)
Rabeh,t S.twcbucfz Phone No.
Power Supplier Address
Electrical Contractor (Company Name)
EClJStoYI E?[., l'?'11.(C f'nmwrN!! Contracmr's Lfcense No.
Mailine Address IContractor or Q ner aking Instailationl
6525 E. 170th S
Aut rized Signature Contract Owner Making nstallationl T ho;ne Number
47-2440
MINNESOTA STATE 80ARD Of ELECTRICITY THIS INSPECTION REQUEST WILI NOt
Gripps-Midwey Bldg. - Room N-191 BE ACCEPTED BV THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (672) 297-2117 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION Ee-°u°°'-°'
. 0 See instruetions for complelinp thia fpm on Aack of ysllow copy. 5s- %?
C 3 8 5 3 2 "X" Below Work Covered by This Request
kdd Rep.T TyOe ol Buildina ? Aoolinncws Wir.d Eauioment Wirari 1
FX
M Fee Servica EntranceSixe eeders/Subleeders p Fee Circuits
U to 200 Am s o 30 Am s 0 to 30 Am
Above 200 Am» [ a to 100 Amps 31 to 100 Aml)s
Swimming Pool Above
100_Am s Above 100_Am
TransPormers gation Booms Partfal- Other Fee
emerks a?gns apeciai inspection g TOTAI,FEr~
?
? ,
Thb roquest
. - - • ?
CASH RECEIPT
? f
CITY OF EAGAN
P. 0. BOX 21-199 ?
EAGAN, MINNESOTA 55121
?
_--,
? DATE ' 19 ?
R<CtIVtD
?-/
PROMr^
AMOUNT $
%(.cf???'? i T?
--= ?----
C) CASH ? CHECK
rOR . '
FVND CODE AMDUNT
..' (,r r ... - .? i
- ? ' ? ? ,.i .. . ..
?- i
1
Thank Yau P
BY
,.
' . . White-PaYers COPY
Yellow-Postinp CoPY
Pink-File CoPY
wid
?..
('o ? ? ??-,f -
Street Address, Box w RouDe No.
t Cihr
?
Lr ,1
Seinion . Township Hane p No_ Range No. Coun[y
R
Occup
(PRINT) P1?one No.
?,C,LCI S
Power Supplier Address
fs
C
, p
:
Electrical CoMgactor ICompamr Namel Cootractor s License No.
.J G , D --70 - ?'
ilinp Address (Contractof or Owner Yating Insm tipnl
?r Z).e ?E MAL)
Author' Sigre (C
or
Yakiny Installation)
Phone Numbe?
TM
-?/ '_ 3 / C./
YINIfFSOTA STATE WA1JD OF EIECTRICITY
Cxiqas-Yid?reV Bldy- -Moo? M-191
1E21 Univsrsiq Ave.. SL Paul. 1111111 56104
Phons (672) 297-2171
THIS INSPECTION REQUEST 1AlILL NOT
BE ACCEPTED 81f THE STATE BOARO
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
Y.f?QIIEST FOR ELE''7T.N. II?PECTION ? EB-00001-W
s.e :-ln.elioms For coompletin0 [hia forw m 6e11 of ytl luw covr-
n n 'X" &-low Work Covered by 7his Request
.
• .r., .,
Fee ,,,.
ServiceEntrancsSiz•
a
Faa
Faeders?u6feeders
#
Fee
Circuits
( ? 0 tp200 AnVs 0 to30A Oto30An?
Abore 200 A? 31 t,? 100 Amps 31 to 100 Anips
Swimming Pool Above 100_Ai??ps Above 100-A?
Transfomters Irrigation Boorrs S Partial• Other F
,
I I I Signs ? I Special inspection g TOTRL F
Re?re.ks /G1 • '?'C' /Q -
I, the Electrical
eccor, hereby
rtZpify that the above
inspection has been
inside.
?W-uw 1 hsrs6Y reqLMSt inSPectiOn of abOye
? Owner elscdiml wort irafallsd at_
1his reqAeu void
. ?
___. _ ___ 5
6'C?Yf,{! 5
Sveet AdJress, Box or Route No.
17
L City
4
j
E
0 1
?t n) - ,
.4?i,
ection o. Township Namr or No. Raoge No. County
DA
Occuoaiii (PRWT) Pnone No.
y S:2 o
Pow r SuDP?ier Address
? M?
' tu;. n
Electrical Convactor ICompany Namel Contractur s License No.
ac - '7'/ _ "??JG . G1 "'7? •- a
Mailing Address (COntra tor or Owne? Makin Instailationl
C ,.!
Z
?
6T-'J ? ?. L'? JJI
M
Authoriz igna[ure (ConNac r/ w r aking Installation) Pho? Number
M ? O
MINNESOTA STpTE BOARD EIECTflICI
Griggs-Midwsy Bldg. - Room N-181
1821 University Ava., SL Pai MN 55104
Phane (812129]Q111
TMIS IfiSPECTION flEIIUEST WLLL NOT
BE ACCEPTED 8`/ THE STATE BOAND
UNlE55 PAOPER IN51'ECTION FEE IS
ENCLOSED.
?'kIUEST FOR ELECTRICAL INSPECTION EB-o°°°' °a AV% See inat?uctions tor completing Mis fnm an back of Vellow copy.
925090 "X" 8e/ow Work Covered by This Request
ana neu. Tvoe ot aunat"s nooliancas we.ea Equitment WireA
Home Range Temowrary Service
Duplex Water Heater Lighting Fixtures
Apl. Buildiny Dryer Electric Heaiin
Commercial 81dg. Furnace Silo Unloader
InduSttial Bldg. qir Conditioner Ralk Milk Tank
Parm ome. Soeufy otne. f5nedivl
[Mr (SUtTdfy pthor Othcr
ompute Inspectron Fee Below
N Fee Service Entrance5ize # Pee Faeders?Sabteeders k Pne Circnits
Q, zO 0 tp 200 qmps 0 to 30 qm ?s !7 ' 0 to 30 Am ?s
Above 200 qm?u 31 to 100 Amps 31 to 100 A
Swimming Pool Above 100_Amps Abovr. 100_AmEn
Transformers Irrigation &?oms g? Partial-'Other Fee
Special Inspection
Bemarks TOTAL!FEE y
Roueh-in DF,t^ j ?!/ ?_ ?? I, the Elecviwl
J 1(j ?C Inspecior, hereby
Final . ce??ify "hat rhe abova
pectipn has been
?ea.
NrLicensed ElecVical Con[ractor I nereby request insoeclion ot aCOVe
? Owner elactncal work installed at
.s Aq1514
6 aZ114.3 ?`
2 5_
6s ? ?a??
RaOUest Ire No. Rough-In Inpsection qequired InsOectian OtM1ar ihan Rough-In
(VOU must call inspactm when reatly) 0 qeady Now ill Notly Inspector
? Ves n o Oale ReaCy
I ensed contractor ? owner here6y request inspection of above electrical work at
Job N 5 IStreet Box ar R ute No., , /? •
u fun ?-'1 Ci?
--
Sedion No. Townshlp Name or No. Range No. Coonty
Or????=... ?oolNTi
PhoOe Na.
o uppier ? Atldres '^^ I
Connactor LCOmpany C. ct 5 icense No.
Addres5 (GctOr or OlwBr Makm Inst Iq?
?
Add
ur fCo iori erMakiglnst ation)
mwryESOTA STATE BOARD OFyWCTRICITY ?
Griggs-Miaway Bldg. - qoo THIS INSPECTION REOl1EST WILL NOT
1e21 Univeni[y qve.. SL Pa.?5510d BE ACGEPTEO BV THE STATE BOARD
Phone (61116E2-080U UNLE55 PRpPEF 1NSPECTION FEE IS
ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTIDN * 6'"?`??r E8-00p01-08
8
?
? ^ ? See In9hnc1ion5 ta! com0leting Mi6 (orm on beck of yellOw copy
? 26?
"X" Balow Work Covered hv Thi.s Ra
ew ? Typaof6uilding AppllencesWlred EquipmentWired v `
Home Range 7emporary Service
Duplex Water Heater Electric Heating
Apt. 8uilding Dryer Load Management
Comm./Indusirial Fumace Other (5pecify)
Farm Air Contlitioner
Oner ?spacity? Contreoror§ Remarks'
Compute Inspection Fee Below:
# Other
Swimming Pool Fee # ServiceEnlranceSize F # Cimuits/Feeders Fee
Transformers 0 to 200 Amps O to 100 Amps
Si
nS Above 200 _ qmps Above 100 qmps
_
g Inspeclor's Uee Only ?
trrigation 8ooms TO
Special Inspection
Alarm/COmmunica}ion
THIS INSTALLATION MAY BE ORDERED DISCONN ED IF NOT
Other Fee COMPLETED WITHIN 18 MONTFIS.
1. the Electrical Inspector, hereby Rou9n-;,, Dare
certify that the above inspection has e -
been made. Finai
/ oate
6A?, , T_ „
F?FFiCE USE ONLY B ?
inis request witl 18 monms Iram
? i 2/84
? CITY OF EAGAN
?
? !?.?
(14 APPLICATI^vN FOR PE?2MZT
• SEWER AND/OR WATER CONNECTIODT
(PLEASE PRINT)
1) PROPII2TY ADDRESS: -0
rFrar DESCFtIPTICN: S ?
(Lo t/Block/Subdivision or Tax arcel I.D. NtmtDer)
S'S:?i.'C'?'-T:Z°., DA'I :' 0° ORIGurtli, riiII.DI::G ?=--:•1: ISFL:?'.%G.:
P°WSLi':' C'S-r.-• ?R-1 Si?;GLLL FP"?SLY .
R-2 DUPLE{ (2:tiD L^tIT5)
? R-3 'ICSv1II?CY?SE (`I".'-F•..' ?' + L^IITS) ( Wi I'"S)
? R-4 AP?m1E?7T/CO.IDGrS`IIL?l ( CTiVITSJ
? CCii'?'?ff..'4CLAL/F2E:AIL,/OFFICE
? i'DL'ST.'L
? I?'?ISTI'S[,'TIONAL/GGVE.RrT,%E.^?-P
Z) APPLIQ?NT-] (PLE E PRIN
J .
N
ADDRESS: ?
CITY, STATE, ZIP: 7p
PHO'KE:
3) pLu-IBER . PLEASE PRI4T) F4R CITY;USE aNLY
?-
:
ADDRESS Pff
" CZTY, STATE, ZIP: cL
PHOiVE: i[
PLUMBER LICENSE NQ6??,y7M
4) OCCUpANT/('J,17NER P EASE PRINi)
NAhfE: ???
ADDRESS:
CITY, STATE, ZIP:
L ? , -?G /? ?S `rs?
PHONE:
5) INpICI1'Pr- iVHICEf PERMIT IS SEING RFQLTESTI:D:
CbDRVECP20N T"J CITY SE,Ti7ER
? CONNFC'TION TO CiTY WATEft
? diE!ER (PLFIISE DESCRIBE)
6) Ifa'DICA.1. C;+Ec
? PZ,ENSE HOID APPR= PER.'?tIT FOR PICFi-L'P BY ONE OF IIBOVE /
? PIFASE. r*AIL APPROVED PERbLiT 'IO _ 3, "4 &1B(7VE?
(Cirle one)
7) SI?TGRE: DATE: 1? F? - O`.S-
.,, ..
MIR 2! OI:Rillf6.? i? Y? QlY:O?s?'.? fM S r!s ?'aii#A i is af ?'.s?i :aa lw! ft ?!f!??tl?? f?l a111R ?RiAC?aY ?
? .. . . .. .. . . . . .. ? .
FOR C I TY U 5 E ON;,Y
PERMIT " ISSUED
E ^?
$
$
$
S
$ /S-?
$ _ l 1. UzJ.
$ $
S
$
$
$ 1,?,?,u •
SE:^iER nrqMr'i (I`_ICLD: SU°CHARGE)
WATER PERt'[ZT (INCL'JDE SliRCHARGE)
WATER METER/COPPERHORN/OUTSIDE REFDER
WATER TAP (INCLUDE CORPORATION STOP)
SE;VER TAP
=.r:0i."_i'I' ,._?GSI= - .._.,=R
ACCOUNT DFPOSIT - GIATER
wac
SP.C
TRliNK SVATER ASSESSi-SENT
TRtiDIK SESdER ASSESS:IENT
LATEr'LAL BENEFIT/TRUNK SE:•7ER
LATERrIL BENEFIT/TRUNK WATER
OTHER '
$ TOTF.L
,
$ AI?IOU:vT PAID; RECEI?T #
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGiiT OF WAY?
YES IF YES, THEN F•. "PERMIT FOR *nTORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVZSION. LIST AS A CONDI-
TION.
SUBJECT TO TfiE FOLLOWING CONDZTIONS:
APPROVED BY;
TITLE:
DAT° : ? 7 /Fl?
.
,
k P" s rr\
1985 BUILDING PERMIT APPLICATION - CITIf OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED {fliH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERCY CALCULATIONS
To Be Used For: NC b.i Cn ivS1• Valuation: 5?,? ? Date:
Site Address: OFFICE USE ONLY
Lot: S- Block ? Sect/SUb pON,pf
Erect
X Occupancy (L3
Parcel !! ?A
v? I
??NpS Remodel Zoning Iz- I
Repair ? Type of Const
Owner J
??? ?i/o'?r;,z?, Enlarge
Move 1! of Stories
_ Length 3?
Address Demolish
d _ Depth 4(0
e
ka _ Sq Ft
City/Zip Code C7 - ---°---- ---------------°-------
Contractor s/'??`? ? pppROYALS
Address
City/Zip Code
' 5;?3 S-
Phone #
Tg-? p -
Assessments Permit
Water/Sewer
? Surcharge
Police plan Review
%Z 3 y ?Te
n,gr sac
Water Conn
P1 nn
a er
Areh./Engr Council
Address Bldg Off
APC
Phone p_ ?-Sl) cfiF6 7 yariance
Water Meter
Road Unit
Parks
Treatment P
? Lc"
roru.
-?04- S--
z8. -:p
s2s, ?
(0 3. ?
22b.?
I 3 z. °?
'esk - S'?-?
t 9 PArc CeZ
COHSUlTIN3 ENGINEEAS
PIpNNEflS and IAND 3UpVEYORS
Bt7HNSVILIE, A1INHESOTA 55337 PM 432'3000
AgCs;l .Iae.vcr4p2{ort: LQT S, BLOCK 3, BEiPKSH/Rf ?ONOS,
, DAKOrA co??vT; MINNESOTA.
i y' rL. C0V1NGTD1V LN.
O
99 ° 3S' 3 "!V "T
?o.e 65.D0
DRA/N,S'G E? UT!L /T y O p ?a3. ??
EASEMENT ?9??i0?
30 ' FRONT BC//G D/iYG
RT
?1
` ?
71 S
3D SETB.9CK L/NE
sca?o a ??
? $za.oo ?
m ^ o
I?
`9?0.0; DENOTES EX/ST/NG \
S I
L--??
-
?
EL E!/f1 T/ON ?9 ?
I M PROPoSED? I
$
?
°
( 9?fo•? ) DENOTES Ph'Of'?SED ? o M NousE N J,
r ,
?
o
ELElG97-101V N a 19 IZ ?
O
R7?1 34.60
?
°
OF SURFACE ?RAlN,9?r' ? S.E,wGo.
nn
I?(
a??? 1:?`? o
, u1
LrL_1?, ? l// tJ
I LOT 5
f/N/SNEl? G'AR.4GE FG QOR
EYEV,97-1ON= 944. S3 .5 L
N 69° 35' 34"W (93I.c?
I hereby certify that thia ie a true and correct reprnsenta,43oa of a tract of
land as shawn'and deecribed hereon.. Aa prepared by me on thia SN day of
/rJA-i . 19 ?5 .
? Hinn. 1teg.
e.._.._
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KPIO6 RD, @ACAN MPI 55122
651•881-4875
Naw Conekuctlon ReauhameMs
• 3 registereG sge surveys showing sq. tl. oi bt, sq. R af house; enA all roafed areas
(20% marhnum lot coverege albwed)
• 2 coples of plan showing beam & window sizes; poured found desipn, etc.)
. 1 set of Energy Calculetbns
• 3 coples M Tree Preservatbn Plan tt lot platled afler 711l93
• Rim Joist Delail Options seleclion shaet (bltlgs with 3 or less un8s)
DATE `-t' D 2
SITE ADC
NPE OF
APPLICANTl'f I IIeyiH r v ? ?eAl.C- ?"-
IULTI-FAMILY BLDG _ Y _ N
FIREPLACE(S) _ 0 _ 1 _ 2
STREET ADDRESS 2 o S8 9 CIiYGLSTATE /4,VZIP
TELEPHONE # 9S -2- 95'3ELL PHONE #f?2/.'` 71-25 FAX #
PROPERTYOWNER ir;e. /UQ%S'o D TELEPHONE# f?S^( 65T 35-3`T
----°-------------------------------------------- -------------- --------- °--------------°---
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ n
(?l submission type) • Residential Ventilation Category 1 Worksheet Submitted •
• Energy Envelope Calculations Submitted
Plumbing Conirqcfor: ___
Plumbing system includes:
Mechanlcal Conhactor:
Mechanical system includes:
Sewer/Water Conhactor.
Phone #
Phone #
as 47V i 1;
NjorJ??U h@?t S,ubmitted
4 LU
?
Fee: $90.00
Fee: $70.00
I hereby acknowledge fhat I hpve read ihis application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of AppBcanf _/.°` ""
...-°--•------°----•-•--------------.r.r .............__..r..?.?.r.-•----._..._.?_---r............. .
OFFICE USE ONLY ?
Certlficates of Survey Received _ Tree Preservation Plan Received _ Not Required _
updaied aoz
BemodaVRaoelr ReauiremeMa / / '" ??
. 2 copies ot plan
• 15etofEnergyCalculationslorheatedadd'Abns
• isAesurveyfarezterbradd'arons&tlecks
• Indirate M home served by septic syslem for atlAilbns
VALUATION '4176 5 O
Water Softener
Water Heater
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
_ Air Conditioning
Heat Recovery System
3u-?r
U ILI
suso. Be.rkshire, ponS
CITY USE ONLY
RECEIPT #:
RECEIPT DATE: 10-mo0
PERMIT #
2000 PLUMSING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, D4I 55122
651-681-6675
Piease cromplete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Aiterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet * minimum -1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic System newlrefurbished ' requires MPC lic. 75.00 X = $
Septic System abandonment 30.00 x = $
RPZ new installationlrepaidrebuild 30.00 X = $
Rou h openin 1.50 x = $
Shower 3.00 x = $
Underground sprinkler if dwelling is under construction 3.00 x = $ ?
Underground sprinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Water tumaround 30.00 x $ i
State Surcha e 50 -> -> -> $ .50
TOtai _' g 30'sp ?
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
---------------------------- •--------------------------------------- •------- • -------- • ----------------------------------------------------
I here6y adcnowledge that I have read this application, state that Me informaGon is cortect, and agree to compy with alt appliwble Ciry of Eagan ordinances.
It is the applicanPs responsibility to notify the property owner that the City of Eagan assumes no liabiliry for any damages caused by the City during its
nortnal operational and maintenance activities to the facililies construded under this permit within Cily propertylright-of-way/easement.
SITEADDRESS: ('1!S76 Cbl>IIP--?pti) 1JAJ->L
OWNER NAME: : 9&G IJ £LSO/,-) TELEPHONE
(AREA CODE) ,
INSTALLER NAME: LEPHONE #: 7b3_ -iSJ'OS SS
1 y ?. ? f (AREA CODE)
STREETADDRESS: k /?`LG 02
ciTV: l r+'to S ATE: {?N • ZiP: SS4?I 1
SIGNATURE OF PERMITTEE
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA147287
Date Issued:12/22/2017
Permit Category:ePermit
Site Address: 1956 Covington Lane
Lot:5 Block: 3 Addition: Berkshire Ponds
PID:10-13750-03-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Eric J Nelson
1956 Covington Lane
Eagan MN 55122
(612) 875-2690
Tri County Water Conditioning Inc
325 Third Ave NW
P O Box 65
Huchinson MN 55350
(320) 587-2950
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA158104
Date Issued:09/25/2019
Permit Category:ePermit
Site Address: 1956 Covington Lane
Lot:5 Block: 3 Addition: Berkshire Ponds
PID:10-13750-03-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Eric J Nelson
1956 Covington Lane
Eagan MN 55122
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature