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620 Hackmore DrCASH RECEIPT I * i CITY OF EAGAN ` 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE I0 47-19?D AECEIVEO ? fiq1A / viw AMOUNT a ? f?j?1 • v ?J 8 DOLLARS ,m ? CASH CHECK ? ?- ' Zo y? r,6'u C 1075 ? ???, ??,, Pirik-?ile cop„ Thank You BY ?? ?? 3830 EIUILDING PERMIT rto be used for SF ??/GAR Site Address 620 F[ACKN0 Lot I Block 3 5ec Parcel No. F. Name KUSTM4S BY 3 Address 1920 H 76T o .... arrurtfiI n ;ITY OF EAGAN `;3 ? 8?60 ad, P.O. Box 21-199, Eagan, MN 55121 `s PHONE: 454-8100 ? ( r? 5 ` Receipt # ' tE UR Sub. AlfT1JltN RI[ 1CUY2AN I Ab: 1 St Phone 892"1! Name Address City Phone Name _ Address Phone I hereby acknowlege Ihat I have read this application and state ihat the inlormation is correct and agree to comply with all applicable ?tate of Minnesota Stawtes and City ot Eagan Ordinances. Signature ot Permitee A Building Permit is issued to: KU5TUIS $Y KR2YZAHIAK on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City ot Eagan Ordinances. Building Official , OFFICE USE ONLY Occupancy 3 K- 1 FEES Zoning R-1 (Actual) COnst V-N Bldg. Permit 664' oo tAllowdble) Y-N Surcharge 53• 5Q ' k of Stories ?1 PlanReulew ?32'? Length Oepih wo SAC. City 100.00 S.F. Total - SAC, MCWCC 600'ou S.F. Footprints - 625.00 On Site Sewage _ Water Conn On Sile Well ? Waler Meter 90•00 MWCC System ? Acct ?eposit 30.? City Water x 3?.? PRV Required 51W Permit Booster Pump - S/W Surcharge .50 252.00 Treatment PI APPROVALS RoadUnit 355,00 Planner il C - park Ded. ounc BIdg.01f. -- _ Copies 3,232.00 Variaryce - TOTAL r Permit No. Permit Holder Date Telephone N WATER ? SEWER PLUMBING H.V.A.C. ?(F'G' / LC?- ? ?? 7W ??/ SO ELECTRIC oe Inspection Date Insp. Comments Footings I Foundation ?C" 3U So. Framing Roofing Rough Plbg. C bugh Htg. "6 j IfC N {sul. Fireplace ?- Z Final Htg. Fnal Plhg. - - Const. Meter Plbg. Inspettor - Notify Plumber Engr./Plan Bldg. Final Z 'Zerl-SZ Decfc Ftg. Deck Final WQII Pr. Oisp. + MECHANICAL PERMIT PERMIT # _ , GTY OF EA(iAN RECEIPT # _ 3630 PILOT KNOB ROAD, EAGAN, MN 35122 i VTRACT PRICE PHONE: 454-8100 DATE: m Name ? Address c City ? Name ; Address O ChY ? TYPE OF WORK i Forced Afr I Boiler I Unit Heater f Air Cond. ? VenL I Gas Piping Outlets # li Other M BTU M BTU M BTU M BTU CFM PERMIT FEE: S/C: TOTAL: BLOG TYPE ORK DE R PTI . W SC I O ' N New Res. Mult Add-on Comm. Repeir Other FEES RES. HVAC 0-100 M BTU - $24.00 ADDff10NAL 50 M BTU - 6.00 - (HES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM -1 PER PERIIAff) - COMM/INO FEE - 1% OF CONTRACT FEE APT, BIDGS. - COMM. RATE APPLIES 1.50 EA. TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTiAL FEE - ALL ADQON 8 REMODELS - 12.00 MINIMUM COMMERCIAL FEE - STATE SURCWARGE PER PERMIT 20.00 - (ADD $.50 S/C PER EACH $1000.00 OF PERMIT FEE) .50 , e%,"` s r ??• SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN r.? + ? PLUMBING PERMIT CITY OF EAGAN • 3830 PILOT KNOB ROAD, EAGAN, MN 55122 uTOxrr oo?re. eunue. weA_Q-Inn Site Address Lot Block _ m Name w Addre c Ciry _ Name r `' ' T •-', PERMIT # - ' -'' RECEIPT # ' DATE: ,4'1 ? " ' I 'e BLDG. TYPE WORK 1 _ Sec/Sub Res. y New _ Mult. Add-on Comm. Repair Zy"7ra..,YI FEES COMM/IND FEE -1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMMlIND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES l '_ PERMITTEE FOR: CITY OF EAGAN Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: N0. FIXTURES TOTAL ._..-Water Closet - $3.00 S ? ? - Bath Tubs - $3.00 Lavatory - $3.00 ?Shower - $3.00 f Kitchen Sink - $3A0 ' UrinallBidet - $3.00 -? Laundry Tray - $3.00 % Floor Drains - $1.50 Water Heater - $150 Whirlpool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMI'n Softener - $5.00 Well - $10.00 Private Disp. - $10.00 =Rough Openings - $1.50 FEE: STATE S/C: _ GRAND TOTAL• ?• ? ? DATE: DEC 3. 1990 .qqE; 620 NACIQ40RE DR (KUSTOMS BY KRZYZANIAK) .? + Your Sewer & Water Permit for the above property has been completed. It will be held at the Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be compfeted for the foliowing reasons: Your 5ewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. 0 4?y-` ,w # ? •? Citp of Cagat? Etpatt[Pttt Df %ai" jttvPttlDlt 77rtr CerAiJmale issued pursunnt [o Me rrqu&m=& of Section 306 of tlre UrriJorrn Building Code certijyinglJux at the kme of i.auance [his structure xws in conrpliance with the various ordinanwes ol rhe Ciry regutabn% bur7ding c+onstiucAion or use For the following: cae a..T.ow w ri.tr, "u ews. Pa ra. 18460 O-V-Xa7Yvc R3 /M 1 z..ig o6w, kl TyaC caw y? OwoerdBuWia?? IKY KR'7.Y'lAMAK Mdieet 1020 W 7?? g? RAfXM'YJR MMIE [acatit7 ?a $3rAUM'! nrrv+c /Duc 2MP2 POST IN A CONSPICUOUS PLACE i SEfNER & WATER PERMIT CITY OF 9AGAN 3830 Piiot Knob Rd. Eagan, MM55122-1$97 DATE & "r 17 1990 S1TE ADDRESS l.`'.':A ?CKl",GRE DR LOT ' BLOCK SEC/SUB APPLICANT: ADDRESS: CITY, STATE Z1P ; PHONE: ? PLUMBER: ADQRESS: 14 69 SHORE 'E CITI', STATE Z{P 55177 PHONE: 496- 4 IL. PRV - BOOSTER PUMP PERMIT AEt}IfESTED x SEWER WATER -TAPS _ COMM/IND - RESIDENTIAL x NEW - EXfSTiNG Lawn Sprinkl,er Met6rs are to be Installed Ahead of DdCtmestic Meters on Water Line_ rs M D d Credit WILL N eae . uct OT be given for e i'ec;REE TO COMPLY WITH CITY OF KUSTGMS BY IkItZYZ.^..NtA': OWNER: ADDRESS: 1920 41 76TH ST CITY, STATE i;.TC,?i ?EL;). MN ZIP PHONE: ' ?' - - ? - ' ' SIGNATURE WHEN ME UED PLEASE ALLOW TWO WORKING DAYS FOR PFIOCESSING. CALL 454-5220 FOR INSPEGTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. ? . i - ?..nr`•?+,«ri..a.?r.^ ?,'..JC.a^w?!'u1R,rf+ci• . .. .. ` . '-S:'!t1'?.++Vm"" ^'.?._. ?.?.-.. - ?..••..,.w .,.?... -. _...... . _ _ . . . .rn^ . ? M SEINgR & WATER PERMIT OFFICE USE ONLY ? CITY OF EAGAN METER # PERMIT DA7E 12103190 -3836 ?iE,'t Knob Rd. cHIp # PERMIT # i' 4 Zagan, MN 55122-1897 B.P. RECEIPT ? METER SIZE -' , ISSUE DATE B.P. RECEIPT DATE ?ZL?C DATE 7 1990 ?. . UMP SITE ADDRESS 620 I-tAG%!^.GKI,: JR LOT i BLOCK 3 SEC/SUB AUTUMI7 RIIUGL APPLICANT: ADDRESS: ' CITY, STATE ZIP _. .... , ? ? ..._._-. ,? ?`??t?? [_.?fil? : 4?6? CITY, STATE ZIP PHONE: 496-3348 OWNER: KUSTOMS BY KRVIZAN tAK ADDRESS: 1970 W 76TH ST CITY, STATE ?t.CHFIELD Y2?ti ZIF PHONE: 692-15'i PLEASE ALLOW TWO WORKING DAYS FOR PRO( SEWER PERMITS, CONTACT ENGINEERING DEPT. METER # yL? ?0? S S9 PERMIT DATE i 2/03 f90 CHIP # 6 a ?. 30 3 S8 PERMIT # 11741 METER SIZE B.P. RECEIP7 *?Lk ISSUE DATE B•P. RECEIPT DATE 10/171 9a _ 800STER P ,,;,. PERMIT REQUESTED e SEWER y WATER ? TAPS ? ? _ COMM/IND % RESIDENTIAL f ? NEW - EXISTING ? ^ Lawn Sprinkler Met6rs are to be Installed Ahead of Ddmestic Meters on Water Line. [:rariit WILL NOT be qiven for Deduct Me;ers. EAGAN CITY OF SIGNATURE WHEN METER ISSUED CALL 454-5220 FOR INSPECTIONS. FOR STORM BUILDING PERMIT To be used for SF DWG $107,000 Site Address 620 HACKMORE DR Lot 1 Block 3 Sec/Sub. AUTUMN RIDGE Parcel No. W IName KUSTOMS BY KRZY2ANIAK a Address 1920 W 76TH ST City RICHFIELD Phone 892-1533 o Name SAMM. g? Address City Phone Name _ Address CITy _ Phone I hereby acknowlege that I hav ea his applicahon and state that the inbrmaaon is correct a agr to mpty with ail applicable?tate ot Minnesota SlatNes and ?of ga Ordinances. ? A Building Permit is issued to: &UbLUM) riT Ki(L TLA1V lAR on the ezpress condtlion that all work shall be tlone m accortlance wM1h all apphca6le State of Minnesola StaWtes and City of Eagan Ordmances 6uilding Otlicial CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt NC_ 18460 O? _J I OFFICE USE ONLY 79-9D- OccuDancy R- 3 1`L-1 FEES Zoning R=1 (AClual) Const V-N Bldg. Permil 664.00 (Allowable) -V--N Surcharge $3.50 k of Stones - Length 6611 Plan Review 432 . 00 Depth 50, SAQ Qly 100.0? S.F.TOIaI - SAC,MCWCC 600-0 n S,F. Footpnnts - On Site Sewage _ Waler Conn 625.0 On Sde Well water Meter 90• 00 MWCC System X CilyWatar ?j_ ?ct.Deposit 3n-nn PRV Required 5/YV Permil 30.00 Booster Pump - SM! Surcharge .50 Treaiment PI 252.00 APPROVALS RoadUnit 355.00 Planner - park Ded. Council BIdg.Ofl. _ Capies Variance - TDTAL -j - 232.00 Address:620 ??WRE DRIVE Lot I Blk 3 Sec/Sub ?LM P= These items were/were not complete at the t3me of the final nspect3on. Date: 2 27/92 Yes No Final grade (6" from siding) f d?¢ a!n i „ WO»c Permanent steps - garage Permanent staps - main entry PermanenC driveway Permanene gas Sod/seeded grass Trail/curb damage Porch Basement finish Deck Pleasa verify vith the builder the removal of roof test caps from tha plvmbing system and the shut-off of water supply to tha outside lavn faucet before freeze potential exists. wcmEOnre? White - City copy Yellow - Resident copy Pink - Contractor copy d 34132 a Repuast Date ^ Fre N. Rough-in Inspeclion Reqm tl4 ? Reedy Now?ll NoLty Inspecror 6 y es ? no wnen neaey? Izficensed contractor ? owner hereby request inspection of above electrical work at: .bb ress (SVeet, Box or RoWe o) Q 2 d ? ? Sxlion No Township Name or No Range No County Occupant(PRIN ? // • Phone No ?l Power plier Z Elec?n ConVactor (COm any Name? ? Contrec?o?5 L nse No. M Malbng AEd w(COnMactor or Owner Making Ins?allat n) 2' 25 nuIDOn?rodOwner Making Installation) ? PIone Num er MINNESOTA STATE BOARD OF ELECTflICITY THIS INSPECTION AEOUEST WILL NOT Grlppe-MlEway BIEg. - Room 9-173 BE ACCEPTED BV THE STATE 60ARD 18Tt UnivareHy Ave, SL Paul, MN 551DG UNLESS PROPEfi INSPECTION FEE IS Plwne (61I) 66I-0800 ENClOSEO. REQUEST FOR ELECTRICAL INSPECTION yY?°`????'4 ? A? ee-oooo?-oe I '. See mstmctions br comple0ng iMS form on back of yellow copy h 3413e ? "X" Below Work Covered by 7his Request ew Add Rep - TypeotBuilding ApphancesWved EqmpmentWiretl Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Buddmg Dryer Other (Speaty) Comm llndu5lrial ' Furnace Farm Air Conditioner Other (SDeciN) Contractor's Remarks Compute Inspecnon Fee 8elow. # Other Fee # ServiceEntranceSize Fee Qmuits/Feetlers Fee Swimming Pool 0 to 200 Amps A to 100 Amps Transformers Above 200 _ Amps J 00 _ Amps PZVL4 SIgf15 Inspedor5 Use Only' T?TAL S /? Irngation Booms 7Q • CJ • Special Inspet[ion Alarm/Communication THIS INSTALLATIO BE O ERtDAISCONNECTED IF NOT Olher Fee ? COMPLETED WIT O I, the Electncal Inspector, hereby Rovg?-in l. oai y? - ?- cerhfy ihat the above inspectwn has been made. p,,,ei ? -...._.? oaie - a 3 OFFICE USE ONLY TNS repuest voitl 18 manlM1S irom • /a-?y? y y??i ? 34106 Repuesl0ate Fire N. Rough-in In3pecli NOw ? R tl AI NotR Ins ector Requ ea y y p n R Wh tl ? D No e ea y I licensed contractor ? owner hereby request inspection ot above electrical work at : Job /dare (Street, Box or Rome .) Ciry I ?[? / (i?--?J'lJ Seclion No Township Name Or No Range No. County ? Occupant P NT) ? Phone No 'D Pawer uppL r >G L? Electncal onVaCOr (COmpany ame) f ConVactw§ Li e No Oyi9 ?3 Maihng tltl.ss onVacior or Uvner Makmg InstalleLOn) / A.Ahonzetl Si Wre (COnvactorlOwner Maki Instellalion) PM1On umber ? MINNESOTA STATE BOAND OF ELECTqICRY THIS INSPECTION REQUEST WILL NOT Grlgqs-A1ldway BIEg. - Poom S173 BE ACCEPTED 6Y THE STATE BOARD 18T1 UnlvOnlly Ave, SI Paul, MN 5S104 ONLES$ PROPER INSPECTION FEE I$ Plqne (612) 6,12-0900 ENCIOSED ;E6?ST ? FORoE?LECTthe RI ? CAL ? INSPECTION ???EJ qqj?I See "X" Be/ow Work Covered by This Request ?ew Add Rep TypeofBwldmg ApphancesWired EqwpmentWired Home Ranqe Temporary Service Duplex Waler Heater Elecinc Heaung Apt. Bwlding Dryer Other (Specify) Comm./Industrial ' Purnace Farm Air CondRwner Olher (specity) Convactork RemaMs Compute Inspectian Fee Below: k Other Fee # Serv'ceEniranceSrze Fee # Circui[slFeeders Fee Swimming Poal 0 to 200 Amps '? O io 100 Amps Transformers Above 200 _ Amps e Amps Slgns InspecmrSUSeOnly l __e7 TA? ?Q Irrigation Booms ? Q Speaallnspecnon Aiaim/Commumcanon TMIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee ? COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspecror, hereby Rou9n-in Date certity that the above inspection has been made. F,nei oe?e `l OFFICE USE ONLY This request wW 18 monihs from City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ?------se ----------- i For Office U I j Permit #: ? Permit Eee: ? Date Received. I Stafl. I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 52:.-t7-2? SNe Address: (Z2_Zt!>_ /4 i.e;.gl 7enant: Suite #: RESIDENT/OWNER Name: Klc I c_/-Y462-- Phone: ???iry s! Address / City / Zip: (0-7? t , Appficant Is: _ Owner ontractor ?? TYPE OF WORK Descri tion of work: EC :54 P Lev,_^ r '?= r 3'?--l6E f0s - s ? S yy, 3oc?lL S6„ / °? o Multi-Family 8uilding: (Yes _ Construction Cost: CONTRACTOR Name: .. License #: -5z 2,5?, Address: Fftpr 6 'A t ' 4 ? L City: State/;?'(? Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF C,ONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cateaory 7 Minnesota Rules 7fi72 Energy Code . Residential Venhlafion Category 1 Worksheet • New Energy Code WoACSheet Category Submitted Submiped (4 SubmiSSiOn lype) • Energy Envelope Calculations Submitted In the last 72 moMhs, 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: Mechanlcal Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and support)ng documents that you submit are consldered to be public )nformatfon. Portions of the information may be classlfied as non-public if you pmvide specific reasons that would permit the City to conclude that the are trade secrets. I hereby ackrwwledqe that this information is comple[e and accurate; that the work will 6e in conformance with the ordinances and codes of Me City of Eagan; that I untlerstand this is not a pertnrt, but only an application for a permit, and work is not to start without a pennR; that the work will be in accordance with ihe approved plan in the case of work which requires a review and approval ot plans. Appl ani s Prinfed x- --?'- b?i?-- Applica s ignaiur? e- G Page 1 of 3 ?,-YSrO4?'? ?ofls?r?= r ?r 11 v . : ... c, :c :a:2 ?Yr.r ? • * , 6 6 4• 0 0-r >3•50+ 432 • 00+ 2Y0 f3 2• 5 0+ 3p232•00*+ 664•OOE ? 53•50+ 432 • OO F 2jOE12•50h 31232-U0*r . ? I tq(oo 1990 BIIILDING PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MIILTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET'OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS _# OF RENTAL UNITS _# OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL SE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. UCT 0 9 REGD To Be Used For: ??7tValuat ion; 10r7jouo Date: ? w, Site Address Ru6pKQ, IN OFFICE USE ONLY Lot L Block 1 Parcel/S b Occupancy Zoning Actual Const R 3 M-I 2-I V-N FEES Bldg. Permit 64.V O Owner Allowable # of stories V- Surcharge Plan Review 53,50 u 32,0 Address pi tli` Length Depth 30 1 SAC, City SAC, MWCC LDO 10 600, Op S.F. Total Water Conn (025,00 City/Zip Code Footprint S.F. Water Meter 90,00 Phone On site sewage_ Acct. Deposi S/W Permit t 30.170 30100 ' Contractor On site well MWCC System City water 7? 7 S/W Surcharg Treatment P1 Road unit e I S?b . ,00 3sS.? Address PRV 17 Park Ded. c Booster Pump _ Copies City/Zip Code SUBTOTAL APPROVALS Penalty Phone Planner TOTAL ?Q Arch./Engr. _ ?- / Council Bldg. Off. RD?o Variance v Address City/Zip Code ,/? ? Phone # 41 -m . VA?t?t/?.T?pN. . -? • . .? ? x2z= 4?t ? z?c ? 68v x??'-1?2,?? t?smr I? x y ? ly?ll Gz? i? 1753 x iv= iosy2 I s71- FL?orZ 3s? i = '-7 5 3 35x 2A- 98? /y x 6, = C ?y) GXZ= I"L 167'1 ? S I ? ?35sZ? ro?z?? , ., .,.? ? 7?HCR: ,fTE AODRESS: •n?...•??J'+N:i.llM':}.f4Y.?.'Y4'a? ?NNMMK?w'?}F:J:.?rf'?L?..?.. . . .. ?XTERIQR ENVELOPEJAVERAGE "U" COMPUTATION '91+TRACTOR: _ K 19j K-, DATE: DETERMINE 1IORKING SOUARE FOOTAGE OF EACH: `OHONE TOTAL EXPOSEO NALL AREA 36;Z? sq ft x"U" .11 '. TOTAL ROOF/CEILING AREA ?6-gs' sq ft x"U" ?. TOTAL EXPOSED WALL AREA CALCULATIQNS: To[al exposed wall area above floor„_...., 3j$7 sq ft a) Tota) wall window area: T-ET- ? 41 azed. .. .. ? 30$ sq ft x-."U" - glazed...... - cn fr Y I4r" 026 Ir ? . ? - •35? * _/vv.-7 z b) Total door area ......... sq ft x"U" , J3 e ,y Y? c) 7ota1 sliding qlass door area: 9lazed...... sq ft x "U-1 9lazed...... `i A sq ft xfoul$ - ' ' d) Total ffreplace wali area sq ft x"U" e) Total uall framing area (Average 10') ........... ?S? sq ft x nUn f) Total net wall area above floor (Insulated) ....... sq ft x "Ur'.: '{l q) Total rim Jotst area...... _ sq ft x"U" Total foundation area (Exposed)........ .. sq ft 1i) 7otai foundatlon • wlndow area........... .. --!,' sq ft x"U" --- ..? e i) Total net foundation ' aroa above gradc...... ... /y C/ sq ft x"U" ? Y . ?7.1,C TOTAL a) thru 1) ? 3/?•S'C? If Item -13 Is the samc as, or 2 h}CAR 1.16008 A and 0. less than item A1, you have met the intent of .,?1 1 4. TOTAL EXPO;ED RQOF/CEIll11f CALGULAT10N5: Total exposed roof/ceillng area........ /S -45 Sq ft J) Total skylloht area........ --- sq ft x"U" `f k) Total roof/cell(nq fram(ng arca (Averaae 1n9) ..... (S? sa ft x"U" 1) Total net lnsulated rooF/ccliinq area....... ?yx7 sq ft x"U" .vz4 ? 3y?s 4 TOTAL J) thru i) 3$,67 If cotal of -°A Is thc same as, or less than N2, you have met the lntent of 2:1CA,4 1.16008 A and 0. ALTERtlATE BUILUIHG ENVEIOPE DESIfN Ta utilize thc total envelope system meChod, the values established by the sum of items 93 and 94 shall not be greater than the sum of items dl and ?2. t 3`I$•86 + 2. ?l.zl - ?/yo•o7 . 3 3/;Z •SD + 4. 3-9,47 ,- . _ C E R T 1 f I t A T 1 0 N I hercby certify that I have calculated the "U" factors and "R" values herein and that the huildinn here descriheA meets or.exce ds the State of Ninnesota Eneray Conservation Act. ? re rlnt name (Date) page 2 • .y r NS7RUCTION R VALUE AMING SECTION: Interlor alr film 0.61! ? Exterlor alr film o_17 R • U ° 1/R - '055 F-C .i L 14ALL SECTION (INSULATED) --jl Interlor air film 0•68 -12 "i i --(3 T,..j ---{4 _ yr sl,r d z z ---l5 Jld 1..? 67 --{F Exterlor_atr film 0,17 ToTAL R 4 z2•.?7 U - 1/R - .ov?- RIM JO1ST SECTION; ? ? 2 3 4 5 6 Q A . •c a ?? A ? .6- .-,? • ?.Ar o •a_ ; ' ' '•a. ; Q.4•. "- d•.f FDUNDATION ItJSULATI0t1 RfQUIRED: • Min. R-5 on entire wall OR U- 1/R R,oyz Min. R-10 down to frost depth FOUNDATlOtI SECTION: ----(1 Interior alr fi)m 0.6$ ?2 GaN? .j UCJ --{3 ?%? / z;' -{4 Exterior a r film 0,17 (S {(. TQTAL R s 7• 13 U V R = .1'q_ SLAA ON GRADE ? ?.d '4•:,?1' ?.'a.: , Fi ' 4' ' ? i f I/'r,. • ,? ? u • • ? '• Neated Sla6s: MinimumR=8:5 Unheated Sla6s: Y?• 4, " Minimum R= 6.2 4-il•? z, '.ej q'?. q• , ,-1?,-• .c???° '4??. V..,a. .. ' •q ,..-, ..a 0. Q . d?,•'' : q;. ??,• • • ? . . .. . , , ,. '?..?'p?_ ?? •;?? .. '?. ?c"?c - tCONSTRUCTION R VAU6"; ' CEIL111fi SELTION (INSULATED): j Interlor air fflm 0.61 AIR 2 ,-c` i?-- •?6 CHUTE 3 r U,oo 4 Exterlor air Fllm still 0.61 TOTAL R m 7/, /ri U - 1/It ' bi ? CEILING FRAMINf, SECTION: I interlor air fllm 0.61 z ? ? s6 3 00 y Inter(or air ilm st 11 0. 1 5 aye- inches soft wooA y-3 \ TOTAL R ? S"l3 U - 1/R - •°zF' ? VENTED CEILIt7G SECTIDN (INSUTATED): 1• InterTor air film 0.61 2 ' 3 4 Exterfor air ilm sttl 0. 1 T07A1 R ° _ . :'. U , , ;.. CEILINR fRAFiRlr SECTION: 1•' Interior air, film 0.61 2 4 Exterlor air flm still 0. ? ' S tnches soft Wood ' T07AL R Ua 1/R°_ ? ( ? 1 _Inslde air film 0.61 2 3 ' 4 5 Outside air film ?•17 T07AL F t! - t /R - Page 4 958274 anrvm nznas riwsvna xmcnm vai.va AGRZEUM . This Agreement, made and entered into the Z22!?- day o! r7 u(' / ST r 1990, by and beb+een the CITY OF EAGAN, a municipsliLy of the SLata oE Minnesota, (hereinaSter ealled the 4 City), and the Ormer and the Developer identified herein. i Tha tarm "oaveloper^ as used herein refers to: AUTtTlQ7 RIDGE LM¢TEp pARTNERSHIP, a Minnesota limited pnrtnership, c/o JAFIES pgyELppKgNT COMPANy whose addzess ie 7808 Creekridge Circle, Suite 310, Bloomington, Minnasota 55435. Tha term •Wrter" as uead harein rePers to: AtlTOlW RIDGE LIMITED pARTNERSHIP, a Minneeota limitad partnership, c/o JAMES DEVELOPMENT Cp}PAltY vhose address is 7806 Creekridge Cirele, Suite 310, Bloosinqton, Minnesota 55435 and RUTH CONRAD vhose address is 5015 - 35th Avenue South, Apartment 215, Ninneapolis, Minnesota 55417. . qf[gRFAg, the Developer has spplied to the City Por approval ot the plat or su6division lceown ns AUTUlIIt RIDGE, located vithin the City; and 9iqEREAS, the Owner and Developer aqree !o notiPy the proposedpolentiIIl buyers of all lots xithin ADTUlRZ RIDGE that Lots 1-7. Block 1, LotB 1-8, Block 2, Lots 1-9, Hlock 7, Lots 1-17, Block 4 add Lots 1-5, Slock 5, are in a high vater pressure zone and a pressure reducing valve srall be installed in each home belov the elevation ot 966 Yaet. Al1 cests shall be the responsi6ility of the Ormer and peveloper and shall be 3nstalled to prevent damaqe dua to hiqh vater prassure. `' •r:y ? NOW, THEREFORE, the City, 0`mez an8 Developer aqree as lollovs: 3. Recordinc. This aqreement shall be recorded vith the Dakota County Reeorder so as to provide aotice to the ovners of Lots 1-7, Hlock 1, Lots 1-6, Hloek 2, Lots 1-9, Block 3, Lots 1-17, Block 4, and Lots 1-5, 81ock 5. The Owner shall provide and execute any and all documanta necessary to implement the recordinq of this aqreemant. 2• Hotice. The recordinq of this document shall eonstitute notice to all rnmers and future owners oP property in the AUTIA4i RIDGE subdivision that Lots 1-7, Block 1, Lots 1-e, Block 2, Lots 1-9, B1oGc 3, Lots 1-17, Block 4 and Lots 1-5, Biock 5 are in a hiqh vater proseure zone and tAat a pressure reducinq valve shall be instn2led in each home below the elevation of 966 feet. All costs snall be the responsibility of the Oimer and Developer and shall be installed to prevent damaqe due to high water pressure. 3. Validitv. If any portioa, sect;on, subsection, sentence, clause, paraqraph or phrase of tAis aqreemeni is for any reason held to ba 3nvalid, such decieioa shall not affect the validity oi the remaininq portion of this Contreet. a. Bindinq xcreement. The parties mutually recoqnize and aqree that all terms and eonditions of this recordable agreement shall run vith the land herein descriLed and shall be bindinq upon the heirs, successors, administsatoss and assiqns of the ovners and developers reterenced in this Contract. i IN tPiTNESS NKmEOF, we have hereunto set our hands. / gy; Oate Its: ? Y"& RXtH CpNgAp at DEVEIAPER: 71I1T0lW RIDGE LIMITED PARTNBtSHIP, a Minnesota limited partnership, By: JAMES DEVELOPMENT CO?lPANY, a liinnesota Corporation its: General Pa7rtner Sy: Date zr.s: .$ CIT1t OP OWNERS: ALTlUHI7 RIDGE LItlZTED FARTTIER.SHIP, a Minnesota limited partnership, e By: JANES DEVEI.OPMENT COISPANY, f a A. an a lSiru+esota Carporation Zb; Mayor Its: General Partner test . J. VanOVarbeke y: Date Its: ity Clerk Its: ?? R ? gy; Date Its• ST71TE OF MINNESOTA ss. CODNTY OF DAROTA 1 On this 7!?& day of t-? , 1990, befoze me a Notary Public vithln and tor said Coun , personally appeared THOMAS A. F•GAt7 and E. J. VanOVERBEKE to me rsonally knovn, who being each by me duly aworn, eech did say that they are respectively the Mayor and Clerk of tha City o! Esgan, the muntcipality named in ihe foregoing instzumant, and that the seal attixed on behalf of saifl municipallty by authority of ita C3ty Council and said 1Sayor and Clerk acknovledqad said instrument to be the free act and desd of said municipality. IUnr,n l N?9fRPFFtAl6 L / Q. ,?C??-•?-rI 1q:4PT M1:il". ? YICNESCTA p iS • P11b1?C DAKOTACCUNTY y ?{ ily [ommrs:ion F.9 icb B. 1^J / I ST11TE OF KINNESOTA ) ss. CODHTY OF ) ? On this ys_ day of , 1990, before me a Notary Public riThi?.??nd?? or said County, personal2y appaared I1?111? USI?GA to me parsonali knorm, vho being each by?me duly s? •??e? d say that they ara respactively the ? ? of JAMES DEVELAPMENT COMPANY, a ![innesota corporation, qeneral partner of ADTtIl9i RIDGE LIMITED pARTetERSH? a Minr?esota limited partnership, to me personally knovn. rho be me duly svorn, did say that they are the +St?•?'?- an1 of the aorporation and limited partnership named in the foreqoinq instrument, and that the seal affixed to said instrument vas siqned and gmlad?otn- P of said corporation and limited paztnexship and ssid- arYrY acknorrledged ?k? said instrument to be the free act and deed of said corporation and limited partnership. G. Notary PuAlUi wNrM?e?? ? ., •• 4?t. .?_?_ ._...._.. . ST71TE OP IS?NNESOTA ) ) ss. CODNTY OF AS94G'^') On this IL1-- day oi ! , 1990, before me a Notazy Public xithin and for said County, rsonally appeared RUTH CONRAD tc •e personally known to be the person deseribed in and xho execuLed the foreqoinq instrument and acknoviedged that she executed the same as her fzae aet and deed. Noiary Public 11PPROVSD AS TO FOItM: Aitorna 0 tod: ? APPIIOVED AS To CoNTENT: Public tiorks partment Detld: 8^7-90 TBZS ZNSTROlEN'P o1A5 DRAFPID SY: S8VffitSON, iiILCOX 8 SHELDON, P.A. 600 lti8way National 8ank Bldg. 7300 xasn 147rh screet ]lppla valley, !Ri 55124 (612) 432-3136 MGD p[i0[3C . , ENGIN CCfiING CoMPFlNY, INC. IUUU EA9i 148Th BTfIEET, 15To1W 61 Kk L coNSU1,Tt? o 4wa NFFns ?3Z72.0/ PLflNNE?S nnd LANU '?UAV6YUBS HUflN6YILLE, MINN680iA 6633T PN 432-3000 Certificate of Survey Legal Description: Lor /, ecvel,- a, Av,-o,-iAv R/GUE, DA.CoTA G'avNTY, M/NNE.S`oTA• (9s%7 ) DENOTES EXISTING ELEVATION (95Z,7 ? UENOTES Pf10POSEU ELEVATION ? INDICATES UIIIECl'IUN Of SUIIfACE DFlAINAGE 5?53,00 = PINISI-IEU (UAf1AUE PLUQfi ELEVA710N 949• 9B = BASEMENT FLOOR ELEVATION Sy 3, 33 = TOP OF BLOCK ELEVATION SCALE i 1' - 30' IUW/N46E ANO 30 F,?NT D,?IJ/LD/N6 ?/T/L/TY EA.?1?IE.?/T s??? L/NE (?9G.v? nJ 89° 06" 551E 301 oo , ? c}o , 26 ???? u?_ -- _ ?. , -?$ ?_ lA- 5? nt5/,7,-75*•v0 ?(952.7? I 10 mQO a- ??_95T,y, N p a ?}\ ?s0, 7.00 N o I \'C ? ?95?J7. ? ? 06 o ? \ Nt'- $ o zz.cb ,o M 70? » WA 10 41- I ?l ?(YSZ.Z>x ` f 952. 7) 15Z,7s N 89° 06' 55" ? (2571 Z-? r, t?? ? r ? v?' ? EAGA?T ?W?dNE1ERIlUG DEPT I Iierehy oer111y Iha1 thia ls a lrue and ootreal represanlallon oi 0 11UC1 OI IAII[I flS BIlOWi1 7?/ and desotlbed horson. As ptepared by'ms on 11de'8 dey ol . 4C;Mex -,1g=10 , 3 l l? A "_.C'? \g ?-- / • R ~ Use BLUE or BLACK Ink r For Office Use lion I _ _ "I 1" III Permit#: ~ I J-7Z. aw City of EaRd 0 Z~ I Permit Fee: 3830 Pilot Knob Road MAY 2 I Eagan MN 55122 Date Received: tab 6 Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: I C r 2013 RESIDENTIAL BUILDING PERMIT APPLICATION A~AA ~ Date: / o a013 Site Address: 620A4c1CM6C4r V494„• 2'3 Unit Name: ~ENt.¢~" ¢ 5o~i ~lll ~'1 ~"t a Phone: (O t Z% g lo- 1"+ Resident/ Owner Address/ City /Zip: CZ0 Ra t1Gnn ort Est nr /h f~f SSf 7~~' Applicant is: _Y' Owner Contractor /Q Type of Work Description of work: Atij, d~ ~Gk-- 1 JWP' E' er e c k.~ Construction Cost:2 Oap Multi-Family Building: (Yes / No ) Company: 1T 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 Building Code must be completed within 180 days of permit issuance. 1 x ~Percer T GJ h x Applicant's Printed Name Applic nt's Signature Page 1 of 3 6"' V DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) Single Family Garage Porch (4-Season) Exterior Alteration (Multi) Multi ~L Deck _ Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of - Plex T Lower Level Pool 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. *D2molition of entire building- give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition SAC Units (25% 100%) Zoning City Water Census Code 74 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 Gas Service Test Gas Line Air Test 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: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge I Plan Review MCES SAC City SAC Utility Connection Charge 6,9 L S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 951.7 DENOTES EXISTING ELEVATION (952.7 DENOTES PROPOSED ELEVATION INDICATES utnECTION OF SURI=ACE DRAINAGE 5 3,oo FINISHED GAnAGE FLOOR ELEVATION Z49. a= BASEMENT FLOOR ELEVATION ,959, 33 TOP OF BLOCK ELEVATION SCALE a 1- 80' 30' FrpD,N7 F1JtGD/jl!!a PAPA IV466 41vp jJrLITY ~.9.SEM&NT 89° .3o.ll0 L 7 o p r- r tz. 14 g 10 ZZ,W x,02 iv, zoo (x$2.7 - 0 952.7 ~v~\ L n /953.91 ~ _ . r 9.53.9} 5Z75 {951y2: 89° o6' 55" 6 (29,Z) "rz AC ~DEP~T I hereby oetttfy that this Is a ttue and cottect teptesentation of a ttoat of land as allow" and desctlbed b*mw% As ptepated by ins on tttts'~_ day of 2Q. l L V ~ 14111111, flog. 1-10. PERMIT City of Eagan Permit Type:Building Permit Number:EA117324 Date Issued:10/17/2013 Permit Category:ePermit Site Address: 620 Hackmore Dr Lot:1 Block: 3 Addition: Autumn Ridge PID:10-12300-03-010 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - 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 by law in ALL single family homes . Mark Mattson Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Jodi Ann Tste Solheim-little 620 Hackmore Dr Eagan MN 55123 Three Pines Construction 2876 Middle Street St. Paul MN 55109 (651) 308-1911 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA119956 Date Issued:01/06/2014 Permit Category:ePermit Site Address: 620 Hackmore Dr Lot:1 Block: 3 Addition: Autumn Ridge PID:10-12300-03-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Jodi Ann Tste Solheim-little 620 Hackmore Dr Eagan MN 55123 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA145239 Date Issued:08/30/2017 Permit Category:ePermit Site Address: 620 Hackmore Dr Lot:1 Block: 3 Addition: Autumn Ridge PID:10-12300-03-010 Use: Description: Sub Type:Reroof Work Type:Replace Description:Includes Skylight 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: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Jodi Ann Tste Solheim-little 620 Hackmore Dr Eagan MN 55123 (612) 810-1434 First Choice Exteriors Inc 7214 Washington Ave S Eden Prairie MN 55344 (952) 380-8248 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r For Office Use City of EaallI6 )C63. Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone:(651)675-5675 Fax: (651)675-5694 Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ' /2-1 1'� Site Address: 6v249 1-tat Cktrrio re ¶7( f--Ctia. titAd 3l23.Unit#: Name: 7.1)G✓\CG•r— 4.)irN Phone: 612—S10- 1L&3�- Restdentf Owner Address/City/Zip: 62.0 14c.c--r►io cc__Dr ._ jc3(n/ M P/ Applicant is: Owner Contractor Description of work: 7 76%-,5 ord.( Ca u :k9 u lo d Dte) Ct-e. ) Type of Work Construction Cost: Multi-Family Building:(Yes /NoX ) Company: 5e 1-r- Contact: ,evLc.er G41::t Contractor Address: Go.o f44,r kis,/ . Pry City: s-C.9 a1--1 State:/0 Zip: <C(2-3 Phone: 442470 -1Cf3gEmail: (Mkt sties-A'Us(-- ho-f'ncft1 License#: N/A Lead Certificate#: 1J/A- If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: NOTE:Plans and supportingdocuments 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.nooherstateonecall.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. '.r 4,/� x �1PC-h GQ!` (A �'l i�E' �- Zf , / Applicant's Printed Name Applicant's Signature Page 1 of 3 Use BLUE or BLACK Ink r - For Office Use /� CityOl L� �11 Permit Fee: /05' 3830 Pilot Knob Road Eagan MN 55122 Date Received: -oZ 3-1/ Phone: (651)675-5675 buildinginspectionsacitvofeacian.com Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: 5-poi c,,r 1)1 h r , Phone:602 _ s2/0 Resident/ Owner �� Address/City/Zip: C,2c) c Gcfr P iL Applicant is: Owner 7( Contractor Type of Work Description of work: / o tit.) n it, 1'y y// P it/1Ii c p/4115 Construction Cost:2 j JvJ Multi-Family Building:(Yes /No A ) Company:A rJU t'1' —chip Contact: ,r?)Yi 1 (4 C i Contractor Address:#2/ 5 fsf/47y (1 L bit. City: /AO/yr e.„ Stater Zip:c9`46 Phone:4/) ��j ' /311Email: License#:1?C „To 3/s' Lead Certificate#: If the project is exempt from lead certification, please explain why: 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: Fire Suppression 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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. 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.000herstateonecall.orq 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. Applicant's Printed Name Applicant's Signature Page 1 of 3