4741 Hauge Cir1 Co& Office ? -• ?
2 Copy: Crew Chlef .00
r." ?.! {
3Copy:Municipafity Pac? ?f?t Poot & Patio - -
4 Copy: Customer A Minnesota Package Products Company
6922 55th St. North 9913 Lyndale Ave. Sa. 4321 68th Ave. No.
North St. Paul, MN 55109 Bloomington, MN 55420 Brooklyn Ctr., MN 55429
770-1313 888•1998 560•6442
CREW CFIIEF
Equipment Needed
• Back hoe ? Bob Cat
? Cat Q Truck
? Snow Fence ?
Inspections Contract
? Walls
? Plumbing
? Footing
? Before Backfill
? Other
ACCOUNT NUMBER POOL SIZE DATE
NAME HOMEPHONE
STREET WOfiK PHONE
CITY STATE ZIP CODE
pool site in relation to house, garage, property line, and
Q?
r
??
t
. Z
?
L 1
,
10
(Allow 3" variance)
? f
- ?
-0 Mark location of filter aNor heater by (#2). ? Elevation from iocation matked "A" in diagram:
?0 Show type and location of slide if applicable:
? Indicate deep end by (X). ,
jE7 Does Customer wish to retain any or all dirt from pool Ci Location for disposal of dirt:
excavation:
ID Will any obstructions be encountered - such as trees,
cVothes pofes or powerlphone iines etc.:
-C'i Pacific Pool & Patio recommends that customer irtstall
(As soon as possible following pool construction):
1. Rain gutters adjacent to pool 2. Retaining wall where diagramed
3. Run off control or drainfield
''` CUSTOMER ALSO UNDERSTANDS & ACKNOWLEDGES THE FOLLOWING '""
Some damage may be done to the yard and/or driveway entering and leaving the yard during construction: Intial .
Customer assumes responsibility for electrical wiring and graunding af the pool (including permit if required): Initial
Cusomter assumes responsibility for the gas installation of heater if applicable (including permit if requlred): Initial .
If debris, structures, or substance foreign to normal soil should be encountered while excavating which requires abnormal
handling and/or disposing - Custamer shall assume responsibility if any extra costs are incurred. Intial .
If you wish to change: filter position, slope of land, or anything else stated in this outline, please call our office - 770-1313.
Crew chiefs are not authorized to change anything on the job or make any promises for work to be done by them. Any Changes
that are not authorized by the office will be charged at a standard sate - no exceptions.
Pacific Representative Signature Customer Signature ?, -
,
?'?
CITY OF EAGAN Remarks
Addition BitlaaCl].ff First Addn_ Loc 12 eik-tL Percel #10 63984 120 04
ownar Street 4741 Hauge Circle State EaQan. MA1 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR,
GRADING
SAN SEW TRUNK Li 1982 298.08 S 298.08 C007616 12-23-81
SEWER IATERAL
I
WATERMAIN
WATER LATERAL
WATER AREA 1982 298.08 $
STORM SEW TRK 1982 638.24 5 638.24 C007616 12-23-81
STORM SEW LAT
Services 1982 637.75 5 637.75 C007616 12-23-81
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 185.00 27748 11-10-81
WATERCONN. 335.00 it ri
BUILDING PER. ?O1
sac 525.00
PARK
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
RtCQI V 60
rROM
AMOUNT $ I
& DOLLAR3
1 oo
? CASH ? CHECK
FOR
C:??' B Y
,
White-Payers Co y
Yellow-Posting Copy
Pink-File Copy
Thank You
Receipt - MECHANICAL PERMIT Permit No. -
CITY OF EAGAN Fee
Fi!l in numbered spaces S/C .:?Type or Print /egib/y Tot.
1. Date 2. Installation Cost ?`'?• '
i
3. Job Address '• Lot Bik. Tract ?
4. Owner
5. Contractor • ? Phone
6. Address '
7. City 'i:ls• State -
Zip 55407
8. Building Type: Residential 0 Commercial O Institutional ?
9. Work Description: New C3 Add ? Alter 13 Repair ?
10. Describe -, .. .. ?_ ? . ? . _. `-, . . Fuel Type
1 11.
No.
1 Equinment BTU - M. Ea.
Forced Air No. Equiament CFM
Air Handlin
:
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond. C
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
Raugh Finel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approvad CITY OF EAGAN 454-8100
Receipt
PLUMBING PERMIT Permit No.
CITY OF EAGAN •
Fee --'t?
Fi!l in numbered spaces S/C
Z/-?L Type or Print legib/y Tot. -2
1. Date 2. Installation Cost
3. Job Address 'LotJ- Blk. Tract ?
4. Owner ? 1? I I ftj j
5. Contractor 1 hr c • ; i_ Phone
l
6. Address
7. CitY -t„? State tj ZiP i ? S. Building Type: Residential El Commercial O Institutional ? I
9. Work Description: New ?( Add O Alter ? Repair O
10. Descri be
11.
No.
_ Fixtures
Water Closet No. Fixtures
Cess
o
l/D
infield
_L Bath tubs p
o
ra
Septic Tank
Lavatory Softner
_L Shower Well
Kitchen Sink
Urinal/Bidet i
Other
?XJ ?
Laundry Tray _-
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 464-8700
GITY OF EAGAN
a»s riloc Kmr aeaa Eason, MN astu o
' . PHONE: 454-8100
BUILDING PERMIT Receipt #
Te M wud fm Est. Value Date , 19
Site /lddrcss Erect ? Occuponcy
Lot Blotk Set/Sub. - Alter (] Zoninq
parul # Repnir ? Flro Zorx
Enlorys ? Type of Consf.
Noma Move ? # Stories
W
? Address Demoifsh ? Length
Cj phone G.ode p Depth Sq. Ft.
°C
O Nartx APprovols F*es
Assessment Permit
?? Address
~ Ci phone Water a S
P
l ew. Surchorge
Pl
k
h
u?
?,W
No^e o
ice
Fire on c
ec
5/1C
?,-?? /Wdress Enp. Water Conn.
tW Ci phom Plonner Water Meter
Counti) Road Unit
I hereby acknowledge thot I have reod this application and state that gldg, pff.
fhe informotion is torrect and ogree to comply with all opplicable ^PC Totol
State of Minnesofo Stotutes ond City of Eagon drdinances.
Sipnoture of Permittee
/1 Buiiding Permit is issued to: on ths express conditbn Ihar
all work shall be done in occordance with all appliaoble Stote of Min nesota Staturt es oad City of Eayan Ordirances.
Buildinq Officiol
Permit No. Permit Holdar Mise. Psrmit No. Holder
Plumbin9
H.V.A.C. vZ??S L 3? ?'I3
W?II
Water
Disp.
S?wer
e?Cc.?? T43 77 I -zA
Inepection Date Insp. Other
FooHn9s
Faundation
Framing 7 4-511 ;,,v ?
Rough Flbp.
Rough HVA ,/dir,%T W
Inaulation f ?? C
Final Plbs. -?'
Final HVAC ?
Final _?s r
Water Dftc?ibs Location:
VYell
Sewer • -
Pr. DMp.
3830 Pilot I
BUILDING PERMIT Site Addr2
Lot 1
Parcel No. .
CITY OF EAGAN
oad, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
ac Name 4V1\L?., ,
= Address 4741 HAUGE CIR
9 City EAGAN Phone 4 5 4- 0 4 S 7
F Name
?? Addre
?- City _
Name _
Address
City -
Phone / / U-
I hereby acknowledge thot I hove read this opplication and stote that
the informotion is correct and ogree to comply with all opplicable
State of Minnesoto Stotutes and City of Eogon Ordinonces.
N° 9033
?
Receipt
Ercct 8 Occupancy
Alter ? Zoninp R1 ( PD )
Repoir ? Firo Zone
Enlarge ? Type of Const. VINYL LINF.J
Move ? # Stories
Demolish ? Lengih 3 6
Grade ? Depth 16 Sq. Ft.
Assessment
Woter & Sew.
Police
Fire
Eny.
Planner
Council
81dg. Off.
APC
Permit 0
c...?a.,._.._ 1.00
Plon check
SAC
Water Conn.
Woter Meter
Roud Unit
Torol $ 85.50
Siqnoturo of Permittes 1
A Building Permit Is issued to: PACIFIC POOI. & PA'I'In on the express condition ttu»
oll work shcll be done in ac?e th all opp ba6(? }State of Minnewta Stotutes ond Ciry of Eagan Ordinnrices.
Buildinp Officiol --? ?o ?"??
Psrmit No. Permit Holder Misc. Permit No. Holder
Plumbing y 3v ? Jt?? I g
H.V.A.C.
Wall
Water
Disp.
Sewar
Electric A O W? 6Ap4 Q- OV
Irapeetion Date Insp. Other
Footinyt
Foundation
Framing
Rough Pibq.
Rough HVA
?
Inwlation '
Final Plbg.
Final HVAC
Finsl '
Weter Describe Location: '
YVell
Sevwr
Pr. Dkp.
Receipt PLUMBING PERMIT Permit No. ,
CITY UF EAGAN
Fee
FiII in numbered spaces S/C . S(-
Type or Print legibly
Tot.
1. Date 2. Installation Cost
?
3. Job Address ?!7`// 1%?L v? Lot Blk.L?/ Tract (?'?-
? 1 J! ( L L" ?
4. Owner ?U T; -T
5. Contractor Phone
6. Address ?-f ? : f% •:_. L. A ?J 1? '.__t -' ? _ _ - _
7. City ': '? I - State " l.'/. Zip `, ', f )-
L
8. Building Type: Residential 15-, Commercial ? Institutional ?
9. Work Description: New ia- Add ? Alter ? Repair ?
I 10. Describe L I
1 11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs $eptic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
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 nrdinances 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 454-8100
CITY OF EAGAN WATER SERVICE PERMIT
3745 Pi1M Knob Raad PERMIT NO,:
Ecgan, MN $5122 DATE:
Zoning: _ No. of Units:
Owner.
Address:
Site Addreu: 7.12 $!a Ric?t+P cl-_f Fe 7
Plumber:
Meter No.: Connection Chorge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree !o eomply with tha City of Eogan Surcharge:
Ordinoneea Chorges:
Misc -
. .
Total:
By Date Paid:
Date of lnsp.: insp.:
SEWER SERVICE PERMIT
CITY OF EAGAN
8795 PFaF Knab Road PERMIT NO.:
Eigan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
' I 1_auge Cire1:-
Site Address:
'el I! C
.:
_
Piumber:
? - .
1 agme to wmply with fhe Cify of Eagon Connection Charge: ,-- ?.
Ordinanees. Account Deposit:
Permit Fee:
Surchorpe:
gy Misc. Charges:
Dote of Insp.: Total:
Insp.: Date Pald:
This request volA
18 months from
A 25878 Li a b-&f
V6a(
?????I A-e- (
(o(t.-1 IS Y
30,06
Request Date.
G,.???
?? -? Fire No. RouPh-7n Inspection
Re
quire A? ?
Raody Nuw Q Will Notifv Inspec-
t
h
?
?
Yes No or W
en Aeatly
qqp???
?icense? Elec[rical Contracror c
1 hereby requast
inspection of nbove ?
? wner elecVical work i nstelled at
S[rxet Adtlre
ss, Boz or Rou[e No. Ciry
,/
A
??% ? / ?N(t-?/
ection o. Township Namr: No. flange No. Counly
OccuD' ?i ?PRINTI Phone No.
L L o "I f7
Power Supplier Atldress
Electrical ConVactor ICompany Namel Convacmr's Licnnse No.
2?` - 2?
Mailing Address (ConVe r or Owner Makiny In. [a' ationl
(
z a
Aunh zed Sipna[ure o wctor/Owner Makiny Installatinn) Phone Numbet
' S S 27 YS
TA TATE BOAND Of E CTRIGITV I
I
E
T
&
Blde. - Aoom N•191 BE
ACCEPTED
BY H
E TATE BOARD
e. St. Paul, MN 55104 UNLESS PHOPEN INSPECTION FEE IS
ENCLOSED.
{o REQUEST FOR ELECTRK,'AL WSPECTION
See instructions lor camn?etin9 <his form on back of Yallow copy.
)? ?-. "X" Below Work Covered by This Request
i
Ee-oooot-a`
nAd eeO Tynnoi Building Aaolirmces Wirod EpaiOment Wired
Home Range Temporary Servicrs
Duplex Water Heater Liyhtiny Fyxtures
Api. Building Dryer Electric Hea[in
Commerclal Bldy. Furnace Silo Unlonder
Industrial BIAg. Air Conditioner Bulk Milk Tank
Farm Otner oeca y Olhe)r ISt>er.ifvl
t e Suer,ify otner ' nth.,
ompute /nspectron Fee Below
p Fea ServiceEntrenceSize h Fee Feeders/5ubfeetlers N . Fee Ctrcuits
U to 200 qm s 0 to 30 Am 5 0 to 30 Am
Above 200 qm ps 37 to 100 qinps 31 to 700 A s
Swinvning Pool Above 100__Amps Above 100_Am s
Transiormers Irrigation Booms Partj Fee
Signs SpeciallnSPection
$
TA
Rem?rks ?
?
???
Roueh-in
inal .
jqbof DI?
D
?
e Elecvi
Inspec or, eraby
c rtity thxt the nbove
soecUOn hes been
matle.
This repueat voitl 78 month6lrom
CI71f OF EAGAN
9793 Pller Knob Raad Eagan, MN 55122 Np 701 0
PHONE: 454-8100
BUILDING PERMIT I Receipf # ?7-77q
re 6e umd fer CF nwr_ir_ea F4 v..I..a $67,000 n?.P November 10 io 81
Sifa Address 4141 nauge ?ircle t rlan lvu /
Lot 12 BI«k 4 Sec/Sub. Ridizecliffe lst
Porcel # 10 63980 120 04
W INome Orrin Thompson Homes
; Addreu 1712 Honkina l',rnscrnaA
p Name _
?
?? Address
I- n..,
Name _
Address
1 here6y ocknowledge that I hove read this opPlication and state that
the inlormotion is correct and ogree to camply with all opplicable
State of Minnewto Sfatutes and City of Eo9an Ordinances.
$Ipnoture of Pertnittea
A Building Permit Is issued to: _ Orriri T'1080R F,
oll work shnll:be done in occordance with oil opp' oble Sfat'
Buildinp Officiol
Erect a Occuponcy R-S
Alter ? Zaning PD R-1
Repnir ? Fire Zone NA
Enlarge ? Type of Const. V .
Move ? # SPories
Demolish ? Length60_
Gmde ? Depth-lh_Sq. Ft.-
Approrala Faes
Assessment -
Water & Sew.
Police -
Fire
Enp.
Planner -
Council _
Bldg. Off. _
APC
Permit JJ4.vv
$urcharge 33.50
Plan check 167.00
snc 525.00
Water Conn. 335 •00
WaterMeter 60•00
Road Unit 185 h(1
Totol 11639_50
on tha express rnndition Ihm
y of Eogon Ordinonces.
? . ?7d
CITY OF &'CvlN
1? I aoirDrNC; prrl-uT hr,rr icATror?
To Be Used For w?Valuation -??ayc???a.
s`F pu' l Ga-
Include 2 sets of plans,
1 site plan w/e]evations 6
1 set of crxc?y cilcvlations.
?? xb,,. ?,I?gI
Site pddress: C\• ? p\dn loo? oF'FIcs usE vNLY
1'a.+nif'l
Lot i2 sior-c sec./sub. R?ay? -Ae : Erect -rX_
'? :/o Co 3q 8a j Zo O? f;?St= Alter Zoning Ov7 R
PaLCel 1
Repair Fire Zone
O..mer: E?az9e - TYPe of Const.
Nbve # Stories
pddress: Denolish Front (? Q ft.
City/Zip Code: Grade Depth ft.
'
Phone # : APPRDVALS rEES
Contractor: ORRjtl ii
AdCZI25S: a Divisi-n cf U. S. Ycm= Cereoration
1712 HCPN,INS G7CSSROAD
City/Zip Code: n.ti^N?cToNKA rIir;N ss:a?
Phone #- sqq-T333
Arch. /F.lng. :
Pddress:
City/Zip Code:
Phone # -
Assessments
water/Sewer
Polioe _
Fi re
En9 -
P1annPs
Council
Bldg. Off.
APC
Pesmit
o-o
Surcharge Z3 ?
Plan Checlc ? 7
SAC
Water Conn. 3 36--
Water Meter ?/' p 02-
Road Unit / j6F6--4A'
'IbTAI. ? ? ? , s-0
?? 3-7 ??? ? Cz? oF EAC-AN
1?x 3? .-
`?`?n , BUILDING PERNIIT APPLICATION
Include 2 sets of plans,
1 Certificate pf Survey &
1 set of ener9y cal.culations.
7.b Be Used For i r, ,, Valuation Date !V-ZZ? d?{
Site Address: t e ?rt
Lot / 2 Bloclc S c./SUb. , 4cG/i '?. '-Erect ?
Parcel ep?air
Enlarge _
O,aner: ?- • , ? a ? Nbve
Pdldress: Deiriolish
" d
OFFICE USE ONLY
OCCtlpancy
Zoning
Fire Zone •
Type of Const. lJ? ? I, ?i 6
# Stories
Front ? ft.
Gra e Depth ft.
City/Zip Code: 55122
Phone #: IS t I' OVf' A2PROVALS FEES
Contractor: ccck4c Y?T,??_-{? e
Address: la r 2Z tiS 4.
City/Zip Code: nq?clc??-z ? S l0 `(
Fhone #: -7*7n- 131 3
Arch./Eng..
Address:
City/Zip Code:
Phone #:
Assessments
Water/Sewer
Police _
Fire
Eng.
Planner
Council
Bldg. Off.
APC T
Pennit FO '02
Surcharge S
Plan Check
SAC
Water Conn.
Water.Meter
Road Unit
? a? 5 d
TarrL
CITY OF EAGAN N. ? g033
3830 Pilot Knob RoadJ P.O. Box 27-199, Eagan, MN 55121
PHONE: 454•8100
BUILDING PERMIT Receipr # y 2 7;?7
To bs usad fer POOL & FENCE Est. Volue $10, 000 Dote P'LAY 3 , 19$4_
Site Address 4741 HAUGE CIR Erecf ? O[cuponcy
12
Lot Block4 Sec/Sub. RIDGECLIFFE 1 Alter Zoning R1 (PD)
?
Parcel No. 10-63980-120-04 Repalr ? Fi.e zone
Enlarge ? Type of Consr. VINYL LINED
z Name CURTIS STANLEY Move ? # Stor+es
Z Address 4741 HAiIGE CIR pemalish ? Length 36
? City EAGAN phone 454-0487 Grade ? Depth 16 Sq. Ft.-
Approvala Fees
w
o PACIFIC POOL & PATIO
Name
Zu 6922 - 55TH ST NO
Address Assessment_
B? City OAKDALE phone 770-1313 Water 8 Sew.
Gw
W
Name Police -
Fi
re
F
_? Address E
0 rq.
1
City Phone Planner-
Council _
I here6y acknowledge thaf I hove read ihis appiication and state that gidg. Off. -
the intormotion is torrect and ogree to comply with oll opplicoble
State of Minnewto 5lotutes and City of Eagan Ordinances. AP? _
Permit ' 0
Surcharge 5.00
Plan check
SAC
Woter Conn.
Water Meter
Road Unir
Total $ 85.50
SipnMure of Permittee I
A Building Permit is Issued to: PACIFIC POOL & PATIO on the expren condition thnt
oll work shall be done in ac5pvddi?e`?th oll app State of.Minnesota Statutes ond City of Eogon Ordinancea.
Buflding Officid ? ? ?'?- ?-?l ??'?
- (ger#ifirtttt af Orrixpttnrg
Citp of tEagan
De.pttrtment uf luiiding In,spertimi
Tbit CMificAtt i.utrtd purfuant k lbt nyuifemtntt of Stttion 306 of tbt Uni(orm Buildrng
Coda cntifying that ot tbe time of irrxantt tbit tt+rature war in romPlianre with tbt vatioxJ
ordiuancet o f tht City ngulating building ronnruttion or ttn. Fm the follouuttg:
$F
o.m. w ema.,OxriII
m...,,NN 4741
7010
V -__ NA
L47-?-- by:
4-1 mn: ?,pril 15, 1982
.s. ,. . .. .
^.? REQUEST FOH ELECTRICAL INSPECTION EB-OU001-03
g?.?' Seo instructions lor completing this form on back ol Vellow capR Cr
`? ??294? ,.:
'"X'" Selow Work Cavered by 717is Request 2Ts? 7
yv Add Rap. TyOe of Huilding ApPliances WfreA Equiument WireA
Hume Range Temporary Service
Duplex
Apt Buildiny
Commercial Bldg. Water Heater
Dryer
Fumace Lightiny Fixtures
EleCtric Heatin
Silo UnloaAer
InduStrial Bldg. Air Conditioner Bulk Milk TaN<
Farm O[ner phci y1 Othei (Specity)
tlini Succify Othcr Other
Coaipute lnspection Fee Below
F Fee ServiceEntranceSize # Fee Fc.aders/5ublaeders A Fee Circuits
U. 00 0 to 100 Am S 0 to 30 Am s .lu 0 to 30 Am S
1 1 t ,200;Ant13s 31 to 100 qmps 31 to 100 Am>s
a-.a ?e a?10,.?A? ps
? Above 100_Amps Above 100_Ainps
? T
5[ rm . RemoteControl Circ. PartiaVOth
Special Inspection r'!1
$
0 ?
?
Renurk 3
,
7" FOTAL
•
Rou9h-in
U?. ?//,^ ' ?
(Z'/?? Date
I, the Electrical
? Inspector, I?ereby
certify Net theabove
I Final D:ne
? ' S"has been
i i1A mede.
T?his repuest voitl 'FM
Tb n reques4void
t $ o93294?
L c ( Z?SY ?I
Rpquest D
a
[tn
1 Fire No. Rouph-in Inspection
R? i¢etl?
?BP.O[ly Now?WillNOli}y InspeC
1 ?
?
1?' s ?No tor Whan fleadv
r icensed Elecnical CmrtiaGOr I hereby request insVaction ot ebova
O wneer eleetrieal work installed at
5 t A'd?djre?s7s{,` eox o"yr.{1R-?o?ute No. ?? ? ?
? { Il'? ,VIVU?L c?I-?•l.?i CiLty f ^J
C.IDVO?,
ecbo.i a. Township Name or Nn. flnnpe No. C,y?1i?lyy'q '-
UN ?74
OcevpnntlPRINTI '
0l,esoa }to?.; s Phone No.
Power Supplier
?? Antlre?snsw ,- +w,
1'^' 1/VGm?
Ele ricail.Cnntractor (COmp?a?ny ?N„amel'
?E?1 ?(.T1??^.lJ? Co^nvacmCr''srLicense No.
. Mailing Atldress IContmctor or Owner Makine Ins[ailation)
1 ?? ? • bf?` ? (c1?$U) ?-
Authorized Sip [ur (Conttactor Owner Makiny Installation) PhunQx qNumbn?rj?y' '
MINNESOTA STATE 80ARD OF ELECTRIGTY . THIS.INSPECTION FEQUEST WILL NOT
Gri99s•Midway Bltlg. - Hoom N-191 gE AGCEPTED BY THE STATE BOARD
1827 University Ave., St. Peul, MN 55104 UNLESS PNOPEP INSPECTIpN FEE IS
P„nn> f6121 297.2111 ENCLOSED.
` 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) jboa(2$U
CITY OF EACAN
3830 PILOT KNOB RD - 55122
? 651-687-4675
New Constructlon Reauiremenis
> 3 regisTered sNe suneys showing sq. fl. of lot, sq. M. of house
and all roofed areas (20% maximum lot coveroae allowed)
D 2 copies of plans (show beam 8 window sixes; poured Fnd. design; e}c.)
> 1 sef o1 energy calculations
> 3 copfes of (ree prepeyvq4on plan R lof plafted afler 7/1/93
DATE:
DESCRIPTION OF WORK:
STREETADDRESS: 41L
r
LOT: I? BLOCK: L'1 SUBD./P.I.D. #:
'j
? ?-f---
Name: ? ,? ? ' ' "'"11 ?? Phone #: ?U
PROPERTY Lost First
OWNER ???I lI?,. , r0 ??
StreetAddress:
City ?IJL? State: NI.A V Zip:
Company: w V`Pf?one #: wi, - ?D r ?-`sq
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CONTRACTOR Street Anddress: i
City State: ? f V Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area eode ( )
Street Address: Registration #:
City State: Zip:
Sewer & water licensed plumber (reauired for new construction onlv):
Penalty applies when address chcnge and lot change fs requested once permit is issued.
I hereby acknowledge that 1 have read this application, atate thaf fhe info afion l c r nd agree ?o comply wNh ail cppllcable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ?
OFFICE USE ONLY
Certificates of Survey Received _ Yes
Tree Preservation Plan Received Yes
No
No
Remodel/Reoair Reouiremenfs
2 copies ot plan
t sef of energy calculatfons for heafed addHions
7 sNe survey foi exler(or addttlons 6 deckz
N COST:
? <v
Not Required
::liA C% ...:.
BUILDING PERMIT TYPE
OFFICE USE ONLY
? 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 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-piex ? 09 7-plex . ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
Ll OS 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
0 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg." ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
Valuation:
% SAC
4 141
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I
C. R. WINDEN 3
ASSOCIATES, INC.
e
f ? V IAND SURVEYORS Td 645-3646
rFOR: 1381 EUSTIS ST., ST. PAUI, MINN. 55106
U. S. HOME CORPORATION
N
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Scale: 1" = 30'
O Denotes Iron
COV I N GTON LAN E
150'
O O
- - - - - - - - -
10 F 110
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DRAINAGE AND UTILITY EASEMENT
Lot 12, rslock 4, nidgeciirre r'irsz
Addition, Dakota County, D4innesota.
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WE MEREBY CERTIFV THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OP THE
BOUNOARIES OF THE LAND A60VE OESCRIBED AND OF TME LOCATION Of Alt BUIIDINGS, If ANY,
TNEREON, ANO All YISIBIf ENCROACMMENTS, 1F ANY, fROM OR ON 5J1iD IAND.
Dafad rhis4yA day oF NoY. A p 198I C. R. WINDEN & ASSOCIATES, INC.
bY ??..?a A'W.G.?.ti
SurvoYOr. Minnnoto Roqisfrolion No. 772C
3519
17
I For Office Use
Permit
City of Ea p el Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 Date Received: ~
Phone: (651) 675-5675 I
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: -4~1 Site Address: T ! ' 1 14A C' C LL-
Tenant: Suite
RESIDENT / OWNER Name: 2E4 Phone: es t'. >
Address/ City/ Zip: C
Applicant is: Owner Contractor
FlL~4 C. L
TYPE OF WORK
Description of work:
Construction Cost: Multi-Family Building: (Yes No
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name Applicant's Signature
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