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4627 Halden Cir Use BLUE or BLACK Ink t55 I Permit I ll(~y I bl1 y o Enn Permit Fee: 3830 Pilot Knob Road I I I Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff: j 2011 MECHANICAL PERM InT APPQLIICATION Date: 3 Site Address: ~+(idVA ely Tenant: 17 Suite RESIDENT/ OWNER Name: 5 _ Address /City /Zip: 1 2,2 j CONTRACTOR Name: r Roll n Wr License Address: jq 04 V City: H s n State: m n zip: V Phone: t(J~.71~ `T ContactAmi 1, HfffflanEmail: fte W&WAUU(m TYPE OF WORK New - Replacement Additional Alteration Demolition T Description of work: I. NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace _ New Construction _ Interior Improvement ::AAir Conditioner _ Install Piping _ Processed Air Exchanger Gas _ Exterior HVAC Unit Heat Pump Under / Above ground Tank Install / _ Remove) Other " When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x1% $55.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.o[g 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 plan . x IL 01f kf~= x Applicant's Printed Name App ' ant's Signature FOR OFFICE USE Reviewed By; Date: Required' Inspections: Under Ground Rough In _Air Test _Gas Service Test In-floor Heat Final _ Exterior HVAC Screening Inspection Use-BLUE or BLACK Ink 1 or Office Us 1 1`► I I t~,hil 1 9 tC!iI I I City of Ea~ a11 r,C, Permit#: 1 Permit Fee:©" 1 I 3830 Pilot Knob Road Eagan MN 55122 I Date Received: j Phone: (651) 675-5675 I~ I Fax: (651) 675-5694 1 Staff: , , - 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 31" a~ Site Address: ~ h 5 ZZ Unit Name: r f~ Phone: 5)"j~ D -)1 5~ RESIDENT I OWNER Address / City / Zip: Applicant is: -V-/ Owner _L/ Contractor TYPE OF WORK Description of work: A ~i- I L Construction Cost: Multi-Family Building: (Yes 7 No Company: I~ Contact: CONTRACTOR Address: City: State: Zip: Phone: License Lead Certificate Does this project require Lead Remediation? ❑ Yes tf No (see Page 3 for additional information) If no, please explain: E ul i It oa,: 19 ~ 0 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.ciopherstateonecall.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. Applicant's Printed me Ap icant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage Porch (4-Season) _ Exterior Alteration (Single Family) Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) _ 01 of Plex _ Lower Level Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition 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 / C.O. Required Footings (Addition) Final / No C.O. Required Foundation NNY) HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: ~ L , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review I/J MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 4" 20 10 Na w~, LAM SJ ----Use BLUE or BLACK Ink For Office Use Permit City of Eatan I Perrot Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: ; Phone: (651) 675-5675 ; Staff.. ; Fax: (651) 675-5694 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Y Site Address: "/f~d+~ / q~.~ et P~~ a c q rn4..) S_S i Z Z Tenant: Suite RESIDENT / OWNER Name: LIB j m*qRk S-J, .vex 1, e,/ Phone: (oSl - 2-jD n/ n Address/ City /Zip: 'y6a 7 W ds, c * aci -e- ;9064- . inDA-i r77 Applicant is: _,X- Owner Contractor TYPE OF WORK Description of work: F I F=,TC 3 arz Rwh ~G Construction Cost:/ Multi-Family Building: (Yes J No ) CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact: Email: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: 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. CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 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. uU NU I wKl It' t3tLUW THIS LINE U13 TYPES , I ~9qI Ci P-- "l5 Foundation Fireplace Porch (3-Season _ ) Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) - Multi _ Deck - Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) _ 01 of - Plex _ Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition - Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace - Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation 0 Occupancy MCES System Plan Review It Code Edition SAC Units (25%_ 100%~Ni 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) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) - Final / No C.O. Required Foundation HVAC Drain Tile Other Roof: lee & 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 Meter Size: Radon Control Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES t Base Fee Surcharge I Plan Review MCES SAC City SAC ' L Utility Connection Charge (fin 61 f L> S&W Permit & Surcharge Treatment Plant a lC Copies TOTAL Page 2 of 2 4627 r ~D C. R. WINDEN & ASSOCIATES, INC. tJ LAND SURVEYORS TeL 645-3646 FOR: 1381 EUSTIS ST., ST. PAULA MINN. 55108 U. S. HOME CORPORATION nn L14:7 0-7 V~ SCALE- I" ,5o' 7 ~ ODEN07F5 IRON ` I s7 \ "`~S ~v 2 rry ~ E / CI 9A ~~h r /O Q o O /IVO Lot 3, Block 1, Ridgecliffe First Addition, Dakota County, Minnesota. 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 BUILDINGS, IF ANY, THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. Doted this I L doy of ST-A.D. 198/ C. R. WINDEN & ASSOCIATES, INC. Surveyor, Minnesota Registration No. P7?G N735t9 ~ ~ ~ ~ ~ ~ ~ ~ ~l ~S ~ 'C7 ~ ~ 1 - ~ ~,s~ ~ ~ ~ tom, ~ ~ ~1 ' ~ xs d ~ W ~ ~ t ~ r~ ~ ~ ~ ~ \A~ - V i • CASH RECEIPT • CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 necervco AMOUNT $ I & DOLLARS 1 oo E]CASH []CHECK R!] Y • White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You ? C_/ 'y? B Y ? ?i r7C CITY OP EAGAN 3795 PiloR Knob Rood Eegon, MN SSls2 k PHONE: 464-8100 BUILDING PERMIT Receipt # 7o be wed for Est. Value Dcte___ 19 Slte Address Erect ? Occupancy Lot Block Sec/5ub. -? Alter ? Zoniny Parcel # Repalr ? Ftre Zone Enlurge 0 Type ot Const. aWc Nome Mova p # Stories ; Addreu Demolish ? Length i? Ci ` phone Grode p Depth Sq. Ft. ? ? Nomtr ApproKOls Faes ?? Addren Assessment Permit ~ Cit Phone Water 8 Sew. Surcharge Police Plan check F ?°W` Neme ?,,, Fire SAC ?? Address Eny. Water Conn. <W Ci Phone Plonner Woter AAeter Council Road Unit I hereby acknowledge that I have read this opplication ond state that gldq. Off. the inform4tion is correct and cgree to compiy with oll opplicoble Stote of Minnesotc Statutes and City of Eagon Ordinonces. APC Totnl Siynature of Permittee A Bullding Permit Is iuued to: - on tfie express tondition tF?at all work sholl be dorx in accordarxe with cIl applicable State of Minnesota Statutes and City of Eoyan Ordinonces. Buildinq Officiol Pormit No. Permit Holder Misc. Permit No. Holder Plumbing -2S coq H.V.aC. Wlell Water Diap. S?vuer Electric 57pt0 (3t ? t F C, Inapaction Date Insp. Other Foatings -/l•?f/ ,i,? t Foundation Framiny Rouyh Plbg. - o- ? Rtwph HVA Inwlation Final Pibq. h Final HVAC Finai ? Wster Dswibe Locat n: YYell Sewar ' Pr, Diep. ? Recsipt MECHANICAL PERMIT Permi t No. CITY OF EAGAN Fee , l Frll in num4ered apaces S/C - ? ° Type or Print /egib/y T t o . 1. Date '-?-30-€'1 2. Installation Cost ?-`?%'-'• ?' 3. Job Address ?:?• ? 'lot Blk. ? Tract 4. Owner , i :1;; , 5. Coniractor - _ ;7. w: ;LT:ii ,. ;...T, 'v Phone 5?5-6' r, ! 6. Address =-G37 Chicu?;,_) 7. City .'_ L' • State Zip 55407 8. Building Type: Residential 0 Commercial D Institutional ? 9. Work Description: New IN Add ? Alter ? Repair ? 10. Describe- Fuel TYPe 1 11• No. ? E,quinment 8TU - M. Ea. Forced Air ` No. Equiament CFM Air Handlin : Mfg. g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. ; Gas, Piping Outlets 12. 1 hereby certify thet 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 Flnal Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Raceipt PLUMBING PERMIT CITY OF EAGAN Fill rn numbered spaces Type or Prini /egib/y i 1. Date ?' ,??? 2. Installation Cost 3. Job Address Lot Bltc. 4. Owner 5. Contractor --? Permit No, ? Fee S/C Tot. Phone /J l 6. Address v - 7. City K ;'. State Zip 8. Building Type: Residential G7 Commercial ? Institutional O 9. Work Description: New EI Add ? Alter O Repair ? f ,o. o???ibe I >>. No. ?-- Fixtures Water Closet No. Fixtures C i fi UD Bath tubs esspoo ra eld n Se tic Tank Lavatory p f S Shower tner o W ll _L Kitchen Sink e Urinal/Bidet h O ? l.aundry Tray t er 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 Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454$100 CITY OF EAGAN Remarks ? Addition Ridttecliffe Addition Lot _ 3 a,k 1 Parcef #10 63980 030 01 i Q,,,,,,er ?1 ;. :?: ?, ?_° h•f?. lXU , (L street 4627 Eialden Circle state Eagan, A4d 55122 Improvement Dete Amount Annual Years Payment Receipt Date STREET SURF, , ,. r, _ ? ? STREET RESTOR, GRADING SAN SEW TRUNK _ 41/2S -980 184.49 12.30 15 147.62 coo7631 2-18-$2 SEWER LATERAL WATERMAIN WATER LATERAL n r i WATER AREA 4 I Storm sewer trun.k. 12 372,2; ??. 7 ^ r? I STORIIA SEW TRK 2 8,2 S 638.24 C007616 12-23-81 STORMSEW LAT 1nnr, 7 r Services 1982 637.75 5 637.75 G007616 12-23-81 CURB & GUTTER SIaEWALK STREET LIGHT I oa Unit 185.00 26706 9-10-81 WATEfi CONM. 335.00 n " I AUiLOfNG PER, 6$67 5AC 525.00 PARK WATER SERVICE PERMIT 'ilof Knob Roed MN 55122 PERMiT NO.: DATE: . No, of Units: , Jo.: Connection Chnrge: ,- /lccount Deposit: No.: Permit Fee: ro ooiaply wieh t1N Citr of Ea9sn Surcfiarge: Misc. ChorGes: t " ,- ?s. Totol: Date Paid: Data of Insp.: ,F EAGAN SEVNER SERVICE PER MIT r . . Wiot Knob Roed PERMIT NO.: Rape, MN 55122 DATE: Zoninp: - No. of Units: Owner: ! )r. r - ? ,; Address: r Site Address• Plumber . 00 1elm M oosptr whU tie Gty of Eogsn Connettion Charpe: Ordinanees. Aocount Deposit: Permie Fee: - Surcharpe: gy Misc. Chorges: Date ot Insp.: Total: Insp : Dote Paid: . CIT' OF EAGAN 3795 PIlM Knob Rmd Eagan, MN 53141 4110NE: 454.8100 BUILDING PERMIT Te 6e u.d {er SF DW $47, 000 Siro Address 40e r nestuen t.irete ?A2LPuCl ivv / Lat 3 Blxk 1 sec/s,b. Ridgeclif@e lst varcel # 10 63980 030 Ol a IN,,, OrZ'in TtiOIDA$OII HOIDEB Z Addross 1712 Hopkina Crossmad t _.. Mtka. 55343 _ 544- 33 ? Name _ 0 i? Addreu Nome _ Address 1 hereby acknowledge that 1 hove read this opplication ond state thot the inlormolion Is corrett ond ogree to comply with all applicable State of Minnewto Stotutes and City of Eogon Ordirwnces. Signoture of Pertnittee A Building Permit is iuued to: oll work sholl be done in accardonce with Bullding Officiol Receipf # N° 6867 r 10 81 erecr g,t ac-voncy R-3 Alter ? Zoning PD Repair ? Fire Zona MA Enlaroa ? TYpe oF Const. V Move ? # Stories Demolish ? Length 60 Grade ? Depth 34 Sq. Ft.- AvVrorala Fees Assessment Permit 11by.7V Water 8 Sew. Surcharqe 23.50 Police Plan check 134.75 Fire SAC - 525m0O Enp. Woter Conn. 3 5.0(3 Plannar WorerMeter bn_nn Countil Rood Unit I g5 Ml Bidg. Off. nrc roroi L1532.75 on t he express condiNon Ihnt ?soto Smtutes and Ciry of Eogon Ordinoncea. ?/,-? 1 CI'I?p=Z7F`?'u?GAN Include 2 sets of plans, 1 site plan w/elevations & FIUIIDIN(; PERMIT APPLICATION 1 set of energy calculations. 'Ib Be Used Far Es ?{L p? m-, p- Valuation ? Date Site Address: 4 4 ba`Z t}Av -0 &N ct.( l.pioo ) OFFICE USE ONLY Lot 3 E1ocx l sec./suv. g?oc?J..?FFS srect )( occupancy Parcel #: /v (p 03C) o ? 39 'R-( F?tis ? alter zoning ,oD Repair Fire Zone Enlarge 'IyPe of Const. Owner: _ M # Stories ove Pddress: a Division of U, S Home CoroM Demlish FYOnt ?(7 ft. - Cliy/Zlp COdE: "?Tl KINS CROSSROAD Grade MINNETONKA- M1vN Depth ft. 3v Phorbe #: S44-1333 APPROVAIS FEES Contractor: r%oD1111'rLJ^A ro PL3drCSS : City/Zip Phone #: - F9 f11rt-0- a Division of U. S. Homc Corporation 1712 . NS LNU?)JJW Cpde: MINNETONKA, MINN. 55343 Arch. /fng. : Pddress: City/Zip Code: Phone #: Assessrents Peimi.t Water/Sewer Surcharge Police Plan Check J? y 1s4 Fire SAC ?sffi gnq, water Conn. - Planner Water Meter (o? Council Road Unit Bldg. Off. APC - Mrau. r REQUEST FOR ELECTRICAL INSPECTION K'. EB-00001-03 See inslrvctions ior camplebng this form an back ot Vallow cuPy. v, ? J 1 $eT>K+Wark Covered by 1'his Request a27 (,73 (p ew Atld Hep. TVVO of BuilAing Appliances WareA Equipment Wved Home Range Temporary Service Duplex Water Heatei Lighting Fixtures Apt Bwldiny Dryer ElecVic Heatin Commercial Bidg. Furnace Silo Unloader Industnal Bldy. Air Condrtinner Bulk Milk Tank Fypp Other SPe.uly Othor ISUerify? thn, Sycufy Ot6er Olhnr Campute lnspectron Fe.e Selow N Fee ServweEnVanceSize p Fee Feaders/Su bfeeeln? F e Circuits .l? 0 to 100.Am?S? 0 to 30 Am " to 30 Am s 101 to 20D?qmps''• 31 to 100 qmps 31 to 100 Am s Above 100_Amps Above 700_Amps l Tr si6qper's" - RemoteControlGrc. Parual,'Other Si s Special 6isprcuon 5 , ?? Rema,ks 1 TOTAL F . Fouqh-in Date I, tlie Electncal , Inspectm, hereby Final ^1e G 7 ? certity that the above 1 Oecbon has been '9 -a de. This iequest void 18 monihs $um This requesl void /d5 18 nwnths 1mm ,C r'r1aQ20 3S ' Oo ?7(0 3 ?P Feq{y:st D.I. I 10 ??,?' Fne No. RouAh-m InsVectmn Re utred? • ?es ?NO [:]Ready NowD&Ol Noufy Inspec- ??r When Readv ?Lwensetl EIer,ViraLConVactor 1 hereby request mspecboo of above ' iLJ Owner I I electncal work mstalled at Street ?A/tl?dress, Bo,?x,}+a-/r?flou[ We No. YY/1? ,IIVVJ ??1_"rv CrtY?t /? CJ??I`°- uon o. 7.waship Name or No. Ran9e No. Cowny . DW-oTp Oc,cu n1?lPQR?IN?T?I ?Q`,,?'I ??(? ?'l'M? ??`1W? 1??1'?/ Phone No. " Power upplier AdtlresQ?s ^lM- r? •'hk701f"i1 He wa1 Co Mractor (Comoeny Name) 66 ConI,actor's License No. - 39S2s -t "R,,; - Mall{1in,A1,fAtlJress(COn[ractor or OwneNr Making Instaila[ioN . , . 1"1 11 L. ?L0* ?V •AuAOrized Si ?9tu? ICOntractor Owner Mabne InstAllationl. . . Php?¢ Numbar 5?o -s s?r MIflNESOTA STATEBDAIID OEE[ECT11iCIT1' " ' - THIS INSPECTION REQUE9T'WILL NOT Grigpi-Midway BICy: - #eom Md91 BE ACCEPTED BY THE STATE {OMO '7821 Univarsity+Ava:, St. Paul, MN 55104 , UNLESS RROPER INSPECTION FEE IS ; 'an,...o Iei>I 197_7111 . . . ENCLOSED. 2007 RESIDENTIAL PLUMBING PeRMiT aPPUCarioN (? ck-? CITY OF EAGAN C/'-- 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Piease complete for modifications to existing residential dwellings. Do not combine inside and outside nlumhinn nn }ha cnma ?nnlirn}inn' cannrnfa annhri}innc anrI r1F?Cm1fA afP fP.[1111fPCi ? Date Site Street Address Unit # Property Owner "? ? ? ? Telephone # 41 ? ?. Contractor Appliance Conneetions 1 Telephone #( ) Address 313 Danita Cr city state zip r 9 1 9? 03 n" _ Licensed Plumbing Contractor The Applicant is: _ Owner (J ccu Refurbished Submit 2 sets of plans and MPC license New Septic System Includes County fee _ _ _ $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fiutures, etc.) $ 90.00 This fee a lies when extensive lumbin re airs are made to a buildin . Alterations to existing dwelling $ 50 00 _ Add plumbing fixtures to main level lower level. This fee includes installation of a water softener and/or water heater at the same time. H you are insta!ling onlv a water softener and/or wafer heater, do not complete this section; move to the next section and place a checkmark next to the appliance(s) you are installing. _Septic System Abandonment ^ _WaterTumaround (add $136.00 if a 5/8" meter is required) Other: i Water Softener Water Heater $ 15.00 _ new Zreplacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 ToWI . I hereby appiy tor a htesidentiai Niumbing rermit ana acanowieage tna[ me mrormauon is compiece ano accurace, mai ine wvrn wiii oe in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a pertnit, but only an application for a permit, work is not to start wRhout a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. 1 rOS Z?y RESIDENTIAL BUILDING ?•? ? Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 $rzs,2,S- New Conshudion Reouiremenls RemodeVReoair Reauirements OMce Use Onlv 3 registered site surveys showing sq. fl. of lot, sq. ft of house; and all roofed areas 2 copies of pWn Cert of Survey Recd _ Y_ N (20% maximum lot coverage albwed) 1 set of Eneqy Calalations for heated addi6ons Tree Pres Plan Recd _ Y_ N 2 copies ol plan showing beam & window sizes; poured found design, etc. 1 site suNey tor additions 8 decks Tree Pres Not Reqd Y N lsetofEnergyCalculations Addifion-mdicafeilai-stesep6csystem On-siteSepficS/siem _Y _N 3 copies of Tree Preservafion PWn if bl platteE after 717/93 Rim Joist Detail Options selection sheet (hldgs with 3 or less units Date 7 1Z ?) l<:?, 3 Site Address `IL7 7 d?j, Construction Cost 4 S G Z e, G-r'/ C i 2 Unit/5te # Descrip[ion ot Work Multi-Family Bldg _ Y::J? N Fireplace(s) _ 0_ 1 _ 2 Proper[y Owner a d• ??,Sg Telephone #({ s'/ „ 9,69 Contractor 1-ri ??c r S e- J Address 361?7a L./ State .11144/ 66ti/ t,3 City Q..rt+,svA/, Zip 5"3-3'37 Telephone#(qs-A ?9*{- 47600 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate orv I Mirmesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submissionrype) Submitted SuGmitted • Energy Envelope CalculaUons Submitted Have you previously constructed a buiiding in Eagan with a similar plan? _ Y _ fee applies. Licensed Plumber Telephone #( Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( N If so, 25% plan review I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN 5tatutes; 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 ApplicanYs Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 37 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck 0 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-pleX ? 12 12-plex Plbg_Y or _ N ? 25 MiSCellaneOUS Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Founda6on) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolltton (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaVC.O. _ Footings(deck) FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing Siding Stucco Stone _ Fireplace _ R.I. Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector RESIDENTiAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New ConatrucNon Beaulremenb • 9 regisleretl sile eurveys showing sq. fl. ol bt, sq. ft. of house; and a roofed areas (20% maxhnum bt cove(ege albwed) • 2 coples al plan showing 6eam & wintlow sizes; poured found desgn, elc.) • lsetatEnergyCakulations • 8 COpiea of TrBB Preservatbn Plan tl IOt pl9ttetl afler 7/1193 • Rim Joist Deleil Options seleclbn sheet (bldgs wlih 3 or less unNs) DATE A.1 3! ?? O O Z RemodeUReoelr HeaulremeMB . 2 copi%ol plan • 1 set of Energy Calculations for heated addaions • 1 skb survey for exAeMOr atldiibns & decks • Indicale A home served by seMb sYSlem ta addkans VALUATION ? `J?d o d 7 ,2( N SITE ADDRESS V? I? (?? ?11?G<.? MULTI-FAMILY BLDG _ Y TYPE OF WORK Ppa/= ?- S?/ m?rk C? FIREPLACE(S),? 0_ 1_ 2 APPLICANT (2117Tz L O,,'v 5 T f< [i r- /_ A c--- STREETADDRESS /l /3 g- i//? ITY ?'k'`l°STATE ;?'-ZIP E_ < < TELEPHONE 412- 7°!!7 1&1 G/ CE11-4?# FAX # 9_1- 2-45 ?Yf qy-z 5w / cr-o PROPERTY OWNER ,!2,1t' ?141 TELEPHONE # al COMPLETE THIS SECTION POR °NEW° RESIDENTIAL BUILDINGS ONLY Energy Code Categary MINNbSOTA RULES 7670 CATEGORY 1 MINNES ' ? (d aubmission type) • Residential Ventilation Category 1 Worksheet Submitted • ?{?' ?'ed? l J IS • Energy Envelope Calculations Submitted JUN 0 3 2002 Piumbing Conhcctor: Phone # ? Plumbing system includes: _ Water Softener _ Lawn Sprinkler BY Water Heater No. of R.I. Baths No. of Baths Mechanical Coniracfoe _ Mechanical system includes: SewedWater Conhactor: Phone # Phone # Fee: $70.00 I hereby acknowledge that I have read this application, state that the informaTion is correct, and wlth all appilcable 5tate of Minnesota Statutes and City of Eagan Ordinqpggs. ' -.00 -------------- wo comply OFFICE USE ONLY _ Air Conditioning _ Heat Recovery System Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? Ot Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04plex ? 31 New ? 32 Additlon ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const ? 20 Pool ? 21 Porch (3-sea.) ? 22 PorchlAddn. (4sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous 0 30 Accessory Bldg O 31 Ext. Alt- Multi ? 33 Ext. Alt - SF ? 36 Multi ? 35 int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundatlon) ? 45 Fire Repair ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 WindowslDooB 'Demolition (Entire Bldg only) - Give PCA handout to appllceM Occupancy MC/ES System Zoning City Water Stories Boaster Pump Sq. Ft. PRV Length Fire Sprinklered W idth REQUIRED INSPECTIONS _ Footings (new hldg) FinaUC.O. _ Footings (deck) FinaVNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other RooF _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final _ FraTning _ Siding Stucco _ Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Buiiding Inspector Base Fee Suroharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Searoh Copies Other ? 07 05-plex O 13 16-plex ? OS 06-plex 0 16 Fireplace ? 09 07-plex ? 17 Garage ? 70 08-plex O 18 Deck O 11 10-plex ? 19 Lower Level O 12 12-plex Plbg_Y or_ N Total 4627 C. R. WINDEN S ASSOCIATES, INC. LAND SURVEYORS Tel 645-3646 FOR: 1381 EUSTIS SL, Si. PAUIA MINN. 55108 U. S. HOME CORPORATION N ! a ti-?? ? SCALE" 1=3Q' QJ ? ODEfJOTES IRON / `L? / ?C W / O 0 ? / ^ S 0 o . o /o? />' ? J'0 O? ! Lot 3, Block l, Ridgecliffe First Addition, Dakota County, Minnesota. WE HEREEY CERTIFY TMAT THIS IS A TRUE AND CORRECT REPRESENTATtON OF A SUNVEY OF tME BOUNDARIES OF THE LAND A60VE DESCRI6ED AND OF TME LOCATION OF All EUIIDINGS. IF ANY, THEREON, AND All VISIBLE ENCROACMMENTS, IF ANV, FROM OR ON SAID LANO . Dorod rhi,IS? day o{ sSepf, A p 19E) C. R. wiNDEN 8 ASSOUATES, INC. br dw-? 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