684 Hay Lake Rd N• CASH RECEIPT •
CITY OF EAGAN
? 3830 PfLOT KNOB ROAD
EAGAN, MINNESOTA 55122
?i
DATE 19
RGCCIVED
AMOUNT $ I
r
? a ooLLwRs
?oo
? CASH ? CHECK
.1...
POR
BY
White-Payers Copy
Yellow-Posting Capy
Pink-File Copy
Thank You
BLDG. PERMIT N0.
01-321'0- ?&1?dg: Permit' ,
01-3422 Plan Check
01-3445 $urch./Adm.
01-344§ SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
c .?
?
' F?
TOTAL -??
. 3830 Pilot Knob Road, P.O. Box 21-
JG PERMIT PHO N E: 454-81
I for Est. Value
Lot Block SeclSub.
Parcel No.
a Name
; Address
° Ciry Phone
a
.o Name
? ? Address
P Ciry Phone
yVj W Name
?; = Z Address
U ?
I herehy ackr
that the inforn
State of Minn
Signature of
A Building Pern
all work shall b<
that I have read this application and
xrect and agree to comply with all applic
iutes and City of Eagan Ordinances.
e
ed to: accordance with all applicable Stat,
199, Eagan, MN 55121
00
13507 1
Date ,19
OFFICE USE ONLY
Dn Site Sewage OccupenCy
_
MWCC System _
Sit
W
ll
O 2oning
n
T
t
f
n
e
e
_ ype o
Co
s
City Water _ (Actuao
(Allowable)
* of Stories
Length I
Depth
S.F. Total
Footprint S.F. I
APPROVALS FEES
Assessments _ Permit
Water/Sewer _ Surcharge
Police _ Plan Review
Fire SAC, Ciry
Engr. _ SAC, MWCC
Planner _
Council _ WaterConn.
Water Meter
Bldg. Off. _ Road Unit
APC _ Treatment Pt
Variance _ Parks
Copies
TOTAL
on the express condition that
? Permit No. Permit Holder Dats Tslephone 7t
Plumbing ?
H.V.A.C. ?S J?2-g
Electric
Softener
Inspection Dete inap. Commente
Fcotings I
Footings II
r
Foundation
Framing /1 4F? /?.
Roofing
Rough Plbg. ' i,.. '•
? f?
Rough Htg. %
ISUI.
Fireplace
Final Htg. 7
Final Plbg. - 7-????
'
Bldg. Final ) ?b ?/c?s !? .? ?rc?.:.• l •?ajs
Cert. Occ. E4'.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
For afNce Use Oniy:
.
? y?Sv W.
W
MECH
NICAL?PERMIT
ERMIT #
C1 TY OF EAGAN RECEIPT #
I
CONTRACT PRICE , 3830 PILOT KNO B ROAD, EAGAN, MN 55122 DATE:
: PH ONE: 454-8100
? Site Address ' ' ??
? ? BLDG. TYPE WORK DESCRIPTION `
Lot Block '-Sec/Sub ?
"
New
Res.
? Name Mutt Add-on ?
? Address xo jn?urwnaTS? aVc Sp Comm. Repair ?
c City MINNEAPOLIS?Q?r,?542Q
'`
C?b Other
J
J FEES
r
? Name RES. HVAC 0-100 M BTU -$24.00
? Address ,4DDITIONAL 50 M BTU - 6.00
?p City Phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM -1 PER PERMin - 150 EA.
TYPE OP WORK COMM/IND FEE -1% OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
Boiler M BTU
-It TOWNHOUSE & CONDOS - RE$. RATE APPLIES ?
Unit Heatet M gTU MtNIMUM RESIDENTIAI FEE - ALL ADD-ON &
Air Cond.
M BTU REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
Gas Piping Outlets # (ADD a.50 S/C PER EACH $1000.00 OF PERMIT FEE) ?
Other ?
'i ? J
.
"
PERIAIT FEE: ;: _ ;
- -• ?-r.? - ,?, -
,? ,; -- ?
, SI OF RM
.
? SIC- ??? j? F
? !`0
TOTAL: ' `?
?
FOR: CITY OF EAGAN
?
50GO
Site Address
Lot
m Name t4LCr
? Address
c Clty
i
Sec/Sub
Name k-A I?
c Address
p City Phone J
TYPE OF WORK
Forced Air M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent. CFM
Gas Piping OuUets #
Other
3830 PILOT KNOB
PHaI
FEE:
S/C:
TOTAL•
;AL
PERMIT
RECEIPT # 75Q f -°?
F EAGAN
iAD, EAGAN, MN 55122 DATE:
454-8100
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other C
FEES
RES
HVAC 0-100 M BTU -$24
00
.
.
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
, CONSTRUCTION)
GAS OUTLETS (MINIMUM
1 PEl3 PERMIT) - 1
50 EA
-
.
. COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPUES
TOWNHOUSE & CONDOS - RES. RATE APPUES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00 '
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
, SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
• . PERMIT ti ?'&
PLUMBING PERMIT RECEIPT #
?CITY OF EAGAN /
3830 PILOT KNOB ROAD, EAGAN, MN $5122 DATE: lU/ e 7
iNTRACT PRICE: ? PHONE: 454-8100
Lot t.'; Block _3 Sec/Sub
m Name
g Address c qe. ?c i._
? ? City C??•-i. - Phone
Name _
Address
FEES . ,
COMM/IND FEE - 1°r6 OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
'i MINIMUM - COMM/IND FEE - $20.00
! STATE SURCHARGE PER PERMIT - .50
i{ADO $.50 S/C IF PERMIT PRICE GOES
BLDi' TYPE WORK OESCRIPTION
Res. New `
Mult. Add-on
Comm. Repair ;
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 1 L
_j__Bath Tubs - $3.00 -
I Lavatory - $100 ?
+ Shower - $3.00
i•" Ki?chen Sink - $3.00
l /Bid
$3
U
i
t
00 ?
• -
-
r
na
e
.
? Laundry Tray - $3.00 -
? Floor Drains - $1.50
_l-Water Heater - $1.50
-LGas Piping Outiets - $1.50
(MINIMUM - 1 PER PERMIn
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
FOR: CITY OF EAGAN
i
STATE S/C: • ''GRAND TOTAL:
CITY OF EAGAN
454-8100 '
DEPT. OF BUILDING INSPECTIONS -
? ?
Correction Notice
Located at `-
I have this day inspected fhis structure and
these premises and have found the following
violations of city codes governing same:
?Ul? +7 s?._'ii 7?f , ,,? S ?, i:? /,? ? ??'1 ' /-' " .?r?/Z'" ?/
y^?T _ o s'I .?J // t o /' 4 . / P .SrIO fl ff ' !/ L.° e/
Lf/
u'I -!1 I
When corrections have been made, please
call 454-8100 for inspection.
.;
Date ?' .-
Inspector City of Eagan
DO NOT REMOVE THIS TAG
1r. s? ?,. ?
K
?
(lerttfir?te nf (Or.rupanrg
Citp of Olagan
llrparimmi of lluilMatg Jnaper#irnt
This Certifcate issued pursuant to the requirements nf Section 306 of the Urlifornt Buildrng
Code certifying thal at the time of issuance thir sttucture was in compliance with the various
ordinances of the Ciry regulating building construcdon or use. For the following.•
Use Clessifcation Mlw Bldg. Flimit No. ??69I
Occup-r TYa R3 zoning oi5ma R I Type const. v
owneroc Ma?ng Gi„4oID OAF: ? Add,. 452 IS0 HAY 1.21 IM), LAC?t,N
BuildingAddrost A):"4., I.oplity LIOy ;,'".
Da4e: J11"Y 30,
Bnilding Olriaal
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Kn.ob Road
P.O. Box 31 'E19 PERMITNO,: -
EagAjAN 5512 DATE; -
Zoning: No. of Unlta: ?
Owner. Grand Oaks
Addiess:
Site Addr
Plumber.
4
I agree to comply w1th&tdit6jj#VWjf 109&"Charge: 59 S(1aPd
`??? ?$Slt
l 5 _ Ilflnl
:
? Ordinances. L?
FH dNE • E
T?
V
? ,
,
R ?a?m
Gt1 i?T
???" -GV ?6?11?c rge:
_ ynna
f G
Misc. Charges: '
_?-
Date oi Insp.: TotaL•
? Insp.:
? Date Paid:
? 3-27
t
D
CITY OF EAGAN Permit No: a
e:
3830 Pllot Knob Road Meter No: 3 9A d 3 Size: ?" ?O
P.O. Box;#199 Reader No: 6 •P 9S y a? Date:
Eagan, MN 55121
Owner
6;?,
5ite Address:
?1 110 7?' (-
:1-o lTav ?'a1r?i?
_
'verliill 7zrr1 T7
Copn. Chg: ' . t;??- ? •- CMUM;-
Acct Dep:??$??Gr??? po.pf f?? '
Permit Fee.
Surcharge: I agree to comply with the City of Eagan
Tr. Plant Ordinances.
Meter. r-
Misc.: BY -`
WATER SERVICE PER
? CITY OF EAGAN SEWER SERVICE PERMIT
3830 PilOt K110b R08d
? P.O. Bax 21.1'99
pERMIT NO.:
? Eagan, MN 551,211
? Zoning:-
? Owner crand DATE: 7
No. of Units: `
0"k''
Address:
Site Addr
Piumber.
II
L ayree lo comRy wfth Ihe pty of Ea9an Connection Charge: 5? ?•??R?
Ordlnancea. Account Deposit: 15. OCpu
Permlt Fee: 1- ?, • L'
Surcharge: • ? ? ?
gy Mlac. Charges:
Date of Insp.: Total:
,
Inap.: Date Peid:
'
. ..?...... ?.. -. _ _... ,_.
.?- _ - ?.?,?yr?,•?:? -- =- -_ _ ...,..:.: ?-??;,,??a
?
.;
GITY OF EAGAN Permft Na_ 7 794 Date: 4-3 -8 7 {
3830 Pilot Knob Road Meter No; Size:
P.O. Box 21199 Reader No; Date;
Eagan, MN 55121
Owner. ' GaY-g '
Site Address:- '•? ''iay T at--e T'1:oad LI(l 33 overhill '_ ai-m 7.T. a
Conn. Chg: 525. OOpd Zaning;
Acct. Dep: 15 _ At?pd No. of Units: '•
Permit Fee: - l0. JOne-
Surcharge:
Tr. Plant . 5+"n!! I agree to comply wlth the Gity of EaQan
.OC!-•"' Ordinances.
Meter. 67 TQ;' „,
nnisc : - Br
WATER SERVICE PERMIT
CITY OF EAGAN N° 13 6 9 7
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
? ?/ I ?/
PHONE: 454•8100 Receipt # d
BUILDING PERMIT J
To be used for SF DWG/GAR Est. Value $74,000 Date JUNE 1 19 87
Site Address 684 NO HAY LAKE RD
Lot 10 Block 3 Sec/Sub. OVERHILL FARM 2ND
Parcel No. .
a Name GRAND OAKS
= Address 4521 SO HAY LAKE kD
o City EAGAN phone 452-8934
,o Name SAME
?a Address
i- City Phone
ww
W Name
`
x,?-? Address
a=
w City Phone
I hereby acknowledge ihat I have read this
that the in(ormation is correct and agree to wi
State of Minnesota Statutes and Cit1' aff Ead
Signature of Permittee ??ri AC ?J /A?
A Building Permit is issued to: GRAND (
all work shall be done in accordance with all
Building Official
tion and state
h?jl applicpble
Fadces
DEVEL CO
atle State of
OFFICE USE ONLY
R3
On Site Sewage Occupancy
RL
A
MWCCSystem Zoning
-
On Site Well Type of Const v
City Water X (ACtual)
(Allowable)
# of Stories
length 52
oean _ ..?6
S.F. Totel
Footprint S.F.
APPROVALS FEES
$ 412.50
Assessments
Water/Sewer Permit
Surcharge ?7 -.0 0
-
Police _ Plan Review 25
Fue SAG City 100.00
Engr. _ SAC, MWCC 25.00
Planner _ WeterCona 575-00
Council _ WaterMeter 67.00
Bldg Off. _ RoaC Unit 305.00
APC _ Treatment P7 1 R(1 _(1Q
Variance _ Parks
Copies
?
? TOTAL ?5
P
on the express condition that
Statutes and City of Eagan Ordinances.
(,,/???7 REQUEST FOR ELEC;RICAL INSPECTION es/-o/opo/oi-os
1 See mstmcbons lor completing ihis form on back ol vellow cooV.
D1_ 2 -7,9 O "X" Be/ow Work Covered by Ihis Request
Adcl Nep. iyoe ot Bwlerne Aoobancna wlred Equlument Wven
Home Range Temporary Service
Duplex Water Heater Lighnny Fixtuies
Apt. Bwldmg Dryer Electric Heatin
Commercial Bldy. Fumace Sdo Unlo:+der
Industrial Bldg. Air CondiLOner Bulk Milk Tank
Farm Ochei oeu y OmerlSperifyl
? nr Sucufy ther Olher
ompule lnspection fee Below
# Fae SarviceEnireneaSize t1 Fee Feaders/5ubfeeders N Foe Grcwts
? 2.CsU 0 to 200 Am s 0 to 30 Amps _i(oW 0 tn 30 Am s
A6ove 200 qmpy 31 to 100 qmps 31 to 100 A s
Swimming Pool Above 100_Amps Above 100_Am a
Transiormers Irngation Booms Partial-"Other Fee
SignS SNecial InsUection C/ TOTA
Remxrks L F
? •
Nough-in r 1, the Ele Tcal
? Inspeclor, hereby
certity that the abova
imal e msoecuon nas eeen
L _ r lb. ranae.
mis reauml void 18 monthe Irom
This requesl voeA
18 nnnths Irom
D12 2_3 0?//l
Fequest Date Fre No. Rouph?in Insper.LOn
fleqwred?
?Ready Nuw (?Will Nntify Insoec-
?/? Yes ?No r? ?a? When HeadY
P licensed Elec[nwl Convactor I herebV mquest insPaction of above
? Owngr elactnwl work mstallad ar
Street Atldress, Box or Route No. ?
C?
- City
?.
?? AKe ?
ecLon o. TownsMp Name or No./ Range o. County
Occuu??tIPRINT)
;? C? Phone No.
?ls Z ?? ? y
Puwer Suppli¢r Atltlress
A . ? • ? c_
Electrical Cnntracmr (Company Name) Contrar.tor's License No.
_,?t?en -f-ri'? ? L ? ! S-3
Ma?
Im
ddress (Con[racior or Owner Makinp Insta?lauon)
A
?
/
)
/?O7
Auth '¢¢d ntractor/Owner Mak ig Installation)
n e
/q/?2j
MIryNE$OTA STATE BOAHD OF ELECTNICITY THI$ INSPECTION REQUEST WILL NOT
Griqps-Mndway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOAFD
1821 Universitv Ave.. St Paul, MN 65104 UNLESS PNOPER INSPECTION FEE IS ?
Phone (612) 642-0800 ENCLOSED.
?a/? REQI'EST FOR ELECTRICAL INSPECTION
? SeS'fshucoons lor comple[ing Ihis lorm on back ot yellow copy
R 71 0' 31 'X" Below Work Covered by This Request
tt?111'q
? EB-OMM -07
?,9p ??PeI
? M ,
'
ew Adtl Rep Typeof8uilding AppliancesWired EqmpmenlWiretl
Home Range Temporary Serwce
Duplez Water Heater Elec[ric Hea6ng
Apt. 8uilding Dryer Other (Spea(y)
Comm./Intlusinal Furnace
Farm Air Condihoner
Other (spentyl CoMracMOr's Remark `
l l
Compute lnspechon Fee Below
A' Other Fee # ServiceEntrance5rze Fee # CircmislFeeders Fee
Swimming Pool 0 t0 200 Amps ? 0 to 100 Amps
Transformers Above 200 _ Amps A62v Amps
Si905 Inspecbr5 Use Only ?
0 TOTAL
Imgalion Booms 6(? 1 r S •'S?
Special Inspedion
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONTHS.
I, the Electncal Inspector, hereby Rough-in oate
certify that the above inspection has
been made F,nai
OFFICE USE ONLY
TM1is reduest voitl 18 monNS lmm
7/ia/so
@ 71831 a s
ReQOest Date Fire No
/?,
? Fough-in Inspeaion "
Reqmred>
7 ?FeaEy Now ? Will Notity Inspedor
n Re
tl
?
W?
I
? ? G Yes N. y
e
a
IYicensed contractor L) owner hereby request inspection of a6ove elect al work at:
Job Aearess (Street Box or Route N. I
cP8 4 NQ Lc?.
? ??.
Cit
Sedion No Township Name or N. Range No. Co n?p y ,
. ? (.l?
Oc am (PflINTJ Phone No
Pow upPLer Atltlress
Electncal Contracror (COmpany Name) Convactor's License No
Harrison Electric, Inc. 421867
MaJing Aetlress (GOnhactor or Owner Making Installalion)
2525 Nevada Ave.No.
#301 Golden
Valley 55427
Aulhor¢etl Sgnature I ontracl g Ins1al?0on? Phone Number
544-3300
MINNESOTA STATE BOAqD OF ELECTRIQTY THIS INSPECTION REOUEST WILL NOT
Grigge-MiEway BIEg. - Poom S-113 8E ACCEPTED BV THE STATE BOARD
1621 UnlversiTy Ave, SL Faul, MN 55104 UNLESS GROPEP INSPECTION FEE IS
Phane(6i 60241(100 ENCL05EC)
?5 \
?
CITY OF EAGAN
APPLICATION FaR PERMIT
SEWER AND/OR WATER CONNECTION
*RM3: PAYMENr OF FEE AT TIlM OF
APPr..zcrTIorr noFS rOr aoNSrITUTE
APPROVAL OF PERMIT.
` ****,tst*,r**w**k***,t*********,e?k?ra*:
P ease Pr1nt
? 1) PROPERTY ADDRESS: •-
LEGAL DESCRIPTION: ? //1 Lot B ock Subdivision or Tax Parcel ID )
IF EXISTING SIRCCPL72E. DATE OF ORIGINAL BLILDING PIItMIT ISSPANCE:
1
'
. FRFSIIW 7ANING/PROPOSID LSE: (Mon Year
? CONP'EE2CIAL/RETAIL/OFFZCE
Q INIDCSTRZAL
? INSTII[]TIONAL/GpVERNMENT
.?` R-1 SINGLE FAMILY
? R-2 DL'PLEX (7.Wo L?nits)
? R-3 7DWNiOIISE (Three + Units) ( C?nits)
? R-4 APARTh43dT/COAIDOMINI[,T1 ( Units)
2) NA[E:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
3) u r ?•
NAME:
ADDRFSS:
CITY, STATE, ZIP:_
PxorE:_ ??7gl MAszEx LIcE[vss#
rlimuoers r3-cense:
Active
FScpired
Not recorded
staff mitiat
4) KCIWu73WA? ..
NAME:
ADDRFSS:
CITY. STATE, ZIP:
PfIONE:
-5) n v i a• •?• : a • s? :. ??
' ?.'PSON 1t7 CITY SEVM QrC&IIdF7CfION 1U CITY WATER Q OTAER '-.
6) A .`•?. ? PLF.ASE HOID APPROVFD PII2NIIT FY)R PICK-UP BY ONE OF ABOVE '---- `._
MAIL APPROVID PEEtbIIT TO 1,2, ./.? 41 ABOVE . .
(Circ'2e-one)
INSPFXTION OF SE.TWER AND/O2 WA7'F]2
TI1SR'Ai.7ATTQN$ 4nj. j`CYj' $E $Q-]m-
ULFD [7NPII, PIItNIIT HAS BEIN
APPROVID.
7) r?• ?" ??/??i 1 cL.[.?t? ? .? ?-J"--
. FOR CITY USE ONLY . PERMIT # ISSUED .
?7 J
Pd w/Bldg. Permit FEES: .
$_ $ SEWER PERMIT (INCLUDE SL'RCHARGE) '
$ IG? "SZ $ WATER PERMIT (INCLC'DE SC'RCHARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOONT DEPOSIT - SEWER
$ $ '
ACCOL
NT DEPOSIT - WATER
S S z S• $ wAc
$ ? Z
$
SAC
$ $ TRLNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ z $
-? WATER TREATMENT PLANT SL'RCHARGE
$ $ OTHER:
$
$ TOTAL
RECEIPT RECEIP-T-79
DOES UTILITY CO NNECTION REQUIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A" PERMIT FOR WORK WITHIN PLBLIC
Q NO ROADWAY" MDST BE
DIVISIO ISSUED BY THE E[VGINEERING
N. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING Cb[VDZTIONS:
APPROVED BY; ? ze7-1-?
?
TITLE:
DATE: 7
T
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
ol ??-A4 651-881-4875
New Canstructlon Heaulremanta
• 3 rBgisterBtl site surveyS ShowNg Sq. fl. of 10t, Sq. iL of houSO; and all ro0f9d areas
(209'e maximum bt coverege ellowed)
. 2 copies of plan snowhg beam & window sizes; poured found design, etc.)
. 1 set of Energy Calculations
. 3 copies ol Tree Preservatbn Plen 81ot pgtted atter 711193
• Rim Joist Detail OpCwns selecHOn sheet (bMgs wNh 3 or Iess unils)
DATE
tl? 3 ?-
'3i6 3
pemotleUHenelr Reaulremente
. 2 oopies of plan
• lsetofEnergyCalculatbnsforheatedadGitbns
• 1 sitesurveyior e#erbradtlitmns&decks
• IMipte tl hane serveU by septic system for add'd'qns
VALUATION P'I' f, 7i
SITE ADDRESS (o 1N /i f za? MULTI-FAMILY BLDG _ Y x N
TYPE OF WORK ?
FIREPLACE(S) _ 0
_ 1_ 2
APPLICANT
STREET ADDRESS /Y(o b WG s h ttujttt n
TELEPHONE # (?524J'1-f L3 z CELL PHONE #i
s
S
eSTATE MII-)ZIP L
FAX #
PROPERNOWNER TELEPHONE# los?-Ys ?/- 31'??
°----- ° ---------------------°---------------------°---------------°-----------------------
COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MPINESOTA RUL,FS 9670 CATEGORY 1 _ MINA`ESOTA RliLFS 7672
(4 submission type) • Residential VentilaUon Category 1 Worksheet Submitted • New Energy Code WoAcsheet Submitted
. Energy Envelope Calculatlons Submitted
Plumbing Conhactor: ____
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Conhactor:
_ Air Conditioning
_ Heat Recovery System
------------------------------------°°-------------------------------
I hereby acknowledge that I have read thls applicaTion, state that
wim all applicable State of Minnesota Statutes and City of Eagan)
Signalure
OFFICE USE ONLY
Water Softener
_ Water Heater _
_ No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Fee: $90.00
Phone#? MAY 3 1 2002 ?
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
uPaeced 4102
OFFICE USE ONLY
? Ot Foundatlon ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 Accessory 81dg
? 02 SF Dwelling ? 08 p6-plex ? 16 Fireplace O 21 Porch (3sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) 0 36 Mutti
? 05 03-plex ? 11 70.plex 0 19 Lower Level O 24 Stortn Damage
? 06 04-plex ? 12 72-piex Plbg_Yor_ N O 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
0 33 Alteration O 37 Demolish (Bldg)` 0 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement *Demolition (Entlre Bldg only) - Give PCA handout !o applicaM
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 W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) Final/No C.O.
_ Foorings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool
Ftgs
AidGas Testa Final
_ Framing _ _
_
Siding Stucco Stone _
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retauilng Wall
Approved By
Base Fee "
Surcharge
Plan Review MC/ES SAC
City SAC', .
Water Supply & Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Building Inspector
Copies
Other
Total
1
SINGLE FAMILY DWELLINGS
/-367
- CITY OF EAGAN
IPCLQDE 2 SETS OF PLANS, 3 CERTIFICATSS OF SQRVEY, 7 SST OF ENERGY CALCOLATIONS
AOTE: ADDRESSES EOR CORHER LOTS - CONTRACTOR/HOMEOfiNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGfiS WILL BE ALLOWED ONCE BQILDING PERMIT IS ISSQED.
M[TLTIPLE DWELLINGS - RFSIDENTIAL RE9TAL VAITS FOR SALE IIHITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SQRVEY - CHECB WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMII9ERCIlL.
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
D
t
:5J- L
:r- Y-'17
To Be Used For: Valuat ion: a
e: ,
Site Address ?[? ?Z•? OFFICE DSE ONLY
Lot D Block-
On Site Sewage
Oceupancy
? CC System _
? Zoning f2. l
Pareel/Sub On Site Well Type of Const
?j
/ City Water ? (Actual) ?
-
Owner 40,..r?
+l (Allowable) ?
# of Stories
Address Length 5 Z
Depth
City/Zip Code S.F. Total
Footprint S.F.
Phone 9PPROVALS FE&S
,LJ/?t4,Nt? V l??/SS
Contractor Assessments Permit 1Z ?
p Water/Sewer Surcharge ?""I
'
Address Police Plan Review 2c?r, .?
? Fire SAC, City IG?.
City/Zip Code Lac? G.r.?
- Engr SAC, MWCC 5 2j -
r Planner Water Conn 525-
- /
Phone Council Water Meter 0
' Bldg Off Road Unit
Arch./Engr. APC Treatment P1 1&0
Varianee Parks
Address Copies
TOTAL --2357,
City/Zip Code
Phone 11
,74--
?.
. , ' .• ''r':. , . .. ,... '.,,ti:, •, ? .. .
• • . EXTEkIOR ENVELDPE AVERAGE 'U' COMPl1TATT.CIfd
GRAfJD DAKS UEVELDF'MENT COMPANY .' '
MODEL Q., AREA U U X AREA
- ti • •
FEQUIFED . 1?73
TOTFlL WALL AREA 1806 X.11
7G7AL ROOF `AkEA 1196 X.U:b 31.096
7. .
ACHIEVCD AREA U U X AREA
A. WINDOW AFE!-1 186.66 . ,5 93 ",
B. DGOR AREA 39.0 .077 3.0646
C. SI.IDE GLASS AREA 13.44 .40 6.Z151:
0. F I FEPLACE A'rtL"A ' p 0
C. WF:LL FFAMG AREA 180 .041
F. NET WALL AREA 1164.1 •049 57•0111.19
G. RIM JDIST AREA 119.52 .0436 5.21I072
H. 1=CUND WINDOW AREA 0 0
1. FOUND ADOVE GkADE 45.48 .135 13.0240
;; 701'AL WALL AREA 1800 ' 105.5026
.
J. SKYLITE 0 0
K. R00F FRAMt 119.6 .032 3•9:7?
L. NET ROOF AREA 1076.4 .025 26.91
4.
707AL ROOF AREA
1196 30.7372
SUM 1.t2. 229.096
SUM 3.+4. 216.2340
4b? City of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
?----- -------
? Fs€€'3Ffc..a-1lse
? Permit#? j
i Permit Fee
? Date Received: ?
I ?
I Staff: I
I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: '5 lO Site Address:
Tenant: Suite #:
RESIDENT/OWNER Name: 1(-PV?\ ?P-P?1 CA-?o^??'`?'^ V? `\ LC.r Phone
Address / City ! Zip: bsy t?)N ?"
Applicant is: _ Owner x Contractor
TYPE OF WORK Descriptian ofwork: P e- rp9 42
Construction Cost. Multi-Family Building: (Yes _/ No
CONTRACTOR Name: License#: ZOS80Zc??
Address: VO
City: w???-- ? t State Zip, SSWg
6o?t -7ss_- ,
Phone. 0?77 ContactPerson: ? ?Q_
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 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: Pfans and supporting documents that yau submit are consideretl fo ba public information. Portions of ;
the information may be classified as non-public if you provide specific reasons that would permit the City to
conGude that fhe . are frade secrefs. ,
?
I hereby acknowledge that this informahon is complete and accurate; that the work will 6e in confoRnance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permd, and work is not to staR wdhout a permil, that the work will be m
accordance with the approved plan in the case of work which requires a review and approval of plans ?
X /?,•, ?wae_l 1.v--? X
ApplicanYs Printed Name A plicanYs Signature
Page 1 of 3
SURVEYOR'S CERTIFICATE GRAND OAKS DEVELOPMENT C0.
NOTE: GRADES SHOWN WERE TAKEN FROM
THE GRADIN6 PLAN FOR OVERHILL FARP1
SECOND ADDITION, PREPARED. BY MINNESOTA
UALLEY SURVEYORS ItdC., LAST DATED
MARCH 28, 1984. '
-=- DENOTES PROP05ED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 9?'/,°u FEET
.XOQ0.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 9>z,o FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 93S.7, FEET
I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 10, kilock 3, OVERHILL FARP1 SECOPJD ADDITION, according to the
recorded plat thereof, Dakota County, P1innesota.
AND OF THE LOCATION OF A PROPOSED [iUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS.
OR ENCROACHMENTS, If ANY, THEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION,
THIS 2ITNDAY OF M3,y , 198n.
SIGNED: JAME?.-. . HILL, INC.
???- U
aY:
HAROLD C. PETERSON, LAND SURVEYOR
SHEET 1 OF 2 SHEETS PtINNESOTA LICENSE N0. 12294
PROJECT NO. BOOK / PAGE JAMES R. HILL, INC.
87325
21 ?5 /14 Planners / Engineers / Survey,ors
FILE NO. 8200 Humboldt Av*nue South
FOLDER ebomington, Mn. 55431 612-8e4-3029
UR V E Y O R' S C E R T I F 1 C A T E GRAND OAKS DEVELOPMENT C0.
N
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SHEET 2 OF 2 SHEETS
PROJECT NO. BOOK / PAGE JqMES R. HILL, INC.
87325 •
Planners / Engineers / Surveyors
FILE NO.
8200 Humboldt Avenue 5outh
FO L D E R Biootnington, Mn. 65431 612-884-3029