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4764 Hauge Cir Use BLUE or BLACK Ink r---------- For Office Use I Permit C95?/ ity of Ea~~ Permit Fee: -GO I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 ► I Fax: (651) 675-5694 I Staff: I 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 6 I9ck# Site Address: to ~T UGC "cu ' ~'(r4~ , a !10 v~ Unit Name:/" 2hY"54a A" Phone: 9011? RESIDENT I OWNER Address / City / Zip: '7~~ c, at~ Applicant is: ✓ Owner Contractor TYPE OF WORK Description of work: CPO ~ ~4d Construction Cost: Multi-Family Building: (Yes / No ✓ ) Company: 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 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. o herstateonecall.or 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. X_ A__2 L5 14 93 G a_4 17 x Applicant's Printed Name Applicant's Signature Page 1 of 3 130~~41&4 HIStINE l SUB TYPES /Foundation _ Fireplace Porch (3-Season) Storm Damage d 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 Tt--* ' Z D X 40 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 Temolition 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 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: Crw (,e , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Ll7~ Q &WO G'rc& 9 From: 952 346 0110 06/16/2011 08:57 #136 P.001/004 ,,.,.w,.......... U Nth ate Events exceeding expectations Date: Thursday, June 16, 2011 To: Mary Gramley . REVIEWED PLANS MUST - REMAIN ON JOB SITE City of Eagan 'Fax: 651.675.5694 EAGAN From: Allison Munsell REVIEWED. BY. Ultimate Events ` f DATE: Phone: 952.358.6304 BUILDING INSPECT .NS DIVISION Message: Please find Flame Retardant Certificates and CAD rendedn$ with this fox for Marsha McCann's 06.18 Graduation Party. Thank You.. Allison . s,r 1 8933 Lyndale Ave. S. Bloomington, MN 55420 952-346-0102 952-3.46-0110(Fax) r A 99 Cff/ From: 952 346 0110 06/16/2011 08:57 #136 P.002/004 .-A AM ISSlJED.*6Y: EUREKA TEi+~T f,e Div: of ~fahnecn;udioo~s:Gear LiLC` B1NGHAMTahI NEW V'ORK-13 02: A rtbsoft? Abut Te;fraicl; Ledri~ Ultimate Events _ ADIDiEq&- 8933 Lyndale Ave. S. srATu:. MN 55430 CRY. Bloomington This Is,to=tq-WMe produces MGM b M been Mer~cMed I= meD BI inbOMRW lleiree wardeM as. herea ter. specMd Iy nuMdO spa'.; . CffUnCaUonislwbyrmdeGpd; fhe dec an'bvdaa. cei oc~hehnure6c~an.n~au(ac d+ llr m M'%= mterdad ciwrk d.*d anusbid and p dthe fid ming codes:; M=M Bbb Fire: MwW Cade; NFF*7M- thAw wii = WgrairM aff Canada X11 "UWand'."ISM, 20' x 10' frame white end section Flame Retarded Ptrx=,Used VAU,Not..B0: R=mvd By.' usWng.Ar d ..I~ Elfer~ive For'ihe LiFe Ol''1'ha.Faibric .t~n'uewraaeacN s~t~+c 1?95-a From: 952 346 0110 06/16/2011 08:58, #136 P.003/004 AMK Aft %pin ISSUED BY: EUREKA I TENTS/ a d`w. of Johnson moors Gear LLC BINGHAMTON,_NEW YORK 13902, !!gels OtNe Fbot y ,AV Ted PAWIS Desciftd m DEAI.ER 4111 - Ultimate Events AD0RES& 8933 Lyndale Ave, S. My. Bloomington _STATFlLP MN 55430 This Is tQ cMiry ttot the pmducfs hemb two bom m ackM them ranWtai inhere* flans Murdaet a h" after specified 6y ft nferial supplier. C9Wfi*Mcn Icherftrmde The aefida de m"b o ftr a been naarrifad+rodrib an appnwW bm. nrw&nE chamicaf thetwI as ki6i wW passed sw fbibW g cu&m Caldaonmia Subs Fn Manhd CDde. t+ PA-701, Ur dwftw LabaaM1titil cd Canada 01",1037) and f L1LM1WM 20'x 20' frame whfte mid section Flame Rowdad Pwons used'Iill Not Be Ihamowad ByWashing And is Efforrtiwa For ft Life Of ft FOIL 1feNTmEWARLlRWi'JaR1~G11 LIiG L..:.MII'i.. . 'LIA~,~oP~p 76q From: 952 348 0110 06/1612011 08:58 #136 P.004/004 Oo 4 O. a cn a a~ w O ~ cm q-~ 6 q ~a~gL Gy~& qqs(?l TENTS/CANOPIES Call the Building Inspections Division at (651) 675-5690 to discuss building requirements for tents and canopies. • Permits are required for all tents over 200 square feet and canopies over 400 square feet. • Tent /canopy setback is 20 feet from property lines.A completed Commercial Building Permit application, $130.00 fee, and detailed site plan must accompany the written application. A site plan shall include the following: • Location of tent/canopy • Size of tent/canopy • Parking Fire lane provisions • Distances to structures and property lines If applicable, provide an interior plan showing exiting/signs, stage location and size, fire extinguishers, trash collection, seating, electrical/exit lighting, heating and floor covering. Tents /canopies must be of an approved type and conform to provisions of the Minnesota Fire Prevention Code, Chapter 6, Article ll. • Smoking is not permitted in tents, canopies or membrane structures. • Approved "no smoking" signs shall be conspicuously posted in accordance with Section 310 of the International Fire Code. • The tent area and surrounding 30 feet must be. clear of combustibles. All tents need a certification of flame retardant that meets NFPA,701 and it should be permanently affixed to the tent or canopy. • If more than 50 people will be in attendance, 2 exits and 2 fire extinguishers are needed for the tent. Call Gopher State One';Call at (651) 454-0002 for utility locations before staking. Call the Building Inspections Division at (651) 675-5675 for a final inspection of the tent/canopy once it is erected. IMKe A )nCCA11r' Z174Y /fo9v~c dy, 6.51 Y5-(- qa7 -8 2 o ZJ ~.IY1/1 Page 1 of 1 CITY OF EAGAN Remarks Addition Ri gP _1 i ff Fi rgt Addn Lot S Blk 4 Parcel #10 63 80 OSn 04 Owner wQ,,?:1 :, :, !'? 1 street 4764 Hauge Circle Stte Eagan, hW 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK OL' 19$2 298.08 5 298.08 SEWER LATERAL WATERMAIN WATER LATERAL WaTER AREA 1982 298.08 ?-2A-81 STdRM SEW TRK 19$2 638.24 5 638.24 12-23-81 SEW LAT Services 1982 637.75 5 637.75 007 6 12-23-81 CURB & GUTTER 51DEWALK STREET LIGHT 185.00 19628 - - WATER CONN. 305. BUILDING PER. SAC ' PAR K CASH RECEIPT CITY aF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 reec¢Iveo FROM ' AMOUNT $ I & DOLLARS I eo ? CASH ? CHECK FOR White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You ? '/ °v- . BY CITY OF EAGAN 3795 Pilet Knob Road Eogun, MN 55122 PHONE: 454-8100 N° 5906 BUILDING PERMIT Receipt .# - Te be used fer Est. Volue Dote 19 - - "' Site Address ` ?!+ ;.: •: ! - Ered E] Occuponcy 1? ? ;ff ? 13t Lot Block Sec/Sub. Alter ? Zoning , Pnrcel # rrt „?,?•`?'?`:`?' , Repair ? Fire Zone E l T f C t n arge ? ype o ons . W. Nome '---?'1?.I1 1$C)7:;T•.???'? ?.O..?P.S Move ? # Stories z 3 1712 Hopkir_, ;r. c,-,sroad Address Demolish ? Front ft. b r;*„ "i nnPtnnka SLL-'7"?i"? Gmde ? Depth ? ft. ix o .........,... Name ?'+PPrv?u?a ~ ?? Address Assessment ? ~ Cit Phone Water & Sew. ,W Name ~" tP Pol ice F FW ire Address Eng ULD Q'Z" Ci Phone . Planner Counci I I hereby acknowledge thot I have read this application and stcte that Bidg. Off. - fhe information is correct and agree fo comply with ali opplicoble Stote of Minnesota 5tatutes and City of Eagan Ordinances. APC Permit Surchorge Plan check SAC ' Woter Conn. '» • ?n Water Meter Road Unit Total 5ignature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all opplicable State of Minnesoto Statutes ond City of Eagan Ordinances. Building Officiol PennM DoM laued POnitN" Plumbing ? C " e - Mechanical v2 INSPEGTIONS DAT INSP. Rough-In Finol Footings 7 Date Insp. Dote Insp. Foundation Piumbing I/c? Frome/ins. Mechonical ? Final lf ? 7- SZS Remarks: No. - ?? cirir oF EAc,AH 3796 Pilat Knob Roed Eo4an. Mlnwesota 65122 Plwnr 454-8100 rv' PERMIT INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS ?,. 7-30-o'-! %C Date: Receipt No.: Single Site /Wdress: 4764 ;':B?LE?t? Circl? Residential ? Lot J Block 4 Sub/Sec. Ridgecliffe 1 Orrin Thompeon Hames Na^'? New/Alter. / Repaf r ; Address 1712 Hopkins CrBrd. Cost of Instailation O City '*inmetonka ?!-?1. Phone: 5414-733? Permit Fee ^I l,1?n Name Wenze1 11feChBIi(S8`1 Surchurge . ? Address 161,r)t:ers!.ebec ?r. ? City "?FT?°?' ? ?' • Phone: a? 52-1565 Totol This Permit is issued on the express condition that oil work sholl be done in occordance with all opplicoble 5tote of Minnesoto Stotutes cnd City af Eogan Ordinances. Building Official No. 1-95; 0 CITY OF EAGAN 3745 Pilot Knob Roed Easan• Mi^nesota 55122 INSPECTOR NOTIFICATION P6n?c aSL.g100 nr?l 11nrn nv 1 A1111 pERMIT Dote: $ite ?.7??4 1iatl?'f-. '? /kJdress: La Block Z. Sub/S Name Orrin TY,amps g Address 1712 FopUtnc ? City ?:lllet+0llk8, i ?2. Nome Fay Weltez' Hee.l 4637 Chiaago Ave-1S. 2 Address 3 - . ' City This Permit is issued on the express Minnesoto Stotutes ond City of Eogon itidgecl3ffe lst 1 ti01'l?S Phone: 544-7331 FOR?ALL INSPECTIONS Receipt No.: Single I Residential New/Alter./Repair Cost of Installation Permit Fee Surcherge '25-F`,r? . Phone: Total on that oll work sholl be done in accordonce with otl applicable State of 20.0 Building Official CITY OF EAGAN 3795 pilot Knob Rood Eogan, AAN 55122 Zoning: Owner: Address: Site Address: PI umber: i_ s _ _ r u., 1 agree fo oomply wiFh Fhe Cify of Eagan Ordinonces. cerir oF eaaAK 3745 Pitot Knob Road Eagan, MN 55122 Zoning: Owner; Address: Site Address: E Connection Charge: qccourtt Deposit: _ Permit Fee: 5urchorge: Misc. Charges: Total: nr WATER SERVICE PERMIT PERMIT NO.: DATE: . No. of Units: No.: to aomply with the Cify of Eagan Connection Charge: Account Deposit: _ Permit Fee: Surcharge: Misc. Charges: - Total: Date Paid: Model 43 CITY OF EAGAN 3795 Pilot Ifneb Road Eagan, MN 53122 PHONE: 454-8700 BUILDING PERMIT APPLICATION Receipt # ?- 1- _--, ,-- SF Dwlg/Gar ? . .. . 47,000.00 ,, . Site Address Lor 5 Porcel # - w Nome UPI`l. ; Addreu'. 1712 b a Name _ ? Su Address 1- r:... 4 Block - SeUSub not recorded Crossroad Nome Sam2 Address N° 5906 / %J? June 30 ,,, 80 Erect E Occupancy R3 Alter p Zoning Rl Repoir ? Fire Zorre III Enlarge ? Type of Const. V Move ? # $tories Demolish ? Front 64 ff. Gmde ? Depth 26 ft. Aoororala Feos Assessment Permit i»•v" Water & Sew. Surcharge 23150 Pollce Plan check 66.50 Fire SAC 525.00 Eng. Water Conn. 05.00 Planner Woter Meter 60.00 CounCii Road Unit 1$5.00 5 20 80 eid9 off . . APC Total 1.298.00 on t he express condition that soto Statutes and City of Eagon Ordinances. I hereby ackrwwledge that I hove reod this epplication and smte that the information is correct and ogree to wmply with all applicable $tate of Minnesoto Statutes and City of Eagan Ordinonces. Signoture of Permittee A Building Permit ts issued ro: Orrix TY tson HOIIl25 all work shall be done in accordanfc,with?l le Stote.of Mina 8uilding Official CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUIIJJING PERNII'I' APPLICATIdN 1 set of p*e*gy calculations. -f/7 d 0c1 ?° - To Be Used For Ru%nE,ce _ Valuation , Date G`RZJ Site Pddress: zt`lln`-? }4A?c,€ «. OFFICE USE Of1LY Lot s slocx Li sec./suu. e t >?_ Occupanc7' Parcel #: Owmer : Address: City/Zip Code: Yhone #: Contractor: ngRIN TN(?MpS(1N I-If?AAFG Addr255: a Division of U. S. Home Corporation 17!2 1 iePNirfs sRessaene City/Zip Code_ MINNETONKA, MINN. 55343 Phone #: 5yq-1333 Arch. /Fng. : Address: Alter _ Repair . Enlan3e Nlove Dennlish Grade Zoninq ? Fire Zone .3 Type of Const. # Stories Fmnt (?y - ft. DePth 2G ft. APPRDUALS ?'? AssessmentS Water/Sewer Police _ Fire Pesmit / 33 `m Surcharge 73 'm Plan Check-lvG? SAC $?y ?- Water Conn. Water.Meter (yo °° Road Unit / $? °? En3 - Planner Council ,7 _ Bldg. Off. APC _ Gity/Zip Code: Phone # : ??' 1 a ` minnesota zocate noara oT eiectncity Griggs Midway Bldg. - Room N791 i0%82.1 u Jversity Ave., St. Paul, Minn. 55104 - PFwne 297-2111 1? ^ _ REQUEST FOR ELECTRICAL INSPECTION ,(G CHECK BEL-OW WORK COVERED BY THIS REQUEST f? E6•00001-02 84981 Type ot Building Ne Add. Rep. Check Applinnces W'ved Foc Check Equipment Wired For Home ? ? Range 'Iemporary Wiring ? Dupfex ? 1-1 WateiHealer LightingFix[ures ? t. Bldg. ? ? ? Dryei Electric Heating ? mmercial Bldg. ? ? ? Furnace ? Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner Bulk Milk Tank ? Fazm ? ? ? Lis[ List ) O[het ? ? ? p He?erS? } Herelsl COMPUTE INSPECTION FEE BELOW Se?vice Enhance Size: # Fee Fceders.?fR,.,., tee3eig; ; °?\Fcb Circuits: # ?ee 0 l0 100 Am s. 0[0 3D'1 m rbs?v 0 to 30 Am eies 101 [0 200 Amps. 31 to 100: Am '? s 31 to 100 Am eies W Above 200 Amps. Above ]O(t1 Amps. Abme 100 Amps. Transformeis Remote Conuol Circ Partial ot other fee Si ns Special Ins ection Minimum fee S5.00 Remarks TOTALFEE I,the Electricallnspector,hereby certify (Final) __ This request void 18 months from has beeny; ade. )late /7- Rate fo7-.30'?'u This jeyuest void ZS 18 monihs from pS Dat of this Request R.1 Fire No. S 84981 I, asLicensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: et Address or Route No. ?l?`? ftUb? Ct?-?` City ?"? 3lLRion Township Range County (? IJkmo4w Which is occupied by Is a roughin inspection required on this job? No ? Yes(21?,? Ready Now ? Will CaVR? Power Supplier Address Fhw1f,)6 iVr` Electrical Contractor P? Contractor's License Nohwi ,l (COmpanv Name) ?r,, Mailing Address _ l% ll ???.(PF /??? . ? (c1_ esyricaonr uwner makmy i nis mstauauon) Authorized Si nature B `H?3r-G Phone No. (ElectrlcalL`ontra<tor or Owner Making This Installatlan) (???? ' ry???? +???,?J e? This inspection request will not be accepted 6y the r.' _? L;'`.\'l?r • w C? lJ State Board unless proper inspection fee is enclosed. CITY USE ONLY L .5 BL ? RECEIPT #: 6 SUBD. DATE:-Y/S 4?2 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD j, 3 Z. EAGAN, MN 55122 (612) 681 -4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES EACH ?.C TOTAL S!i.^.`.1eP 3.00 .. _ Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tu?b/S.p? 3.00 x = a erf e 3.00 x = rain 3.00 x = Gas Piping Outlet * minimum -1 3.00 x = Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal * Dakota Cty. license 50.00 = (new and refurbished systems) U.G. Sprinkler * home under const. 3.00 = Alterations * to exiseng 20.00 Water Turn Around 20.00 STATE SURCHARGE TOTAL ,63 9V-6- oSo-o ?/ 51TE ADDRESS:?.1 LERLI RhITHONV 4764 HfiUGE C I RCLE EAGAN , 55122 OWNER NAME:_. H 685-844$ w INSTALLER STREET ADI .50 ?'50 CITY: STATE: ZI P: PHONE #: ( ) PERMITTEE OFFICE USE ONLY L BL RECEIPT #: SUBD. DATE: 1896 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please compiete for: . atl commercial/industrial buildings. ? mufti-family buildings when separate permits are = required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR OESCRIPTION OF WORK: tS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? _ YES _ NO. FAILURE TO PROVIDE THI5 INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO. IF 50, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of p?rt js fee due on all permits. CONTRACT PRICE x 1°k STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: OWNER NAME: INSTALLER STE. # .., .. ....r n .:.ADDRESS: -- .., .-::. CITY: V STATE: ZIP: PHONE #: SIGNATURE: OFFICE USE ONLY APPLICANT METER SIZE: DATE: INSPECTOR: ?i?? C. R. WINDEN a ASSOCIATES, INC. !r)? IAND SURVEYORS T!l 645•3648 FOR: r 1381 EU5TI5 SL, ST. PAUI# MINN. 65100 U. S. HOME CORPORATION N ? ? U ? ? u Scale: 1" = 30' oDenotes Iron Ll ? Z ? ? %9 147.45 ?o?-?-------? 1 P4.6 (10 N ? I 3! ? I ? I 0 ? 24.6 ? \ I ? ??'a 'e9 \ I Lot 5, Block 4, Ridgecli££e First Addition, Dakota County, Minnesota. ?'r \ s?4; ? F/V? ? j Io ti ? ti WE HEREBY CERTIfY THAT THIS IS A TRUE AND CORRECT REPRESENTAiION OF A SURVEY Of THE 60UNDARIES OF THE IAND ASOVE DESCRIlED AND OF TME IOCATION OF All 6UIlDINGS, If ANY, TMEREON, AND ALl VISIEIE ENCROACMMENTS. IF ANY, FROM OR ON SAID lANO. Dotad this ? ? doy oF M°A.D. 1980 C. R. WINOEN 8 ASSOCIATES, fNC. br Cl? dkr-,t?. Surwyer, Minnewto Rapiserolien No. 772g NTL19 CITY OF EACAN - --- - -- - - EARLY UTILITY CONNECTION PERMIT 4764 Hauge Circle LS B4 Ridge Cliffe lst Address Subdivision/Parcel - --- - -- -- I hereby request permission from the City:of Eagan to connect to the sanitary sewer and water lateral line in the public right-of-way. I - - -- - understand that the City has not yet completed, inspected and/or accep[ed .- the sewer and/or mater lateral. I agree noc to use, tesc, or connect these individual services to any interior plumbing and understand the require- --ment to cap the sewer service to prevent any unauthorized use. - - - -- - In accepting this permit, it 1s agreed that I will hold the City and its agents harmless from any damage that may occur due to this early,connection. It is understood that no Occupancy Yermit vill be issued or water allowed to be turned on until the City utility system has been declared operational - by the Ci[y Engineer. Signed by - Plumber:? - - Owner: Developer• 0 Builder: Dated: CITY OF EAGAN " EARLY UTILITY CONNECTION PERMTT - 4752, 4758, 4764, 4768, 4769, ' L3 B4, L4 B4, LS B4,, L6 B4, L7 B4, 4765, 4759, & 4753 Hauge Circle L8 B4, L9 B44 & L10 $4 Ridge Cliffe lst Address Subdivision/Parcel I hereby request pexmission from ihe City of Eagan to connect to the sanitary sewer and water lateral line in the public zight-of-way. I' understand that [he City has not yet completed, inspected and/or accepted the sewer and/or vater lateral. I agree not to use, test, or connect these individ_al services to ar.j iaterior plumhing and unders[and rhr require- - ment to cap [hP sewer service to preven[ any unauthorized use. _ In accep[ing this permit, it is agreed that I will hold the City and its agents harmless from any damage that may occur due to this early connection. It is understood that no Occupancy Permit will be fssued or water allowed to he turned on until the City utility system has been declared operational by the City Engineer. ° Signed by - Plumberz?CU? C/ Owner: Developer: Builder: L'ated: ?(???/ OtJ T I 10?? 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 4 651-675-5694 New ConsWction Reauirements RemodeUReoair Reauiremenls Office Use Onlv 3 regislered site surveys showiig sq. tt. of lot, sq. ft. o( house; and all mofed areas 2 copies of plan CeA of Survey Recd _ Y _ N (20% matiimum lot coverage albwed) 1 sel oi Eneqy Calculations for heated additions Tree Pres PIanRecd . _ Y _ N. 2 copies of plan showing beam 6 window sizes; poured found design, elc. 1 sile survey for additions 8 decks Tree Pres Required . Y _ N i set of Energy Calalations Addifion • inMicate if onsite septk system Onsile Septic System _ Y _ N 3 copies of Tree PreservaUon Ptan if lot plaHed after 711193 Rim Joist Detsil Oplions seledion sheet (buildings with 3 or less unlts) Date Site Address C '7 ?? Constructioo Cost /-7/? (/sQ UniuSte # Description af Work Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner ?.1? G45 S Z/fl t Gr _! Telephone #( ) Contractor kh),?qz C-I,?q 4w.;'p ?:7L1i/ `n C Address State i"J''"fc-GI f'?i City Zip Telephone #(e/2 E/6 -2d' G/ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (+l submission type) Submitted Submitted • Energy Envelope Calculalions Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( ) Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the infotmation 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 Statutes; 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 ap,groval of plans. 1-1---) / ApplicanYs Prin d Name ApplicanYs Signa e 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.) ? 31 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 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) O 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interiar ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement *Demolition (EnUre Bld g) - Give PCA handout to applicant Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new 61dg) _ Final/C.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 _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatrnent Plant License Search Copies Other Total Building Inspector PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA129186 Date Issued:01/20/2015 Permit Category:ePermit Site Address: 4764 Hauge Cir Lot:5 Block: 4 Addition: Ridgecliffe 1st PID:10-63980-04-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Applicant: Ann Hoffman 505 Randolph Ave St Paul, MN 55102 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 $60.00 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 - Scott R Mccann 4764 Hauge Cir Eagan MN 55122 (651) 456-9078 Bonfe's Plumbing & Heating 505 Randolph Ave St Paul MN 55102 (651) 228-9071 Applicant/Permitee: Signature Issued By: Signature