2110 Cliffview Dr- • ' ? '? CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?T
1,?I ? 9035
PHONE: 454-8100 ,
BUILDING PERMIT Receipt # ' - l
Te bo rad fer ' °?[TIt1C 1-a C???R1?CT, Est. Volue Dote
,
SlteAddress CLZFV'VIEGi I);, Erett ?
-
???ncy
Lot ?, Block 3 ?ec/Sub. C}' `) ('. T.? i•'i L Alter ? Zoninq
Parcel No. -)- i' (- (• 1- 090 - 03 Repoir ? Fire Zone
E
l T
f C
orpa ?
n
, . .
?
ype o
onst.
W Name .
Move Srories
_
? Address Demolish p Length
City Phone Grede ? Depth Sq. Ft.
? Name
Z?' 12
5 i7ZATA i
ou Address
CILY PhOne ` 6_3J
u? ?,
Neme
Address
City , Phone
I hereby acknowledge that I hove recd this opplicotion and state that
the informotion is corred ond agree to comply with all opplicable
State of Minrxsoto Stotutes and City of Eagan Ordinances.
I Siqnoturc of Permittea .
," ,i,t,,,_..,
A Building PermiT Is issued to:
oll work shall be done in utcordante wlth oll oppticable State of Minn
? Buildinp Officiol
6_4?w
Assessment
Woter & Sew.
Police
Firo
Enp.
Plonner
Council
Bldp. Off.
NPC
Permit .' • , o
Surchorfle 5 rJ
Plan chetk
SAC
Water Conn.
Wote? Meter
Road Unit
Totol
_ on the expross conditlon thoo
City of Eoflan Ordincnces.
Permit No. Permit Halder Miac. Permit No. Holder
Plumbing
H.V.A.C.
E
Well
Water
Disp.
Sewer
ENctrie
Infpection Date Insp. Other
Footinyt
Foundation
Framing
F
Rouyh Plbp.
Rouyh HVAC
Inwlation `
Final Plbg.
Find HVAC i/
Final
Water
?
Well
s 3 0 - ? ?-
?.?.
Pr. D'?sp.
• s
- - cirr oF E?caN
' 3795 Pilof Knob Road Eagon, MN 55122
' PHONE: 4648100
BUILDING PERMIT ReceiPt #
N! 6711
To `e ded for Est. Volue Date , 19
Site Address Erect Q Occupancy
Lot Blxk Sec/Sub. Alter ? Zoning
Repair ? Fire Zane
Parcel #
Enlorge ? Type of Const.
W Name Move ? # Stories
Z
Address Demolish ? Front ft.
p
.-:...
' r . :o?___ _•
Grade
I-l
Death
ft.
g0Nome _
'
???
Address
? rit.,
Name
I hereby atknowledge that I have reod this opplication and state that
the informotion is correct and agree to tomply with all opplicable
Stote of Minnesota Statutes and City of Eagun Ordinonces.
Assessment _.
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bidg. Off. -
APC
Permit
Surchorge
Plon check
SAC
Water Conn.
Woter Meter
Road Unit
Total
SignoLure of Pertnittee ?
A Building Pertnit is issued to: ° on the express condition that
all work shnll be done in accordance with oll applicable 5tate of Minnesoto Stotutes and City of Eagon Ordinonces.
Building Official
..mk ? o.?. a.wa r«.i"..
Plumbing 7- ? 0.(" t Ct C
Mechanical $",2, ?- $ -PS) -W?? ?- r-
7 y3 -7-/3-S
INSPECTIONS DATE INSP, Raugh4n Final
FooYings ci/ Date Inap. aate Irmp.
Foundotion Plumbing
Frame/ins - j-$ f Mechonical
Fina - ?
Remarks:
C?1rtifiratt uf (Orrupaury
Citp of (Eagari
Dr.pttrtmpn# nf Euiibing 3tcoprr#imt
Thi.r Certificrtte issued purtuant to tbt requirement.r of Section 306 of the Uniform Building
Code certif ying that at tbe timc o f issuance thi.r .rtructure waf in compliance with the various
ordinances of the City regulating building construction or use. For the f ollounng:
?022sificAt;on S3ngle Family IArellinr BIdg.PecmitNo. 6711
Occupyocy Type R3 Type ConsWCtion v Fire Zone NA Zoning District iLl
a„fmrofBuud,,,6 Zachnan Iiomes, Incllaa?.LOt 9,.Block 3,?Cedar. Cliff
Bw]ding Addres Locality
By; AUguBt 20, 1981
,-r--
:
? ?,7? t0lT I N A
Receipt MECHANICAL PERMIT Permit No. -"
CITY OF EAGAN
Fee
fill in numbered spaces S/C ?
Type or Prini legib/y Tat.
1. Date -2. installation Cost
c3`. ti
3. Job Address 1 10 1%]. iif?!].''•• Lot Blk. Tract
('??- '?)- I
4. Owner
5. Contractor Phone
6. Address 637 h1CEtgC .. ` ?„ `' a'
7. City
MplB.
8. Building Type: Residential r-I
5?4U?
5tate Zip ' ?
Commercial ? Institutional ?
9. Work Description: New 0 Add 0 Alter ? Repair ?
I 10. Describe? Fuel Type
1 11.
No.
? Epuipment 8TU • M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
Mfg. g
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 Finel
., Inspections: Date Insp. Date Insp.
I ' This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
fill in numbered spaces S/C ?
Type or Print Jegib/y Tot. ?
1. Date 2, Installation Cost
3. Job Address Lot Blk, Tract
4. Owner
5. Contractor Phone _
6. Address
7. City State Zip I
8. Building Type: Residential O Commercial ? Institutional O
9. Work Description: New ? Add ? Alter ? Repair 0
I 10. Describe
I 11.
No, fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Batfi tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Orains
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
Rough Pinal
, Ihspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
4pproved CITY OF EAGAN 454-8100
) CASH RECEIPT
CITY 4F EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE -
19
rreceIvto
FROM ,
AMOUNT $ I
& DOLLARS
too
? CASH El CHECK
FOR ?
?--
41L,
i
?
FUNO , CODE AfAOUNT
Thank You
B Y
.. . i
?
White-Payers Copy
YMlow-Posting Copy ,
Pink-File Copy •
` _ J
CITY OF EAGAN Remarks
Addition CEDAR CLIFF 2ND ADDiV.
OwnerhYi(CL A-? 1L12 WJ Street 2110
Cliffview Drive stace Eagan, MN 5
Improvement Date Amount Annual Years Paymenc Receipt Date
STREETSURF. 1983 1776.56 355.31 5 1776.56 C007776 8-2-82
STREET RESTOR.
GRADING 7 1983 522.84 104.57 5 522.84 C007843 9-13-82
SANSEW TRUNK 973 119.14 7.94 15 47.68 A010563 - 4-
*SEWERLATERAL 7 1983 2182.58 436.52 5 2182.84 C007843 9-13-82
WATERMAIN
* WATER LATERAL 1983 5
WATER AREA 57
*Services 1983 5
STORMSEW TRK 1981 452.03 90.14 5 361.63 A010563 9-14-8
STORMSEW LAT U-N 1982 756.57 151.31 5 756.57 C007310 10-1-81
CURB & GUTTER
SIDEWALK
STFEET LIGHT
Ro 6-9-81
WATERCONN. 335.00 25060 6-9-81
BUILDING PER. 6711
SAC
PARK
INVOICE
of E
P.O. Box 21199
3830 Pilot Knob Road
Eagan, Minnesota 55121
454-8100
TO:
r ,
T1s1tn'1'A ('[NiN'1'S' H7(;HLTAY Nf'TAiFFR
7300 W 147th ST. SiTITE
APpLE QAL3.8Y, HU 55124
L J
2379
Date• Jan. 20, 19$7
DESCRIPTION AMOUNT
_ y -e County Contract 28-07)
Utility Adju4tson[s S1; 932.;;_
Less City's Share (450) - ),6I9,84
313 i
Total Due Upon Receipt - Thank You
CITY OF EA6AN WATER SERVIC E PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagar, MN 55122 DATE:
Zoning: No. of Units:
Owner: -
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reoder No.: Permit Fee:
I agroe fo comply wiNh Hhe Cify of Eagon Surcharge:
Oedinaneea. Misc. Charges:
Totol:
By Dute Paid:
Date of Insp.: Insp.:
CITY OF EAGAN SEVIIER SERVICE PERMIT
3795 PUot Knob Rood PERMIT NO.:
Eagon, MN 55122 DATE:
Zoninp: - - No. of Units: 1
Owner: Zacl._ .n .? I.^.r
Address:
Site Address: 1? Cl: • ?S, ? r r I T
Pl umber:
I egree to osmply whh 6e Citp of Eagan Connection Charge: .„-' •??? ?
Ordlnences. Account Deposit:
Permit Fee:
Surciwrge: r
BY Misc. CFwrpes:
Dote of irup.: Totol:
0 41772
,
Ready Now ? wrll NoOfy Inspector
WhenReady>
Ij licensed conirector ] owner here6y request inspechon of above electrical work aP
Job Atldres: (Sreet Bax or qoute No ?
? Gty
Secoon No ITOwnship Name or No Range No County
No
Bemnczl Co nacmr ?CorRpany ame?
Conlractor's License No
?' Ci?C=/'/ZiG
Mad?n9Atl?s?pacmrorpwnar Making teila?ion?
Aulhorrzea i lur ICoo(racto•O neMaking
, ? Phone Number
Gn ??50 BOAq ?LECTRIdTV? w .?• ?ED BV TH6 S?ATE BOARpT
99s-MiaaY 61tl y3 ?aTHIS Jf?• .., BE ACCEP
1821 Univer e. St Paul MN 55106
662-0800 UNLESS PqOPER INSPECTION FEE IS
ENCLOSED
REQUEST FOR ELECTRICAL 1NSPECTION pi. r
g EB-00o01-08
? See iashuctons br oomplenng [his form on beck oi yellow copy
"X" Below Work Covered 6y This Request
Imp- lypeof8wldmg
? AppliancesWired EqwpmantWired ?
?_ Home
Duplex qange
Water Healer Temporary Service
Electnc Heating
Apt Budding Dryer Other (Specify)
Comm /Intlusinal Fumace
Farm Av Conditioner
OtherlsuecJy? Coniracmr's Remarks
Compute lnspechon Fee 8elow
x Other Fee # ServiceEniranceSrze Fee # Circmts/Feedere Fee
Swimming Pool
Transformers 0 to 200 Amps
Above 200 _ Amps 0 to 100 Amps
A6ove 100 _ Amps
Signs Inspecto's Use on:y TOTAL
Irngation Booms
I
?
Speaai inspection
U
I
-
Alarm/Communicahon THIS INSTALLATION MAY BE O
DE
Other Fee R
1SCONNECTED IF NOT
COMPLETED WI7HIN 18 MONTHS.
I, the Electncal Inspector, hereby
certify that the a6ove inspechon has oaie
been made. f Date. w/?_q?r
OPFICE USE ONLV •
?•? w?=??wIu ro i"iiimslmm ?
?/ ? G_?? ?? I C ,CrG
This request void
18 months from
A 7t
_25736 ?
Date of this Request E_29_8? Fire No. ?743482
1, as O Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wuing installed at:
Street Address or Route No. 2110 Cliffview CitY Eagan
Section Township Range County Dakota
Which is occupied by 7arhman Hnrnes
(Name ot Occupant)
Is a rougltin inspection required on this job? No ? Yes?] Ready Now ? Will Call ?
Power Supplier Dakota Electric Address
-11
Electrica] Con2ractor- Sunrise lPr tr; r ! r0 Contractor's License No. 7-9,7-g
(COmpany Name)
Mailing Address
(E sctricdl Con rdctor or ner Mdking T??el tlOn)
AuthorizedSignature_ Keith R H sli PhoneNa 566-8600
(Elecb}cal Contractor or Owner Making Tbis Installal7ort)
((? n??
p???D ?OnM This inspeetion request will not 6e accepted by the
v?_,, W?, fr 1! State Board unless praper inspection fee is enclosed.
Minnesota State Board ot Elec[ricity
Griggs Midway Bltlg. - Room N791
1$21 University Ave„ St. Paul, Minn. 55704 - phone 297-2171
E73-00001-02
REQUEST
?
ION
f 25-736
'HECKBELOWW,Rg
OV REDBR
THISREQ EST
Ty
e of B
ildi ? 43482
p
u
ng New pdd. Rep, Check A
ppliances W'ued For
f7ume ? Check E
9uiDment Wired For
?? Range ?
Duplex ? ? ? Watet Heater
0 Temporary Wiring ?
Apt. Bldg, ?
El ? Dtyer ? Lighring Fixtures ?
Commercial Bldg. ? ? ? Fornace El Electric Heahng ?
Industrial BId
g. El 0 ? Air Conditioner ? Silo Unloader ?
Earm ? [] Q List
{ Bulk Milk Tank
List ?
Other_ ? D ? Oehers
IT_ Otherc? to 1
to
TOTAL F$E ?
I
(Rough , the Electrical Inspector, hereby certif at th b e jnspection has been made.
in)
(F nal) Date
This request void Date
18 months &om
" CITY OF EAGAN
3795 Piloe Knob Rmd Eagan, MN 55122 N2 6 711
PHONE: 454-8100
;4:5?
BUILDJNG PERMIT APPLICATION ReceiPt # F-
Te be vaed fer SF DW('i Est. Value 42?000 Date J1Il1@ 9 , 19--m-
Site Address 2110 C1iPfV3eW DTiVe Erect t] Occuponcy ??--
Lot 9 Block 3 sec/sub. Cedar (?ilj.Ff 2 Alter ? Zoning R1
par"l # 10 16603 090 03 Repoir ? Fire Zone NA -
Enlarge ? Type of Const. n
s Name ZaCt1i09I1 HOIIIEB Inc. Move ? # Stories
Z Address 7760 Mitchell Rd. Demolish ? Front 36 ff
6 Ci F. dPn Prflirie Phone 937 952(l Grode ? ?epth y+ N.
Aoorovals ? Fees
o Name _
??r
Addreu
Name _
Address
1 hereby ocknowledge that I have read this avPlication ond stote ihat
the infortnation is mrrect and ogree to comply with oll opplicable
State of Minnesota Statutes and Ciry of Eogan Ordinances.
Assessment A96-3-91
Woter & Sew. -
Police
Fire
Eng.
Planner
Council
Bldg. Oft.
APC
Permit 120_50
Surchorge 21 -n0
Plan check 61 _ 25
SAC 525-00 Water Conn. 335_(]0
WaterMeter 60_nn
Road Unit 185_(1(1
Total l ?()fi_ 75
$ignature of Pertnittee I
A Building Permit is issued to: Z&ChII1831 HOID28p Inc, on the express conditlon that
all work sholl be done in nccordance with all applicable?i'itate of MinnfSfta Statutes end City of Eagon Ordinances.
Building Officiol
CITY OF EAGAN Include 2 sets of plans,
•? ?}r 1 site plan w/elevations &
BUILDING PERNLIT APPLICATION 1 set of energy calculations.
'
d i D
t
Ib Be Use
For S on
Valuat a
e
Site Address: -)l\ OFFICE USE NLY
Lot ? Block ? Sec. '
/Sub. t. rect
?C Occupancy .?'
Parcel #: ?!? _
Alter Zoning /
gepair Fire Zore a
Enlar4e Type of Const.
Qaner: _
Nbve # Stories
Pddress: ? Q Dennlish Front 3? ft.
.
ode:
City/Zip C Grade Depth .0 ft.
/ \
Phone #: APPROVIIIS \ FEE5
Contractor: Assesssnients Fermit `'
? Water/Sewer Surcharge R/ ?-
Pcldress: P
li P1an Check '-11
ce
o ? O A
City/Zip Code: Fire SAC
Phone #: Ehg. Water Conn. 3 3 3
plarmer Water Meter ?
Council Rc>ad Unit
Arch./Ehg.:
Bldg. Off.
Pddress: APC
City/Zip Cocie:
Phone #:
TOTAL ? , -7 <
?y
? CALVIPD H. HEDLUND
#. Lone $urwyor Civll Enpinqr
. ,
,
?
?
&?z
SURVEY FOR. ZachmHOm
?c
0€SGRIBED AS: Lot 971
i Dakota County, Minnes t
L _c;?'
I
ToP o-C blouk 904.Z
13sm-F. ;loor 901.0
Draina9e wcrows --i-
PrDposed eleV.O
Existing ctev.
Deno-Fes 10-1- i-ro» o
JOB N0. al?213
? m
y u
o -
1_J+8
lo'p s+o.kes
cERTIFICATE OF SURV? -
S hereby certify thot on I surveyed tbe {xQperty dexcribed above ond thot
the oDOVe plot is o correct representation of safd survey.
9609 Glrard Avenue Soufh
BloominQton, Minnesota 55431
Phons : 8 8 8-20 80
Calvin H. Hedtund, Minn. Req. No. 5942 ..
100.3? ?
SECOND ADDITION, City of Eagan,
sementa of record.
i
1
?
?
`? CLIFFVIEW DRIVE M
- -. -- ---=_-_.
? CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8700
BUILDING PERMIT
r_ w....a s_. A'iTACH GARAGE
$5,000
SiteAddress 2110 CLIFFVIEW DR
Lot 9 Block 3 Sec/Sub. C•D .TFF 7
Percel No. 10-16601-090-03
rc Name
; Address SAME
b City Phone
& I WESTERN CONST CO
o Name
z? 5 WAYZATA BLVD
Address MPLS 546-3385
r City Phone
Name _
Address
City _
Reteipt #
N° 9035
Erect pfJ Occupancy R3
Alter ? Zoning R1 ( PD )
Repair ? Fire Zone ,N,/A
Enlorge ? Type of Const. V
Move ? # Stories
Demolish ? Length_
Grode ? Depth Sq. Ft.-
Approvola Feas
Assessment _
Water & Sew.
Palice
-
Flre
Eng.
Plonner _
Council -
Bidg. Off. _
APC
1 here6y acknowledge thot I have read this applicotion and sfate that
the information is correct and agree to wmply with oll opplicable
Stote of Minnesoto Stotutes and City of Eogan Ordirwnce:.
Signofure of Pemnittee _
A 8uilding Permif IS issued to:
oll work sholl be done in?
Building Of/iciol
Permit $ $0•50
Surcharge 2.50
Plan check
SAC
Water Conn.
Water Meter
Rood Unit
Tota-?? 0
WESTERN CONST CO on fha express condition thm
with ail op , icabl Staje of Minnewto Statutes and City of Eogon Ordinances.
CITY OF EAGAN Include 2 sets of plans,
1 Certificate af Survey &
BUILDING PERMIT APPLICATION 1 set of energy ca].culations.
Jedl4e" 1,P?. To Se For % G c'c G; Valuation ?{ ?«U Date
Site Prldress: --,2110 /i /t v;- F4-:!?i OFFICE USE ONLY
Lot __'? B1ock .3 sec. /sub. Ck -Y' Erect ? Occupancy
Parcel #: r Q 3 Alter Zoning /r /- N43
Repair Fire Zorie 0"
oaner: 3 Enlarge Type of Const. ?-?-
Nbve # Stories 1
Address Demolish _ Front ZZ ft.
City/Zip Code: Grade Depth z-c' ft.
Phone #:
Contractor: l?V ?-7? ?.- vi la NS /(v
Address: 5j-53 vda,17 luc/
City/Zip Coclec ?L5 A17 -5?'S lo
Phone #: ? 9 L - 13 $rj
,
Arch./Eng..
Address:
City/Zip Cade:
Phone #:
APPROUALS FEES
Assessments Perniit Sd ?
Water/Sewer Surcharge
Police Plan Check
Fire SAC
Eng, Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off. 1_7 • 3 'i,<;
APC
nrrAL `7S3 • o-a
C.°'ALVIN H. HEDLUND 8609 Girard Avenue soutn
? Bloominqton,Minnesora 55431
, Land SurwYOr Clvll Enpineer Phone :888-2080
? s G'crt??'?alte
;
a?z Joe No. -*'213
SURVEY FOR: Zachman Hbme-a
?
OESCRIBED AS: Lot 9, llck 3,CEHAL F SECOND ADDITION, City of Eagan,
Dakota County, Minnes t and reservl-nt? e ments of record.
? I ?99., _
I "00.3? ?
? I
? I
I I
i?
I L) I I ? I 1-JT ??
ToP o4 b i x.k 904.2 I n3 ?
QswrF. floor 9ot.o ?-? cic?,??
•-4- --- '3(0 / -
Drainage. Fu ?
Proposed elav. O N/SPLIT FoYek , GAR.r?I , io'p stakes
Exis+i n r-lev..,__ ? W9°dHua.sr,/ ?
benoies l01- i-ron -f-
? I o?, 03?
- 10?0 `J1a
L
?
900.8 q o I. I---
m cLiFFVI Ew DRiVE M
1? M
? l1
O -
900.8
4_fRTIFICATE OF SURVFY
Z hereby certi}y thot on ???? ?r?? = surveyed ihe preperty de-tcribeC above ond thot
the oDOVe piot is e correct representotion of said survey. •
3 Cclrin H. Hedlund. Minn. Req. No. 5942 - •.
?. -- - - --
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? l?? a5
CITY OF EACAN I
?--? ?--? ? 3830 PILOT KNOB RD - 55122
651-681-4675
New ConshucNon Reauiremenh Remodel/Reoatr ReauhemeMs
D 9 registered sMe surveys showing aq. tt. W lot, sq. H. W houu
and go rooled areas (20% maximum lot coveraae allowed)
? 4 copies ol plans (ihow beam 3 window s(zes; poured fnd. design; etc.)
D 1 set of energy calculaNons
a 3 coples of hee preiervaNon plan B to1 plaMed afler 7/1/93
DATE: ? -'2 4- 1 "I
2 copies ol plan
1 sef ol energy calculaHons tor healed addlNOns
7 iHe survey for exferlor addlHons 6 decks
CONSTRUCTION COST: -1 v! q U/ Y. OO
DESCRIPTION OF WORK: SI fMmGa, 'cSOf-flt ¢
STREETADDRESS: o K I I v LA, I I ' f I r/W , -
n??
1 0 T : cl BLOCK: ? SUBD./P.I.D. #: C-p O Q N
Name: 1`" Q e.s?'.'l et D'0-0 Phone #: ??? ? 0lD -
PROPERTY ?an FW
OWNER SheetAddress: v?116 Ni(('IiIPiLU hY
ci+r -Edr /',?.n srate: i17 ziP:
Company: / w Phone #:
(area code)
CONTRACTOR SheetAddress: 400 T?7?P,9-6J'I T?GCJ?l License# ?y1W577 Exp.
City Lzr lo State: m ti Zip: SS 3&9
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code (
Sfreet
City
RegisfraHon fk:
State:
Sewer E waler Iicensed plumber (reau(red for new conslrucHon onlvl:
Penolfy,appliea when address change and lot change is requesfed once permk Is Issued.
Zip:
I hereb`y acknowledge that I have read ihls appiicaNon, state that the informafion Is corte and a ree to compy wNh all applicabl
State d.Minnesota Statufes and CIFy of Eagan Ordinances. / j^
Signalure of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No _ Not Required
- ? ?lY
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 PordUAddn. (4sea.
? 03 1 of _ plex O 08 6-plex ? 13 16-plex 0 18 Deck ? 23 Porch (screened)
? 04 2-plex 0 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg.• 0 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
GE
NERAL INFORMATION r!+ v 6.?. rc nf?n
n y
i ? v
a inivili iv o?JFJlii.aill iVl uO111V
IlUUI lp0.Y IIIiIf
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of 5tories
Length
Width
APPROVALS
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq.ft.
sq. ft.
sq.ft.
Footprint sq. ft.
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
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CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
MO,fi,A*CA?;:?Ew'A'
FOR CITY USE ONLY
PERMIT #
RECEIPT # I?
DATE:
??jp?NxZpy?,: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
.,.... .... .
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
- ----------------------------------
----------
WORK DESCRIPTION
NEW CONST _
ADD ON
REPAIR _
OwNER NAME: ?Jah-c?J ?n c se- i? ?
SITE ADDRESS:
-
iui: ? nivCri ? SunD.
?-
INSTALLER: _ s_a;.,..? .y.? f?i?-? ? ir /?.o? ? lADDRESS:
CITY:,..'? /,_? zzP: ssyo.s
PHONE #: 2 /. rl
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
?r
SUBTOTAL:
STATE SURCHARGE: .50
/5 -
T'J.AL:
SIGNATURE OF PERMITTEE
COMM$kCSALfINDUSTRTAI.t: PLEASE COMPLETE THZS PORTION FOR ALL COMMERCIAL/INDUSTRIAL SUILDINGS,
APARTMENT BUILDINCS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE #: '
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.SO FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
ZIP:
TOTAL: $
. ( S I GNATiJRE )
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155719
Date Issued:05/30/2019
Permit Category:ePermit
Site Address: 2110 Cliffview Dr
Lot:9 Block: 3 Addition: Cedar Cliff 2nd
PID:10-16601-03-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Jerry Campion
2110 Cliffview Dr
Eagan MN 55122
Prostar Exteriors Llc
525 Quantico Lane N
Plymouth MN 55447
(612) 581-0859
Applicant/Permitee: Signature Issued By: Signature