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1377 Cosmos Lane• CITY OF EAGAN 1 0 ? ? ? 3830 Pilot Knob Rosd, P.O. Box 21-199, Eagae, MN 55121 PHONE: 4548100 BUILDING IPERMIT ae«ia ? ADDITTON 4,000 Site Address Lot BIOCk SeclSub. ' j''r' !`??; Percel No. ? Name ` Address ? . City Phone `} - `- ~ ` -J 4' j Name _ Address City _ Erect U Occupancy Remodel ? Zoning i Repalr ? Type of Const. ? Addition ? No. Stories Move ? Length Demolish ? Oepth Int Impr. ? Sq. Ft. Install ? Approvab fees Assessment _ wore. a Sew. Poliu Fin Enp. P1onnK Permit _ 5urcha?ge _ Plan Review SAC Water Conn. Water Meter Council Road Unft I hereby ocknowledpa that 1 how rcad this opplicotion ond state thot gldg. Off. ? f 1 Q/8 5 Tr. PL the informetion is correct and ogree to comply with oll opplicable A? parka Stah of Minnesota Stotutes and City of Eogon Ordinonces. Var. Dete Copies Sipiatum uf PertnittN' Total A Building PeRnit Is issued to: an the exprsss tonditfon Ihat oll work sholl be dorw in occordonte with oll opplicobl• Stoft of Mirvwsota Statutes ond City of Eoqon Ordinances. ? Pwmk No. Pwmk HoIdK Dsft Telephone s PlumbinY d-J H.{/A.C. El.ce?tc U ?- 1 Soitener Impeecion Da" Insp. OthK Footln9sl Footings II Foundatlon Frsminy ? ? Roofing Rouyh Plbg. s Rough Hty. Insul. Firoplaee Final Hty. Final Plby. -I-?? Flnal CsryOcc. Water Do+C?ibo Loestion: wai Sevmr Pr. Disp. Receipt PLUMBIN(i PERMIT Psnnit No.. CITY nF EAGAN fi/l in numbered s,paces Type or Print /egibly ?. , 1. Date , 2. Installation Cost 3. Job Address' Lot ' Blk. Fee S/C ?i Tot. _ Tract 4. Owner t- - _ -., ? •+ 5. Contractor - Phone 6. Address 7. City ? . 8. Building Type: Residential .0 L ?. State ' Zip Commercial ? Institutional ? 9. Work Description: New ? Add El Alter ? Repair O 10. Describe ", ? - ! - 11. No. Fixtures Water Closet No. Fixtures Ce i fi l/D ld Bath tubs sspoo ra n e ti S T k Lavatory ep c an ft S Shouver ner o Wel I Kitchen Sink Urinal/Bidet r Oth Laundry Tray e 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 F inal Inspectiona: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Reaipt . MECHANICAL PERMIT CITY OF EAGAN Permit No. • FN Fill in numbered spsces S/C Type or Prin[ lepfbly Tot. . /6 2. Instellation Cost ? 1. Date -3. Job Addreu Lot Blk. Tract 4. Owner 5. Controctor phone " _ - 6. Address 7. CitY State Zip , 8. Building Type: Residential 0 Commercial ? Institutional ? 9. Work Description: New O Add Cl Alter ? Repair 11 10. Desa'ihe Fuel Type 11. No. Fquinment 8TU - M. Ea. Forced Air No. Equipment CFM Air Handling: Mfg. Boilers Mfg. Mech. Exhauat Unit Heater Mf9• Other Air Cond. Mfg. Gas, P'iping Outleis 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 Rouyh F inal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 CITY OF EAGAN Remarks Addition Wilderness Run 2nd Addition Lot 15 Rik 2 Parcel 10 84351 150 02 ,a Owner Street 1377 Cosmos Ln. State Eagan, MN 55123 Improvement r- Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1973 $175.00 $8.75 20 PAID SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORM 5EW TRK- C005357 6/3/80 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT SEW CONN 1974 $240.00 .0 WATER CONN. 300.00 6264 8-15-72 BUILDING PER. sa,C 8240-1710 7211 1-11-73 PARK I 7- I: CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 I (612) 681-4675 4 SITE ADDRESS: I 0 t- 1<N I . . H iirv N 0 PERMl,T, -$UPT,Y ', I Fi (3 (') F 1 IV +. I F. f: t 411 f: : ? Q RECQRD PERMIT TYPE: Permit Number: Date Issued: APPLICANT: i t4tl ??.; ? >.i? !`?1'+ TYPE OF WORK: i:i , I i ! I +l;7 Htl 1 1 f? ( NR H:' I 'at+t, 0ollAfqs RFPAIf ft[)tr}; I? 7-- Permlt No. Permit Holder Dats Telaphone N ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ? ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG OHSAT TEST BLDG FINAt. /,f av ?? -- BSMT R I. - - - BSMT FINAL DECK FTG DECK FINAL GcJ r/i , VILLAGE OF EAGAN 3795 Pilot Knob Hoad Eagan, PTinnesota 55122 PERNLiT NO.: 296 The Village of Eagan hereby grants to Ngil. & Hubbatd Heating o£ 99 No. Snellias Ave., St. Paul 55104 a ?• r. Permit £or: (Owner) q'ilaen Conatruetion Go. at 377 Coamos & 1439 11i7Y 1.+n1frid , pursuant to application dated 12/15/72 Fee Paid: $60 00_ dated this 21 day of Aepogyer , 19 72 _._ 1.50 s/c Building Inspecto:? Msohanical Permits: Bia Toi.al: a /JO U-v?- G?',? ? TOWN 0F EAGAN 3795 P11ot Knob P.oad Eagan, Tiinnesota 55121 PERMIT N0. 272 The Board of Supervisors hereby grants to y_ H. P.Ars Co. of 1854 (irand Ane. st. Pma 55105 a pr.rnaRrnTre Pexmit for: (Owner) TiIA n nenRtruntAnn - ?a -7 -7 Gos ma& at 4s22g__Lod2epo38--Hrtpe. &443?2=0jame , pursuant to application dated 10/3/72 Fee Paid: 0.00 Dated this lOth day of QOtObBt' , 19?• 7.00 s o (sorry amn so late getting t,hia out to yau.) Building Inspector ? EAGAN TOWNSHIP BUILDING PERMIT Ownex '---"1? .-e?,........................ ..'---'-"-...._"'- Address (Presen!) _...,.Q?....SI.?^.r?-:'?--......?....?'.Y!^^?............ Suilder Address N° 2797 Eagan Towaship Town Hall ? Dale ........ ......-"............................. To Be Used For Froni Depth Heighi I Esi. Cos! ' ermi! Fee Ramarks 7 ia.?.E..- v SireeL xoaC or oSher DescsapAOn oi l.ocaxlon I Lot nlock naalxlon os Traet / 3 -'? 7 F --? .4? I /s- e., -'__ This parmiY does not autkorise the use of c2reels, roads, alleps or sIdewalks aor doea it give the ownar o: his agent the righ! !o creale any siiuation whieh is a nuisanee os which presenls a hazard !o the healtd, safelp, convanience artd genezal welfare !o anpone in the community. THIS PERMIT MUST BE KEP,T ON THE PREMISE WHILE THE WOAK IS IN PROG?R SS. This is !o eerrify. !hal...... 1,,.It.-4.._....<a-x:rx.-T...........has permisaion to erect d- -_?-_.-,•?• ...,."?.".,.?...C.?..? .. ........ •_--..._upon the above deaoribed premise subjeaf !o the provisiom of the Building Ordinaace for Eaga Township adopled April 11, 1953. .............. ........'.._' _'-"'-"-""-...""""'?7^c?:-.:.:..""'°-... Per --'------'---"---....'-"_/?.?.'Z...°...?.................................................. '-'-"-"'- ? Chairman of Tnwn Soard Buildin9 IasPector 16 48 This reque4l Witl 18 rtnnths fiam L t A 079657 Req^uBSt Date ry ` q Fire '? `? fAi? /D //er- DLicened Eleclriral ConUactor Owner Street Atldress, Box or Route No. ? /-,777 Cos?naS s /w er rElee?tri?l NoINT) nvacwrlCOmpany Namel u...u.... end.wnc ICOnttac[or or Ownar M; ?1t?1?5 lJ ;! d Rc?. 1- ?vv _ csil ,uHh-re'tl? ?? InsVection ?fleeAy Nuw Wili NntifV InsPec- aw ror When Reatly ? ?V N 1 hef0by nBquesl inSOBCtion ol abova electrical work installed at: Ll- -1z:;0, .t-h CoDu leo f Q Ph?o/ne No. TJ.Z'1` 3 ? Authorizetl SipnaNfe {GOnxracvorvw.?. THIS INSPECTION NEQUEST WILL NOT MINNESOTA STATE BOAMD 11 CTIIICITY . BE ACCEPTEU BY THE STAh 90AflO Gripps-Midwey BIdB• - poom •191 UNLESS PPOPEN INSPECTION FEE IS 1821 University Ave., St. Paul. MN 66104 ENCLOSED. Phore (812) 297-2111 _ EB-00001-0d ? U REQUEST fOR ELECTRICAL INSPECTION ' See instructions lor comoeting this fmm on beck af Yellow co cV' „m l "'X" Below Work Covered by This Request n7WO a? MASTER CARD LOCATION [;444K?q . 13 7 SiRUCTURE AND LAND USED AS s- .2- Issued To Permit No. I Issued Con}rac}or Owner BUILDING _2_7_y__.:? g-g PWMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL ? HEATING GAS INSTALLING ? eo< 5ANITARY SEWER ?/D I OTHER ? I OTHER I Items Approved (Initial) Date Remarks Distance From Weil POOTING FOUNDATION SEPTIC CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUM8ING 71-7? 12 -?y -;2,?-' WELL SANITARY SEWER Pt ? ' ' ?? 3 Violations Noted on Back COMMENTS: . EAGFN TOWNSHIY 3795 Pilot Knob Road St, Paul, Minnesota 55111 Telephone 454-5242 PERtUT FOR WAT13R SERVICB COPINECTION Date:Aytaust 15. 1972 Billing Name:Ti sen Construction Co. Owaer• Plimmber; Tiiankan F.v?ravating Remarka: acation of ConnecCion Meter Size 5/8 Conaection Chg. 300.00 Pd 8/15/72 ' lo t4-?t Meter No?3'r Permit Fee 10.00 pd 9/12/72 Meter Reading Meter Dep. •50 pd 9/72/72 s/c Meter Sealed: Yes Add'1 Chg. NO Total Chg. Inspected by Date Building is a: Residence XL Multiple Ko, Units Commercial In<lustrial Other Number: 944 /,5- -,:,) W - Z• -J Site Address: 1377 CoOmos Billing Address $25.00 RE-irJSPECrIoN FEF r-oR IMPROPERLY INSTALLED METERS. By: Chief Inspector In consideration of the isaue and delivery to me of the abwe permit, I hereby agree to do tte proposed work in accordance with the rulea and regulations of Eagan Towaship, Dakota County, Mlnnesota. gy; Loren Gallati Luecken Excavating Please notify the above office when ready for inspection and connection. EAGtiN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE COidNECTION DATE: Ad io S? io,72 OWNER:'ri t en,n .ene n nn o. PLUMBER Luecken Excavating NUMBER 1104 Address 1377 Comnos /S`..) /-1 ? '=?- TYPE OF PIPE Hepw Cast Iron DESCRIPTION OF BUIIAING industriall Commerciall Residentiai I Multiple Dwelling I No, of units Location of Connectiona: Copaection Charge -0' Permit Fee 10.00 pd 9412472 . Opd91272sc Street Repairs Total Inspected by: Date Remarka• Sy. Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Bagan Toeraship, Dakota Couaty, Niiaaeaota gy I,oren Gallati Luecken P?ccavating Pleaee notify when ready for inspection and cosmection and before any portion of the work is covered. ?5?33 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Conswctian Reauirements • 3 regisrereA sde suneys showing sq. ft. of bt, sq. fl. of house: antl a0 mofed areas (20% maximum lol coverage allowed) • 2 copies of plan showing beam & window;izes; poured found design, etc.) • t set of Eneryy CalcNations • 3 copies of Tree Preservation Plan if lot oatted after 7/1;93 . Rim Joist Oetail Options selection sheet (bldgs wilh 3 or less unRS) DATE 9-?-?z-- SITE ADDRESS /a^/ TYPE OF WOR APPLICANT? STREET ADDRESV TELEPHONE # LIP J Sr rj-.,.,, "(dC-SS CELL PHONE # MULTI-FAMILY BLDG _Y !W _ FIREPLACE(S) _ 0 _ 1 _ 2 PAX # PROPERTYOWNER 61'2fU?42_?' Ko/1 I eV TELEPHONE# COMPLETE fOR "NEW" RESIDENTIAL BUILDINGS ONLY 't--ZIP 5 //E Energy Code Category _ MIN\'tS<)"C.1 RL'L1:S 7670 C:\'CL'CO1tY t NIIV\`L•'SO"I'A RULI•:S 7672 (d submission rype) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Workshee[ Submitted • Energy Envelope Calculalions Submitted Plumbing Contractor: ____ Plumbing systein includcs: Mechanical Contractor: Mcch.uiical svstcm includrs: Sewer/Water Contractor: WaLer Soltcncr LVater Heatcr No. of'Badis .-1ir Condiuoning Hcal Rccovcr}' Systcm PllOl1C # I.tuvn Sprinkler No. of R.I. Aaths I hereby acknowledge that I have read this application, state thot with all applicable State of Minnesota Statutes and City of Eago Signature of Applicanf Phone # Fee: $90.00 Pcc: $70A0 Phone # ? c r-.. "? v ? ?Dp ? I motion isi2orrect, and agree to , n ?--- OFFICE USE ONLY RemodeVReoair Reauirements • 2:cpiesotplan • t se( of Energy Calculatians for heated aaaitions . 1 sde survey for eztenor additions 8 decks . IiMica[e if home serveA by septic system for additions do VALUATION 6D R) D Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4102 PERMIT ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 1377 COSMOS LANE LOT: 15 BLOCK: 2 WILDERNESS RUN 2ND BUILDING 027985 es/18/96 SITE ADDRESS: p.I.N.: 10-84351-150-02 DESCRIPTION: R o o F r-, P.Wiltlin?g Permit 7ype 3TORM DAMAGE ,guilding'Work 7ype REPAIR ,)?'Census ?odi? ? 434 RLT. RESIOENTIAL s, .s( . . . ?i...,.k,? ? tw PERMIT TYPE: Permit Number: Date Issued: i ? r,.. :,? ..-' ?.? w?.,`•ulia ..?; ^._ s?..t ._ REMARKS: FEE SUMMARY: R. CONTRACTOR: - APPlicant - sT. Lzc.O?IF APEX ROOFING 18911919 2004228 W?Y ERNIE 944 ORIOLE DR 1377 COSMOS LANE APPLE VALLEY MN 55124 EAGAN MN (612) 891-1919 (612)452-4389 ? I hereby acknowledge Chat I have read thisapplication arvd state that the, I informati:on'is coreaet"and egree to compiy wYth'all applicable State of Mri. Statutes and Gity of Eagan Of°di.-nances: , 'APPLICANT/PERMITEE SIGNATURE 4?? 4__Zn?o ISSUE : SIGNATURE _ CITY OF EAGAN 4fthft 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? ? q 8 s 681-4675 ? ll Cj New Conslruciion Reouirements RemodeVReoair Reauirements ? 3 registered sile surveys ? 2 copies of plan ? 2 copies o/ plans (include beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior addftions & decks) ? 1 energy calwlalions ? 1 energy ealculetions tor heated additions ? 3 copies of iree preservalion plan H lot platled atler 7/1193 required: _ Yes No pC DATE: A /T ? 6 CONSTRUCTION COST: a ?7 /I J DESCRIPTION OF WORK: !?c?c 7 / ti2 /C, .?a STREET ADDRESS: /G• = LOT BLOCK Z SUBD./P.I.D. #: Nhsu -AL-t PROPERTY Name: f r e? i c- kaA. lc.. ,?PPhone #: ypU OWNER , "' """? Street Address, Z'3 -7 7 CoS e"es ?c-te City: f'ca c+ c. r. State: /ir. ,-.-r Zip: CONTRACTOR Company: P\C'r,?':z Phone #: lJ ( License #: ,?/Al-V Street Address: qUc-r aRTOL £ B City: /-{: U0 State: !" Pz ? Zip: ARCHITECTI Company: Phone #: ????Z? -10 ENGINEER Name: Registration Street Address, City: State: Zip: Sewer 8 water licensed plumber: change are requested once permit is issued. Penalty applies when address change and lot I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabte State of Minnesota Statutes and Ciry of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preservation Plan Received Yes No CITY USE ONLY PERMIT RECEIPT DATE: fIO-O/ fimIDEwTIi4L MECHt1VICAI. PERMTP APPLICATION crrYoF E?snx 3830 Pnor xxos xn E?eaR IMssisx 651-661,4675 Please complete for: D single family dwellings townhomes and condos when permits are required for each unit Date: 0q .1 0 N? a I SITEADDRESS: 13-77 Cosmos La.ne, OWNER NAME: EY h 1? K o l, I wev INSTALLER NAME: Wohlers Southside Htg. & AJC, Inc. 6950 West 146th Street, Suite 106 STREET ADDRESS:Apple Vailey, MN 55124 CITY: Dl- ? n6e..1' -.L ..e..1 t.. 11.e n ..?N wnrL \anu TELEPHONE (osr tI Sr7 - LI 3 S9 (AREA CODE) TELEPHONE#: q5PL 431- 7099 (AREA CODE) ZIP: New residential dwelling unit under constructionand not owner/occupied $ 70.00 7,S Add-on, modification or alteration to existin dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other Natureofwork: raplLtov AurnpCe CzciGt ctiY' GO"4ionez- State Surchar e $ 50 CQ Total $ 50 • Renrinder: C¢!! for inspections. Updatcd 1 101 APR 0 S 2001 'Calvi P_ SIGNATURE OF PERMITTEE / 1985 BOILDING PERNIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRAC70RS NUST BE LICENSED 4fITH THE CITY OF EAGAN ??t) oy- INCLUDE 2 SETS OF PLANS ? 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS L41? °? To Be Used Foq luation: ?f? Date: '7 9-?S Site Address: ?uYIC OFFICE USE ONLY Lot: L? Bloek ? Sect/Sub (.LJ? Erect r Occupancy ??emodel - Zoning Parcel 11 ----"pair Type of Const r / I Addition ? # of Stories Owner ?I"I]EST ?pMove _ Length Demolish Depth Address ?37J___Co,f VvJO,f LG/(Fj Int.Impr. _ Sq Ft City/Zip Code Ca Install ---------- -------------------------- Phone APPROVALS FEES Contractor A?r5oe) - 5 ? ?o Assessments Permit ??O ? ??? ? Water/Seuer _ Surcharge Address _ ? &/rGf Police Plan Review n J Fire SAC City/Zip Code N1OOY?liq?/o? 6-,Yv31 Engr Water Conn ? ??/ Planner Water Meter Phone Council ? Unit Bldg Off /o Treatment P1 Arch./Engr. APC Parks Variance Copies Address ?(YfAL Z5p. 2u- City/Zip Code Phone fl I(ox22 = ? S2 y- 5¢ ' 19 cDoet> <1x k2- - Ic?g . r? ?-c = _ 442g 23 4- 3& , ., CITY OF EAGAN PJ° 10562 ? 3830 Pilot Knob Road, P.O. 8ox 21-198, Eagan, MN 55121 ? PHONE: 454-8100 > BUILDING PERMIT rteceipt # T. h. easea fw ADDITION Est Value $24,000 pete JULY 12 I q SS 1377 COSMOS LN Erect IJ Occupency n.? Site Address WILD RUN 2 15 b 2 Remodel ? Zonin9 R 1 sec/su . giak Lot liepair ? Type of Const. jIL l N ? Stories No o. Parca Addition . Move ? Lanqth W ERNEST KOHLWEY Name Demolish ? Depth Address SAME Int.lmpr. ? Sq. Ft. ? Phone 452-4389 Install ? City ApprovaM F?es S` Neme ANDERSON-SODERMAN _ ?u 9609 GIRARD AVE SO Assessment Permit 12 ?? Address $$1-5044 BLMTN ?yufer y Sew. Surc?arge • 25 82 ? phone City palica - Plan Raviaw ?W Name Fin S'0'C Z E?, WaterConn. z- rcZ W Address Phane Citv Plonror Water Me[er ? Council Road Unit 1 here6y ackrawledge thot I have read this applicotion ond store th 1e Bidg. Off. 7 1 Q $ 5 Tr. PI. tho inlormotion is correcf and Ogree to compl wit oll aDP APC parks u-'Jt ard Ciry of Ea n O nanus• Stare of Minnezota $tot Var. Date Copies J Slpnoturo of Permitteq/ Totel +S z 5 a. 7 5 AND RSON-SODERMAN on the express condition thol A Building Permit Is iss? ap worlc yw11 be done in accordance with all licabla State a inne ro Srowtes ond Ciry oi Eapon Ordlnoncet. Bulldirq Wfidal ? - _- - - - - RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN t-i I?3830 PILOT KNOB RD, EAGAN MN 55122 -? ? 651-881-4675 Naw Conetructlan ReauiremeMs • 3 replstered sae surveys showing sq. ft. ot bt, sq. iL of house; antl aII rooted arees (20°k maximum W[ coverage albwed) • 2 copies of plan showing beam & wmCOw sizes; poured fountl desgn, etc.) • 7 set of Energy Cakulations • 3 coples of Tree Preservetbn Plan H lot platled a}ler 717193 • Rim Jo4st Detail Optlons seled'an sheet (bidgs wRh 3 or less unLS) DATE a I , q I 0,/1, SITE ADDRESS I 3?? COSmOS L"- NPE OF WORK MULTI-FAMILY BLDG _ Y _ N _ FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT STREET ADDRESS 9 9?7 L -1 C??? O I.F .??J r2: CITY Ia:V • STAiEN ZIPSS/? y TELEPHONE #? S 1 U.3 ?- CELL PHONE # Ls I?- ?O°l-7?67 FAX # G 1- -79 PROPERTYOWNER TELEPHONE# COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RIILES 7670 CA1'EGORY 1 MIVNESOTA RULES 7672 (J submission type) • Residentlal Vantllatlon Categary 1 Workaheet Submittad • New Energy Code Worksheet Su6mined • Energy Envelope Calculations Submitted Plumbing Conhactor: ___ Plumbing system includes: Mechanlcal Conhacfor: Mechanical system includes: Sewer/Water Conhactor. _ Air Conditioning Heat Recovery System Phone # Phone # Fee: $90.00 Fee: $70.00 ----.----------.----'--'-----"""'"-'-""_""'-.'-""'_'------------""'-----"'-"""_"II ?i i? ?i I hereby acknowledge that I have read ihis application, state that the information is correeJt nd agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinanc s ---- Signolure of Applicant OFFICE USE ONLY ? Water Soffener _ Water Heater No. of Baths RemodeVNeoair Beaulremants • 2 copies of pl2n • lsetolEnergyCalculatlonatorheeteaadd'Abns • 15itesurveyforatterbratltlitions&decks . intlicate if home served hy septic system for addHions VALUATION /? ??? - oo Phone # I.awn Sprinkler _ No. of R.I. Baths Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ uPaecaa aro2 PERMIT City of Eagan Permit Type: Building Eaaan. Permit Number: EA104508 Date Issued: 05/24/2012 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 1377 Cosmos Lane Lot: 015 Block: 002 Addition: Wilderness Run 2nd PID: 10-84351-02-150 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Replace Description: Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Tim Schenk Elder-Jones Buildina Permit Service 1120 East 80th Street. Ste. -211 Bloominaton. MN 55420 Fee Summary: BE - Base Fee $500 $40.00 0801.4085 Valuation: 500.00 Surcharge - Based on Valuation $500 $0.50 9001.2195 Total: $40.50 Contractor: - Applicant - Owner: Home Depot At Home Services Ernest G hohhvev 656 Nlendelssolm Ave. N 1377 Cosmos Lane Golden Valley MN 55427 Eagan NIN 55123 (763) 42-8826 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 Cite of Eaaan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature Us_e BLUE or BLACK Ink ! For Office Use - i G 1 i Permit City of Eap I Permit Fee: 3830 Pilot Knob Road I i Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 1 Staff: I Fax: (651) 675=5694 1 1 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 127 7 COSo~yD S Lo'?AlE Unit Name: ' C4N1 c f(_nt{ 1 Phone'&S/` 621d;r~ R13413 RESIDENT OWNER Address/ City /Zip: /,?777 G6iD. Applicant is: .Owner_ L Contractoc TYPE OF WORK, Description of work: Z?/e Construction Cost !o Multi-Family B tiding: (Yes -/No Company: 6r l 1q E e Contact: 1iT~C/C~Q CONTRACTOR Address:.~6 / MAE A City: MA State: Zip: Phone: -Sc~ License L© v~4Sv2. Lead Certificate #:f4 7e23 7 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA IF CQNJTRUCI NG 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 thfa.: are trade secrets. CALL BEFORE YOU DIG Cal! Gopher Stage One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. ZW,gg2h2rgtateonecail oro I hereby acknowledge that this Information is complete and accurate; Mat 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 wont 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 Applicant's Printed Name Ap ant's Signature Page 1 of 3