2135 Cliffhill Lane......_...s...? -
BUILDING PERMIT
Ts 6o u?d fer
CITY OF EAGAN
3795 Pilot Knob Rood Eugop, MN 55122 N2 5855
PHONE: 454-8100
Receipt #
Site Addreu Ered 0 Occupancy
Lot Block Sec/Sub. Alier ? Zoning
Parcel # Repair ? Flre Zone
Enlarge p Type of Const.
W Name Move Q # Stories
3 Address Demolish ? Front ft.
0
Ci `
Phone
Grode ?
Qepth ft.
?
0 Nome Approvah Fees
u? Addreu Assessment Permit
Water & Sew. Surcharge
~ Ci phone poiice Plon check
??
FW Nome Fire SAC
O Address Eng. Water Conn.
U
`W Ci phone Plcnner Water Meter
Council Rood Unit
I hereby ocknowledge thot I have read this application and stote thnt Bldg. Off.
the informotion is correct ond agree to comply with oil opplicable APC Total
State of Minnesoto Statutes and City of Eagon Ordinonces.
Siynoture of Permittee
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with oll oppliccble Stote of Minnesota Statutes and City of Eogon Ordinances
Buildirtg Qffitinl
he?M # pah laoed ?e?IfNe
Plumbing 7 - 3 " F-0
Mechanicol - p
-
A -? L d '
INSPECTIONS I DATE INSP.
Rouqh-1 n
Finol
FoOtings - -,- ? i Dafe Insp. Date I? nfp.
--
Foundation
Frame/ins.
Final
?. - aJ
7 Plumbing
Mechnnical
f
Rema rks:
Na.
? CITY OF EAGAN
. 3795 Pilot Knob Road
Eogen, Minnesota 55122
Phone: 454-8100
PERMIT
Date: ?
Site Address:
2135 Cliff Hill Lane
INSPECTOR NDTIF(CATION
REQUIRED BY LAW
FOR ALL INSPECTIONS
Receipt No.:
S+ngJe , l
Residential I
Lot Block Sub/Sec. Multi
Name
?
3 Address
O
City Phone:
Name F lli;i:'!1'_. ..Itc ,
?
P Address OAk- C?reen Ave. ;'
e
0
? City Phone: - 'f-
This Permit is issued on the express condition thot all work shall be
Minnesota Statutes ond City of Eagan Ordinances.
New/Alter./Repoir
Cost of Insrallation
Permit Fee ' -
5urcharge
Tota I
done in occordance with oll opplicnble State of
Building Official
CITY OF EAGAN
3745 Pilot Knob Road
' Easae, MinnesoM 55123 INSPECTOR NOTIFICATIQN
No. Phewe: 454-E100
REQUIRED BY LAW
PERMIT FOR ALL INSPECTIONS
Date: - Receipt No.:
Single I
Site Address: _a i`, _11?f' '._i.I I. T-F:'1e Residential
lot Block ' Sub/Sec. ' Multi Res., Comm./Ind. I
Name -'aChiII821 HOfi@B I New/Alter./Repoir
Address ?",L) ` s tChell i{- • I Cost of Installotion
City 1.-A@Zl Prairi i! Phone: 137-r, 5 = I Permit Fee
men
Name -'-f'•y Vielter litd. Surcharge
r
Address !. ?? ?ti'1C3;;;0 i VC. ??.
? ..I '.,r• ;•
0
V _ F.
City Phone: -? " Total
This Permit is issued on the express condition thot all work shcll be done in xcordance with all appllcoble State of
Minnesoto Statutes ond City of Eogon Ordinances.
Building Offitial
of Orrupaurll
Citp of (eagari
19r,pttr#mrn# n# Building Nspprtinn
Thit Ccrti f icatt issued purturaru to tbt tequirement.r o f Section 306 o f the Uni f orm Building
Code urti f ying that at tix timc o f i.rsuanct this rtructurc wus in com pliance with thc variou.r
ordinances o f the City rrgulating building construction or uje. For the follou7ng:
SF Dtir, eldg-rerniit Na. 5855
Ume clasueaum T,
OccuPaa.7' 1YPe =W TYP.comuucHoct V Firo znae 3 zonin8 Dirvicc R3.
bl7VVe -IlA l ?>
- etiaair4oM.i ?
By: 1981
D,ta: I?ec?cit?r 8,
LiTMOiHU_S.a.
O61 ?
CITY OF EAGAN Remarks
Addition Ci-,dar C13ff Addition - Lot Z Blk a Parcel
Owner}411f Street 2135 (:liffFij 11 T.anP State_EagBII., ME 55122 _
7 Cr 1> i?n}?•? ?i , ; r ,, '??? Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1982 1496.30 299.26 5 1197.04 12-15-81
RESTOR.
GRADING Sa 1981 541.38 108.28 5 324..84 A010805 -17-is-81
5AN SEW TRUNK 1973 7-04 35.23 A010805 12-15-81
* SEWERLATERAL 19$1 2541.01 $0$.20 5 1524.61 A010805 12-1S-91
* WATERLATERAL 1951
WATER AREA 19 7 5, 94
97 6
33 44.33 A010805 12-15-81
. .
STORM SEW TRK ,ry 1981 405.09 81.02 5 243.07 A010805 12-15-81
* STORM SEW I.AT I981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILOWG PER.
SAC
PARK
ON RECURD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
,- 1! w 0; i 1.1
I 'i {iflk 'l J I i l + i .' , it".,' .? > ''•
PERMIT SUBTYPE:
h AM 1 Nis
iil#t;11 I hf !'1 f?fi
I , . ;',nliti:
TYPE OF WORK:
I N •,i11 1a I I tIN
t INAI
I: P/1kAil I'f NMI f:ti Akt !:{'9Il)Isf !i 1 Oh AMY 1'l 11MttINf, 01t I 1 1 1 1 t; 1 LAt. tP114
Permit No. PermR Holder Date Telephone #
S/W
PI.UMBING
HVAC
ELECTRI /.O,flrw
ELECTRIC
Inspectfon Date Insp. Commertts
Footings i
Foundation
Framing
Roofing i
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Pibg. Inspector- fVotity Ptumber
Const. Meter
EngrJPian
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
&Vg,' ? fOVA46 Peyn?
??'p? l? ? s.t? Nc? /?Y> ?Y S8 G?ora?
.
WATER SERVICE PEItMIT
cITY oF EAG,a?N
3745 Pilot Knob Road PERMIT NO.: i
Eagan, M'A1 55122 DATE:
Zoning: No, of Units:
Owner. - ,
Address:
Site Address: '
?
Plumber:
MeYer No.: Connection Charge:
Size: Acwunt Deposit;
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Qrdinances. Misc. Chorges
Total:
By Date Poid:
Date of I nsp.: I nsp.:
CITY OP EAGAN
3795 Pilot Knob Road'
Eagan, fJ?N 55122
Zoning: ,
Owner:
Address:
Site Address:
Plumber:
1 agree to eomply with the City of Eogon
Ordlnanees.
R.,
Date of Insp.:
SEVHER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Connection Cherge:
Account Deposit: _
Permit Fee:
Surchorge:
Misc. Charges: -
Total:
Date Poid:
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-16600-020-02
DESCRIPTION:
PERIVIIT
PERMIT TYPE:
Permit Number:
Date Issued:
2135 CLIFFHILL LANE
LOT: 2 BLOCK: 2
CEDAR CLZFF
r ..
e,0'?.ld.ing'._Psrmit Type
.?uilding lJes.rk Typs
?
?.
?., ?,...-
BASEMENT FINISH
ALTERATTtlN
?, 33?s
/G?I7
L /D/fMG
024762
10/26/94
ZJ
REMARKS:
SEPARA7E PERMITS ARE REQUSREp FOR ANY PLUMBING OR ELEC7RICAL WORK
FEE SUMMARY:
Base Fee $35_00
Surcharge $.50
Total Fee $35.50
CONTRACTOR:
OWNER: - Applicant -
DTMENT ANDREW
2135 CLIFFHIIL LN
EAGAN MN 55122
{612}452-6375
I I +
I hereby aeknqw,l!adge that I have resd this appiication and stat8 that the
informatian is correcC end agree to com.p2y wiCh a31 appXiceble StaCe af Mn.
Statutes ancf City af Eegam drdinances.
L . ? ?
APPLICANT/PERMITEE SIGNATURE
???? 941-ILI 1161./
ISSUED BY: IGNAURE -k
-
CITY OF EAGAN
1994 BUILDING PERMITAPPLICATION
681-4675
I) -?i
??,
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surweys? ? cop?y o energy
calcs. ?
COMMERCIAL 2 sets of architectural & structu -- "-"' '
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date l? /?Lo / I( Valuation of work
Site Address: (-t-IFf--I+1LL LN.
STREET SUITE N
Tenant Name: (commercial only)
LOT ? BLOCK SUBD.
(?'
v
#
P.I.D.
Descri tion of work1?srv1'f 'Ili ?L
The applicant is: [?Owner ? Contractor ? Other (Describe)
Name DI M6n%I ' J}/bORI k/ Phone Ll S? -6 37 S
Property LASr FIesT
Owner qddress c-1-II'F14IL_(, LN
STREET STE #
City State .MAll Zip S 5d4
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
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 Applicant:
Model CITY OF EAGAN
- ' 3795 pI1M Knob Raad Eagan, MN 55721 N2 5855
PHONE: 4544100
BUILDING PERMIT APPLICATION Receipt # /.20 U
Site Adslress
Lot Z
Parcel # _
Block 'V Set/Sub.
W INome Zachman Homes
z Address 7760 Mitchell_ Road^^ry ^'^
p Ncme
i?
Erect [.?'. pccupancy R3
Alter ? Zoning Rl
Repair p Fire Zone j
Enlaroe Ej Type of Const. V
Move ? # Stories
Demolish ? Front ? tt.
Gmde ? Depth {t,
APDrovale Fees
OU
Addtess
Assessment
~ Ci Phone Water & Sew.
Uw Nome Same Police
?w Fire
_0 Address En9
<. G Phone Planner
I hereby acknowledge that I have reod this application and state that Council
}he information is correct ond pqree to mm with all applicable Bldg. Off.
Stote of Minnewto $tatute5.a4Ciy , a9a ' es. APC
Signature of PertnitteeC-2-
A Building Permit is iuued to
Permit 117.50
Surchorge 20.00
Plan check 57.75
snc 525.00
WaterConn. 0$.00
Water Meter 60. 00
Road Unit 185.00
7oral 1268.25
oll work sholl be?-d Sn'eoc/c/otda/n P
c/e-1w ol liwble State of Minnesoto Statures ond City of EaqanrOrd nances.n mat
Building Officiol +'????%
.zr? CITY OF EAGAN
? BUILDING PERMIT APPLICATION
r7? Zb Be se/.?uAp /? ? Valuat;ion
site Paaress
. Sub.
Lot ? Block ?- Sec' 11_
Parcel #:
Oaner:
Address: 22G0
C.ity/ZiP Code:
Phone
Contractor:
P,ddressc
City/Zip Code:
Phone #:
Arch./Enq.:
Address:
City/Zip Code:
Phone #:
IncluUe 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
Date
OFFICE USE ONLY
Erect occupancY
Alter Zoni-n4 0(?/
Repair Fire Zone ?
Ehlarge _ Type of Const.
I"bve # Stories
Danolish Fxont Slo ft.
Grade Depth 3g ft.
APPFJD7ATB FEES
Assessaents
D
PEMTLit
[4ater/Sewer Surch
ar4e a0 ?
Police Plan Check
Fire SPC S-,)S
EnJ• Water Conn. -30S
Planner ?
Water Meter /n0
council
Bldg. Off. Foaa unit lqs J?-
APC
TCTAL ?1 a??,?
r--'Z-?. `?•? ?!?_J --
EQAN FI ELD & NOV!/AK ?Q
T -?1 SURVBYOR9
-?
TIIS WAY2ATA SW6 B F Mllp{EAi0US, MI/1MLfOTA
ttifA?. 1?)1
CERTIFICATE OF SYRYEY
F« Z4ef1MAN NO.tdES
Ea3 ? - 78.00
iRO.u _ -+,?- iROM
?S'UT/[/Yy ?,I/Nq6E ' i
? I EASEMENT
I
L^
..
p ?,,I
o
? • ?- ?.? ' ?:??ti
y ? ?._...
?t
? ?,; ? ? ?
--*---
?
t;
? y 78.00 --? ?/. SCA1E:111=30'
/O'UT/G/TY i qpq/.U46f EASEMENT
CG/FFN/[.G GANE
(::D INDICATES PROPCSED ELVIATION
PROPOSED GARAGE FLOOR
OE"/PT/ON' LOT ,2, BGOCK Z, 4E49" GL/FF
we hereby certify that thia is s frue and correct representetion af e survey of
fhe bounderies of the land ebove describe0 and of fhe Ixetion of sll buildingo,
if eny, thereon, end all visiDle encroachmenla, if any, from or on seid tand.
ted this 2_Day of M8y 1980
. . ECaAN, ELO i NOwAK, IMG
No?k urveyor
i
Book No by , ?
Fc'r. F"4 422.3
?
tA••.•a7.7o) MAP OF ' QPERTY
See at;ached for legat
Lot ? eik. 2 Addition CEDAR
ACdress:
E
FIELD NOTES
Show location of ineters
Private well
Private septic system
Public water
Public sewer
Natual gas
L.P. Gas
Culvert required
Curb cut required
Sewer $ Water stubbed in
Driveway surface arT AsPNALT
Front yard setback
5ideyard setback
Att. Garage
Garage left right
Local Inspector
City of
idame
Phone
LOT DETAILS
'size width 78'
Size depth 125'
Approx. S.F. of lot 9,750
High point
Power Poles
Telephone poles
Underground
Larger trees E3
Street = Elev. 0.00'
Lot corners
High point
Low point
Gutter or Ditch
CL IFF
L an-e
' . .............. ......................"'"'........"'•.•
Eullder Zachmen Homes lnc.
House Name OAKWOOD CEXptijJvEpJ
House Style SPL IT FQYEt?
?
I Sq.Ft.House 9D6 # sq.ft.Garg?
M
Power ples P
Telepone poles T
Larger TreesC?
9oY3?
Local Electric Co.
Name ,
Phone
Lotal Gas Co.
Name
,
Phone
riser
a) Stoopsj( ) $
,
Decks 441
?
b) Sidewalk s.f $
Driveway s.f. ?
Parking PaU s.f .$
Curb Cut ? Peimits ?
lawn steps # $
c) Finish Grade $
-
_
d) Black Dirt F, landsc aping
?
sod s.f $
e) Underground Util. $
TOTAL ?-
??AC CHARGE
ater charge
-Park charge
8
N
\I
qoay'
$
$
Low Areas
Highest Point
r
78, 00'
? I I
I ?
I I • ,I
I I /Ox/D I
pEcK I
? I9ov-3' fG?
N I
N ?
?
9 v/.7'I -
?
I ? 9 oy i' i qoY.3'
I
NORTH
gOy.S
?
0
ti
78.00' / 901,6'
ELEyR 7-/O0 -'9N
pv???] ? c G??EC Of'mrh'7J?L AN s RE F?R s TD
GA?PfFG? S?.a 3
DIRECTIONS TO SITE: ?
ucrw • na
C M. ...... .'"""""".. 7....... ............... 1.- """_
- ? ? . ...... ? . . ......--.. a
••:•
?_......
.10
.._....t
a _
_ 10 . . I
.. tl woaa
C ?..r?rY
? ...... S,.
c..... .. ..o ....... + •.... . .io...... .
3 o.. n%
U 9 EOY'irlM d A?KYTq
This request void 18 months from l-, -z '?','a CG-41'"' 6?wzf7/3
1
Date of this Reques ,1L -7 'R 97436
I, as ? Lice nsed Ele cal Contractor ? wner, do hereby request inspection of the above electci-
cal wiring installed a :
Street Address or Route N " City
Section Township Range County
1
Which is occupied by "
( ame of Occ ant)
Is a rougliin inspecti req ired on this job? No ? Yes Ready Now ? Will Call
Power Supplier Address (? ? ?r» ? Gt-?.
?? C ?Jd7?
Electrical Contracto ?? ? Zf Contractor's License No. _
i / . ICOxooam Namel , ,
Mailing Address
Authorized SiRn
STWTE BOV"8RD
This
No.
iking This Ins[allatlon)
This inspectian request will not be accepted 6y the
State Baard unless proper inspectian fee is endosed.
Minnesota State Board of Electricity I"
1954 University Ave., St. Paul, Minn. 55104-Phone 645J703 ztvarl
REQUEST FOR ELECTRICAL INSPECTION 'R' 97436
CHECK BELOW WORK COVERED BY THIS REOUF.ST
Type of Building New dd. Rep. Check Appliances Wired For Check Fquipment Wiced For
Home ? ? Range ? Temporary Wiring ?
Duplex ? D ? Water [ec ? Lighpnglixtures ?
ApL Bldg. ? ? ? Dryex ? ? Etectric Heating ?
Commercial Bldg. ? ? ? Fum Silo Unloadei ?
Induslrial Bldg.
Faim
O[her ?
?
? ?
?
? ?
?
? Air C ditt -------`'?
Lis[ })
Heters) Bulk Milk Tank ?
Lis[
OSheis?
Here 7
COMPUTE [NSPECTIONiFEE BELOW
?
Serv ize: # Fee Feeders&Subfeedeis: u Fee C'vcuits: # F•C6'
0 to 100 Am s. 0 ta 30 Am eies 0 to 30 Am eres
o mps ??s d 31 to 100 Ampexes 31 [o k00 Am eres
Above 200 Amps. Above 100 Amps. A6ove 100 Amps.
Transfoxmers Remote Conttol Cim Partial or othex fee ..t) (P1 '
Signs Special lns ection Minimum tee $5.00 1 I
Kemazks
I, the Electrical Inspector, herehy certify
(Final)
This request void 18
TOTAL FEE
?A .
bov?"?{i'; ? io as een,zqade. ? U ? ? _
REQUEST FOR ELECTRICAL INSPECTION
064720 ? See insvucnons for completing IhiS brm on beck ol yellow copy
'X" Be/ow Work Covered by This Request
E8-00001-08
? ?' ? 335435
ew A Typeot6wlding ApphancesWiretl EOwpmentWired
Home Range Temporary Service
Duplex Water Heater Electric H@8ting
Apt. Bwlding Dryer Load Menegem0nt
Comm./Industnal Furnace Other (Specity)
Farm Air Condinoner
Otner (sui Conlractors Remarks
Compute Inspectron Fee Below:
# Other Fee # ServiceEn[ranceSize Fee # Circwts/Peeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps AGove ?_ Amps
SIgnS InsOectar§ Vse Only
i
?TA?
Irri
6
8 `r ?
ga
on
ooms ? ?
b o
S
eaal I
ti GSernc n 1'\? ? \
p
nspec
on
Alarm/Commurncatwn THIS INSTALLATION MAV BE ORDERED DISCONNECTED ff NOT
Other Fee COMPLETED WITHIN MONT 5.f,
I, ihe Electncal Inspector, hereby Rouyn-in p ;
, 0a1e
certify that the above inspection has /'
been made oare
OFFICE USE ONLY ?
?
This requast vmd 18 monIDS Irom ? C ? /?/(??
C? 64 7 2 0
d ??/??
?- 33 ?3"?
i•
? L $
?
?
Repuesi Date Fire No Rougn-In ion qeawretl
(?'ou mus call inspaclor when rea0
Y' Inspection Other TM1an RouBh-In
? Reatly Now NotHy inspector
Ves ? No Date Ready
IEJ hcensed contractor >I?pwner hereby requesi inspection of above elecirical work at
Job Atltlress (SVeat 8oa or Route No ) c??y
, -1 CL -?f ?LL LN L
Secbon No Township Name ar No Ranqe No County
OcWpant (PAINT]
Pnone No
ndr+z+N I ;mon f-1i??G375
Pawer Supplier Atltlress
Elecincal Conirector iCompany Name)
S Grn 2._. Contracror5 Lrcense No
Meiling Atldrass IConnacror or Owner Makmg In i
Huthonz tl Signeture iCOntracronOwner Mebng InstellaLOn)
- Phone NumOer
y Li ?-G37
MINNESOTA STAtE BOAPD Of ELECTHICITY ? ?(J THIS INSPEQION REOUEST WILL NOT
Grlggs.Mitlway Bldg - poom S1]3 0? 8E ACCEPTED BY THE STATE BOAftD
1821 Unrversfy Ave. St Paul, MN 55tp6 UNLESS GROPER INSPECTION FEE IS
Phone(612) 602-0800
ENCLOSED
For Office Use
f I I
I Permit
City of Eagan I a
I Permit Fee: ~ I
3830 Pilot Knob Road j
Eagan MN 55122 I Date Received: 1
Phone: (651) 675-5675 I ` I
I
Fax: (651) 675-5694 I Staff:
1 I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 3 i t frv► t~vnpL~-
Tenant: Suite
RESIDENT / OWNER Name: v► V1 0- ULJOA,4~ Phone: 6~1- yir ~l j 4(
er 3; 00
Address/ City /Zip: 71 35
Applicant is: _ Owner Contractor
TYPE OF WORK Description of work: f
Construction Cost: C~C Multi-Family Building: (Yes / No )
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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.
x one, x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
I - Argo 3 a 3 00~
- - - - - - - - - - - - - - - - -
F;_ O ice Use
City of E1 Permit#: ZS D~e~7
m
3830 Pilot Knob Road I Permit Fee: yv
Eagan MN 55122 I
Phone: (651) 675-5675 I Date Received:
Fax: (651) 675-5694 1 Staff: i
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: ~O O Site Address: a2 19 5~- CL-t r-r- l HLr; - -P14', C.CL
Tenant: 252. IA-Z,4-(L WC-i2 /Z,6 R-A Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
CONTRACTOR Name: 1VA'S=-C-P' ei6c~, C+t- License
Address: l Z 2 `J. (.vA ~JAr`fsb(„- z l OJ
City: State: N Zip: SS- r,!:):7
Phone: Contact Person:
TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild Modify Space Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ PVB) ( Main _ Lower Level)
Septic System Water Turnaround
_ New
- Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $ ~ 6-D
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 fora 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,
Applicant's Printed Name 's Signa
FOR OFFICE USE Reviewed By: Date: _
Required Inspections: -Under Ground Rough-In Air Test Gas Test Final
Use BLUE or BLACK Ink
r
For Office Use I
t 1
Permit
1
l"t I Lo C
yof E a,R
I / 7 I ~S
D I Permit Fee: ~
3830 Pilot Knob Road NE I
Eagan MN 55122 1 Date Received: ZIA.
Phone: (651) 675-6675 staff:
Fax: (651) 675-5694 1 t
2012 RESIDENTIAL BUILDING PERMIT APPLICATION Cad vql
Date: 99, & rJ (P- Site Address: A I 3S & 4 Lanf L a.r. -5 1 2 90nit M
Name: C f Phone: (05 2
RESIDENT /
OWNER Address ! City / Zip: oZ 1-36' I r=Gh,,c,( Lct n -OLP a n 5 5 / ~ %I
Applicant is: Owner C 'fl' etor~ r I-cLoCe, 4196 -9 3oZCD
TYPE OF WORK Description of work: Construction Cost: 000 Multi-Family Building: (Yes / No
Company: Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
License m Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Ve s buU W cl ec k-
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. i
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.oopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x Anne ELVILrdti~ _ x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE t ZA)
SUB TYPES -Zi(
Foundation Fireplace T 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 Occupancy MCES System
Plan Review Code Edition 7 SAC Units
(25%100% Zoning City Water
Census Code 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 / G.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: rIce & 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 T Backfill Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee G
Surcharge Ir
Plan Review
MCES SAC
City SAC
Utility Connection Charge
_
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
E G A N. FIELD A N OWA K
SURVEYORS
741SWAYZATA iWa ~ R MINNEAPOUS, MitNINTA
:1Ai. 4f71
CERTIFICATE OF SURVEY
F« Z&RMAN MOMSS
< 79.00 QED
/AtW
~S' ~r~cirY r L6P,fI,+iG16E ' i
Zo4SEMEIVi'
l
00~
•w,
IT
1, k
ell~ i t
79,00 (ED
f f/~d't/Ti'61TY r'q~pA/~t146E EASEMENT
CL IFI PILL LAND'
C> INDICATES PROPOSED ELVIATION
D¢_f>_~
PROPOSED GARAGE FLOOR
aesc Wr/ow• for z, dwe& z' C.6'0" aioc~r
We hereby certify that this is a true and correct representation of a survey of
the boundaries of the land above described and of the location of all bulldingy,
if any, thereon, and all visible encroachments, it any, from or on said land.
Lafiegdwthlg~ 2,_„~8thday of m87~ 1980
.E GJFurveyor E L 0 t tlOrlll►K~ ttlC
ok' l8 Boo
k M ZZ76-J$ by
Use BLUE or BLACK Ink
r
For Office Use I
Permit 15cl o l
City of EaRan
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: 3
Phone: (651) 675-5675 I /~I
Fax: (651) 675-5694 I Staff: t-fi~ I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 1 6 Unit
A _J -
Name: tl Phone:
Resident/
Owner Address/ City/ Zip: 's t
Applicant is: L~~ Owner Contractor
i
Type of Work Description of work: C- iQ ?
a,
Construction Cost: Multi-Family Building: (Yes / No _,!(L_)
Company: ( 1,,J N ~Z Contact:
Contractor Address: City:
State: Zip: Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that 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.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Iding Code I be-c pleted within 180
days of permit issuance.
i
x x
U
Applicant's Printed Name ppli n s Signatur
Page 1 of 3