765 Hay Lake Rd NBLDG.;. PERMIT N0.
01-3210 Bldg. Permit
01-3422 ' Plan Check - ? -
01-3445 5urch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge -
17-3860 Rvad 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.
TOTAL
CASH RECEIPT ?
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
y DATE 19
_
REGEI V ED
MdUNT
r -
E] CASH
& DOLLARf
770
F] CHECK
White-Payert Copy
Yellow-Postin9 CoPY
Pink-File COpy
Thank You '
BY
d i :i :?
GOLD COPY PERMIT RELEASE FORM
PERMIT #
ADDRESS
??-"1.?'
PICKED UP BY `
`'-
?
?
4
CITY OF EAGAN
13393
3830 Pilot Knob Road, P.O. Box 21-199, Eagsn, MN 55121
PHO N E: 454-8100
Receipt ?
Est value ' 76, OU -, Date ' 4 3 0 ,19
Site Address •
Lot Block Sec/Sub. ?li?GE 2ND
Parcel Na
a Nsme
; Address
0 C1ty Phone
a ua..,e
Phone
BUILDING PERMIT
To be used for ' 'AR
Name
City Phone . ' ''
OFFIC E USE ONLY
On Site Sewage _ Occupancy
MWCC System 2oninp
On Site Well T Type of Conat
City Water -` (ActuaQ
(Allowabls)
* of Stories
th
L
ang
Depth
S.F. Total
Footprint 3.F.
APPROVALS FEES
Assessments _ Permit
WatedSewer _ Surcharya
Police _ Plan Review
Fire _ SAC, City
Engr. _ SAC, MWCC
Planner _ Water Conn.
Council _ Water Metar
.5%)
1 hereby acknowledge that I have read this application and state Bldg. Off. _ Road Unit ?
that the information is correct and agree to comply with all applicable APC _ Treatment Pt ?-
State of Minnesota Statutes and City of Eapert Ocdinances. Varfance _ Parka
CoPiea
Slgnature of Permittee TOTAL
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutea and City of Eeqan Ordinancea
Bulldfng Official
. Permft No. Permit Holder Dato Tdephons i?
PTumbing .`? <??i(?? 'C?' ? •'1 (';,??. `'j `??%;;
H.V.A.C.
Electric c?'7?,41 ?' • .? :? fi?a?_??? ??'r/??.,
Softener
Inspection Qet* Insp. Comments
Footings I ?
Footings II
Foundation
Framing ?
Roofing
Rough Plbg. ?.?
Rough Htg_ ?S
Isul.
Fireplace " v
Final Htg Pp
Final Plbg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Frmg.
Well
Pr_ Disp.
•; PERMIT #
PLUMBING PEAMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
:T PRICE: PHONE: 454-8100
1(?_
Site Address 7 tG rj (.}y;?' ?1r1 Nlt?? Lt %
Lot 14' Block f Sec/Sub f-r, wi
' ,
l
? Name Li'L, 1l1PCnG?'1?C?t(
?
L
ro l L5 6 LAJf 4(% 5 t
Address
c City
oG !? Q. Phone R?t? l I
Name t'`,I ulCtitA V-ibcf12S
c Address
3
p 4>,
Ciry t'i`,'?J It1?_ Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - 50
(ADD $_50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATU5E QF PERMITTEE -
. _?? r
FOR: CITY OF.EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. - New x
Muit. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPIETE THE FOLLOWING:
N?, FIXTURES TOTAL
Water Closet - $3 00 $ ? • ?-'?'%
--/-_Bath Tubs - $3.00
? - Lavatory - $3.00 ? • ?
/_Shower - $3.00 ? • ??
_4--Ki!chen Sink - $3.00 ?• ?'?
Urinali8idet - $3.00
-,I-_Laundry Tray - S3.00 ?• ?
Floor Drains - $1.50 /• ?? '
? Water Heater - $1.50 ?, 7 v
Whirlpool - $3.00
Z Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMI'n
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
--?-Rough Openings - $1.50
FEE:
STATE S/C: • ?`
GRAND TOTAL: '? ? ? '"
Site
3830 PILOT
Block I " Sec/Sub
4 m Name `•
? Addre
c City
Phone -'
Name Address
p City ., Phone - 6 _Sfij
Forced Air -7 T_ M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent. CFM
Gas Piping Outlets #
FEE
S/C:
TOTAL•
N IT RECEIPT #
GAN, MN 55122 DATE: 7
?
i. TYPE WORK DESCRIPTION
I[ New
Add-on
n. Repair
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 PER PERMIn
- 1.50 EA.
""COMMIIND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS
MINIMUM COMMERCIAL FEE
STATE SURCHARGE PER PERMIT
(ADO $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000) - 12.00
- 20.00
- .50
SIGNATURE OF PERMITTEE
fOR: CITY OF EAGAN
?.
(tertt#tratt af (Orrupttury
Citp of (Eagan
?epttrtinent uf luflbmg JttWrttnrt
This Certificate issued pursuant to the reyurrements of Sectian 306 of the Uniform Building
Code cenifying that at 1he time of rssuance thts structure was in compliance with the various
ordiirances of the City regulating building eonstruetion or use. For the following.•
ux c???, _;`,` DWGIGAR s?+s. t??it No. l.',393
, .,
0-wpi-r Tyx zoning au,;a R1 rra c- ,
oww creaaing k'TI'f,APII3 HcwS Addrm 14450 I3`vu1..,T: I':Y
? "'d3??IF! t3AY I.E1i:E RQt?I?ity 1,16, B1, FA4dN
aWa? naa=
nare: ?tMV 25, 1987
suuaing offiaal
POST IN A CONSPICUOUS PLACE
m Name _
?o Address
c City ;f?..:
- Name
? Addre:
O C'ry _
PERMIT # ?
PLUMBING PERMIT RECEIPT q
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAH, MN 55122 DATE: g,,f//S- 7
ICE PHONE: 454-8100
`' i - ? BLDG. TYPE WORK DESCRIPTION
Block SeciSub Res. New
Mult. Add-on
• ? . ?? 'Comm. Repair
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - ,50
(ADD $.50 S/C IF PEEiMIT PRICE GOES
PERMITTEE
FOR: CITY OF EAGAN
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
' Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL:
?
PERMIT # . ? ? ?J •?
PLUMBING PERMIT RECEIPT tk
CITY OF EAGA!{
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address N• A. 1
Lot Block Sg/Sub
Name + ti?} L i U c)
°e Address avC N
c Ciry E1 Phone
Name v ?? < •
3 Address - titi C Y;J. a,? 1 I,c ?C e ir
p Ciry Phone j? L uL: lo 1
FEE5
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMiT PRICE GOES
BEYOND $1,000.00)
SiGNATURE OF PERMITTEE
FOR: CITY OF EAGAN 3,w
? - -- --__
BLDG. TY_?E WORK DESCRIPTION
Res. ??
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
-LWater Closet - $3.00 $
Bath Tubs - $3.00
?.Lavatnn_ Q? nn
Kitchen Sink - $100
UrinaVBidet - $3.00
taundry Tray - S3.00
Floor Drains - $1.50
Water Heater - $1.50
-:YWhirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMI'n
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE: STATE S/C: '
ii/
L( -? "TD Bt ??r??
TQTAL:
-_- •-,.. - ._
CITY OF EAGAN )_,i?. 16251
3830 Pilot Knob Road, P.Q. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
Tn hc i-A fnr .i? ?Est. Value s1 , ow
Receipt # -? -
nafo APi( G 14,04
Site Address ??1 k-y LAX.E c i!
Lot 1(' Block 1 Sec/Sub. ? P•?^?' '? ?l ?^ OFFICE USE ONLY
Parcel No. occuPancy FEES
W
Name A?f T' ?ZI NC?-? Zoning
(Actual) Const
- Bidg. Permit ,?
t?• U?
Address 705 'iAY L_`.•;L: :-'.:7 (Allowable) -
Surcharge .5G
o City EAGArI Phone # of Stories -
Plan Review
Lengih _
, p
r Name S?"C Depih - SAG City
z
ou
0¢ Address S_F Total _
SAC, MCWCC
? City PhOnB S.F. Footpnnts -
Water Conn
On Site Sewage _
?
? W
Name
On Site Well
- Water Meter
?? Address MWCCSystem -
Q W
City Phone
ciry water Acct.D osit
- ?
S
W Permit
PRV Reqwred ;
-
I hereby acknowlege that I have read this application and state that the Booster Pump - S.NV Surcharge
intormation is correct and agree to comply with all applicable State of
Minnesota Statutes and-" ef Eagan?Ordi artCes. - Treatment PI
Signature of Permitee ? APPROVALS Road Unit
A Building Permit is issued to: -`?ATT ?'O2I ?? Planner - Park Ded.
on the express condition that all woric shall be done in accordance with all Councii - 2.?
applicable State of Minnesota Statutes and City of Eagan Ordinances. g?, pK. _ CoP1es
28. SG
BUilding OlfiCial Variance - TOTAL
Permit No. Permit Holder Dste Telephone #
WATER
SEWER
PLUMBING
H.V.ILC.
ELECTAIC
Inspectlon Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Freplace
Final Htg.
Final Plhg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
WeN
Pr. Disp.
f
? ?
CITY OF EAGAN SEWER SERVIGE ?MMIT 1
I 3830 Pilet Knob •RdW
P.O. Box 21199 PERMIT NO.: ?
? Eagan, MN 551?11 DATE:
I Zoning: No. of Units;
en Hoaes
?
n..
i .... ? ?....
'
? I agree to comply wNh the CRy of Eagan Connection Charge: 52 5. n'?ru
15n ?
? Ordinances. Account Deposit: ? ?' ?
I Permit Fee: 1 t. .00pd
+! Surcharge: . SQpd
i gy Misc. Charges:
Date of Insp.: Total:
i Insp.: Dale Paid:
: - -- --- --
CITY OF EAGAN Permit No:_
383U PilotiCnob Road Meter No: _
P.O. Box 21199 Reader No:
Eagan, MN 55121
n....,a.- -. •:l.r?^c? i'?? avs
Chg:
8635
Zoning: _
No. af Units:
Date: 4 14--97
Size:
Date:
?3ts'f. ?'.,?,;?'•A TI
,
.?
Urd-
Permit Fee: ? • U
Surcharge. • 50pd I agree to comply with the CNy of Esgan
Tr. Plant o0 ! Ordinancea.
Meter. ? 7 r'n,,i
M isc.: gy
WATER SERYICE PERMIT
CITY OF EAGAN Permit No: 8635 Date: 4-14-87
3830 Pilot ibnoEi Road Meter No:
P.O. Box 21199 Size: S
Reader No: ?
Date:
Eagan, Mk 55121
Ownec
SiteAddress: ?,16 Rl ^awn 77e ZI
chanical
Plumber, •`=e
g: 32 S.OOnd ? 'N t'
Conn.Ch
• T 1
ni
, p
_
n
Acct Dep: ? ?. )0 d
Permit Fee: ' ?. UO efore , G,pa ?
Surcharge: _SE???? FPH tb?``jWy with the Cify of Eagan
Tr. Plant ?`.00,1 ?
r n n s.
Meter.
_2
Misc.: By
WATER SERVICE PERMIT
CITY OF EAGAN No- 13 3 9 3
3830 Pilot Knob Ro9'd, P.O. Box 21-199, Eagan, MN 55121
PHO N E: 454-8100
BUILDING PERMIT
To be used tor SF DWG/GAR Est. Value $ 76, 000
Receipt #
Date MARCH 30
19 87
Site Address 765 NO HAY LAKE RD
lot 16 Block 1 Sec/Sub. FAWN RIDGE 2ND
Parcel No
rc Name KEYLAND HOMES I
? Address 14450 BURNSVILLE PRWY
a City B' VILLE Phone $94-2636
=alName SAME I
0? Address
? Ciry Phone
Fw Name HAT.T.(20TST
xa AddreSS
aw City BLMGTN Phone $31-1875
F¢ I
I hereby acknowledge that I have read this application and state
thattheinformatloniscorrect? dagreetocomDlywithallapplicable
State of Minnesota StatuteS?ar?d City pt Eawfiy?r?lina8ces.
SignaWre of Permittee_?v '
A Building Permit is issued to: KEYLA
all work shall he done in accordance with all
Building Ofiicial
State of
OFFICE USE ONLY
OnSiteSewage Occupancy R3
MWCCSystem X Zoning R1
On Site Well Type of Const V
CiryWater _
_V_ (Actual) -
(Allowable)
V
# of Stories
Length ??
Depfh []$
S.F. Total
Footprint S.F.
APPROVALS FEES
Assessments Permit 419. SC
Water/Sewer _ Surcharge 38.OC
PoliCe Plen RBView 2 0 9-75
Fire SAC,Ciry 100_0(
Engc SAC,MWCC r+?5 - o(
Planner _ WaterConn. ?2 5 O(
Council _ WaterMeter ?? 0 (
BIdg.OFf. _ RoadUnit 305r p(
APC _ Treatment P1 1:8 0. o(
Variance _ Parks
Copies
TOTAL $2,369 ? 2 !
on the express condition that
ryjksofa $tatutes and City of Eagan Ordinances.
BUILDING PERMIT
To be used for DECK
CITY OF EAGAN N? 16251
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 // ?
Receipt # <? x-•
Est.Value $1,000 Date APR 4 , 19$2-
Site Address 765 N HAY LAKE RD
Lot 16 Block 1 Sec/5ub. FAWN RIDGE 2ND
Parcel No.
W IName MATT MOZINGO
o Address 765 N HAY LAKE RD
CiTy EAGAN Phone 685-0001
o Name _
z?
ga Address
? City _
Phone
•
ww Name
!=Z Address
<W City Phone
I here6y acknowlege that I have read this application and state that the
informa[ion is cortect and agree to comply with all applicable State oi
Minnesota Statutes anttBiW d EaoanlOr6ioarices. -
SignaNre of Permitee ?' •t ?
A Building Permit is issued to: MATT M07IN(:n
on ihe express condition Ihat all work shall be done in accordance with all
applicable State ofMinnesota Stalmes and Ciry ,/ot Eagan Ordinances.
Building Otficial '1n?1 ?Tl-PI l? I
OFFICE USE ONLY
Occupancy - FEES
Zoning _
(ACtual) Const - Bldg. Permit 26.00
jAllowable) - Sumharge • 50
# or srories _
Lenglh _ Plan Review
Depih - SAQ Ciry
S.F.TOtal - SAC,MCWCC
S.F. Faotprims - '
On Site Sewaqe - Water Conn
On Site Well - Water Mater
MWCCSystam -
Awt. Depasit
City Water _
PRV Required _ SIW Permit
Booster Pump - S1VJ Surcharge
Treatment PI
APPROVALS Road Unit
Planner - park Ded.
Council -- Z
oo
eldg.OH. _ Copies ,
Variance - TOTAL 28.50
///c11gREQUEST FOR ELECTRICAL INSPECTlON ee.ooooi-os
1 See ins(mctiona lor com0letin9 this lorm on Eack ol veilow coOV.
J ts?SlcC?
D'!l?61 5 H "R'" Below Work Covered by 7his Request
Ney? AAd ReO. ? TyOe ol BuilUing Appliancee Wired EpuiVmanl WireA
" Home Range Temporary Serviw
Duplex Water Heater Lightiny Fiztmes
Apt. BuilAfng Dryer Electric Heatin
Commercial Bldy. Fumace Si!o Unlonder
Industrial Bldg. Air Conditio er Bulk Milk Tenk
Farm omnr R omc? Isnndfyl
tar Su41C ifY Other OtM1Ur
Comaute lnsoection Fee Below _
p Fae Service Enlrance5iia p Fee Feaders/Subleeders Fce Circaits
0 to 200 qm s 0 to 30 Am s J 0 tn 30 Anlps
Above 200 qmps? 31 to 100 Amps 31 to 700'Am s
Swimming Pool Above 100_Amps Ahove 100-Amps
Transformers Irrigation Booms Partia6-0ther Fee
Signs Speciallnspection SC1
S? ? ' e_
TO7AL FEE
errN rks
r .UG
Nauph-in
? Datn
- ,y, y I. the Elecni I
Insai herebV
c9rtity that the ebove
Final
. . ???j `:?ti. y , ?i
7/77
D
? 1? .?
has been
nsDection
?ee.
TOle teQUeat voltl 18 monlhs Irom
This requesl void ?/??ep{/
78 months from ? ? .
D 66158 -.
Rgquest Da,e Ffre o. Rouph-in Ing ecUon ? yyill Notity Inspec?
equired? ??ady Nuw
\ 'Y I fl ?R
?? ?? ?Ycs nNO 'orWhenPwdy
E] Lice.ysed Elecvicai Con[rac[or I hereby mquest insPection of abova
fJl....... _. elactrical work installed at:
Addr3ess. ox or Route No
N. l-?N C'ty
N wns hip Namn, or N. County
Phmie
Address
Elecbical ConVaclor (Compony Namel Cnntrar.lor?s Liceose No.
Mailing Address IConVactor r Owner
? Makiny Instaila[ionl
? a
6 . uf`k,
Aut orized Si amre ICOntr i? Instal ' n)
? Phg^ _mner f
G C??? C& l
(/
ii unr
MINNESOTA STATE BOAHD OF EIECTNICITY ? gE IACCEPTED BV TME STATE BOARD
Gria9s-Midwey elde. - Reom N•191 UNLESS PROPEF INSPECTION FEE IS
1821 Universitv Ave.. St. Paul. MN 55104 ENCLOSED.
anooaf6t21642-0800
This repuesi void
18 nnnths trom . 911PIFIF12
Siree/t Atldresqs?, ,Boz ojr, ?Route No.(/
ln /V. EiE?I 1X? K?)1 Citv g?
ecuon o. Township ame or No. Range No. County
Oc/C? ?upan[ IPpINTI`
' I H'? „? I?U.J LT
?• I O Z 1"' V Phone,p No.
Power SupDlier Address
Electrical Contractor ICompany Namel Convactor's License No.
Mailing Addres^IContrector or Owner Making Instailationl
? R.('1L
Au W $ r ctodO=llation) PhonQe Number
?i U ? ?
MINNESOTA STATE eOAND OF ELFyC?{ICITY THIS INSPECTION NEQUEST WILL NOT
Grigqs-Midwav BldO. - paom N49'1I f BE ACCEPTED BY THE STATE BOAND 1821 Univeraitv Ava., 51. Paul, MN-35704 UNLESS PROPEH INSPECTION FEE IS
Phone (612) 297.2111 ENCLOSED.
? licensed Elec[rical ConVaclor I hereby request inaDection of above
? Owner etecirical work instailed at:
C?REQUEST FOR ELECTHICAL INSPECTION ?eJs-00Q001-04
, See instruetiens for comOletinB this torm on beck ot yellow copV.
r a Q'? 7? 0 "X" Be1ow Work Covered by This Request
k,Ie4Fddj PeD.I TVOe a1 Builtling I Apoliancea Wired I Equiument Wiretl I
Fi
??.ommeraai tl?ag. ? ? rurnace 1 1 a'io unioaaer ?
??ntlustrial BIAa. Air Conditioner Bulk Mi Ik Tank ?
M Fee Sarvice Entrance5ize tl Fea Fenders/SUbfeetlers # Fee Circuits
U to 200 Am s 0 to 30 qm s 0 tn 30 Am s
Above 200 qmpy 37 to 100 Amps 31 [0 100 Am s
Swimming Poal Above 700_Amps Above 100_Amr'
Transiormers Irri ation l3ooms Pertial-Other Fee
L. L ISigns I I ISUecial Inspection IS d
TOT F?E_ I ?
?}O
me 14..?rca i
Mtor, hereby
thet ihe nhova
soaction hes bee.
This rcquest witl
,48 no9h1f,7 0 4 131
?/ cYG o2
0,:??o,52
Hequest D<ate Fire N0. qQqAA-eid7lnspe<tion E] Ready Now [QNfill-Alntify Inspec-
? ?No [or When Heedy
cens§dElecir4cal ConVactor - I hereby requeat insoection of above -
? Owner electricel work imtalleA at:
Street Ad
ss, Box or Route No.
tlre City
I
7
/ (L' ? ! J
i?
ecbon o. TownshiD Name or No. Range o. Coun?.
L'
• O
OccupnntlPRl Phone No.
Power SupDl ier r AddreSs
G' -
Electrical o vacto, ICOmpany Name) Conlra or's Lice
nse No.
?dG'? p
??/
Mailddrass (COnVactor or Owner Making I nsta' a ionl
I/ S' / G. ? c G)I.' Y r?
Auihorized St re ICant ct Owner Maki Install?,' 1 Phong inber
MINN SOTKSTATE BOAAO OF ELECTRICITY THIS INSPECTION PEQUEST WILI NOT
Grigps-Midway Blde• ? Moom N•791 BE ACCEVTEU BY THE STATE BOApD
1821 Univereifv Ave., Sf. Peul, MN 56104 UNLESS PROPEfl INSPECTION FEE IS
Phonef6121642-0600 ENCLOSEO.
? REQUEST FOR ELECTRICAL INSPECTION JV% e?ya-00001-05
, See instruetions for camoleting thie 7orm on back o1 vallow coDV.
k_.p q. -M A "X" Below Wwk Covered by 7his Request
RIwvlAddl AeV.I Tyoe of BuilEins 1 Aooliancae 1'lired 1 Equiument Wired I
Mi
p Fgp- ServiceEnvenceSlze B Feeders?5ubfeetlere b? Fee Circoits
, up U to 200 Am s to 30 qm s ?GJ 0 M 30 Am
Above 200 qm u a 1 to 100 Amps 31 to 100 Amps
$winming Pool 100_Am s
Above Above 100_Am s
Transtormers rrigation Booms Partial-'Olher e
Signs Speciai Inspection S
emarks l V C TOTAI 6 )
/
nooqn-m ( ``?.C,? I, M eacEtorlecvical
v Insp, hereby
certify thet tpe above
Final DO?0 insoection hee baen
I ) mede.
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
8008 COMMEtCIAL M£CHANIClEI. P£RMIT APPLICATION
CI1'Y og 3:A6lkN
3$30 PILOT KNOS RD
3'u46M. MN 551SS
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #:
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
STREET ADDRESS:
CITY:
TELEPHONE #:
STATE: ZII':
WORK TYPE: New cunsuuction Install U.G. Tank
Interior Improvement _ Remove U.G. Tank
_ Processed Piping
Specify Nahue of W ork
When installing/removing underground tank, cal! 651-681-4675 for inspection by Fire Marshal and
Plumbing inspector.
Fees: 1% of contractprice OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee
Contractprice: $ xl%=$ (BaseFee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1/02
CITY USE ONLY
PERMIT #: ? ? RECEIPT DATE:
2002 MIDENTIAI. MECiELANjCiA. PEEtMrr 1??PLICATIOR
CI1'Y OP f.A8!!A
5930 PII.OT KPOB RD
EA6AA MA 55122
651-681-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: Q a
SITE ADDRESS:
OWNER NAME: PLL(it,I JL , T kSc1 V1 ??(;" SV-A TELEPHONE #: C-65i-_Go -0 5-7 /
INSTALLER NAME: Burnsville Heating & A/C, Inc. TELEPHONE #: 95.Z o i`+'"u2)J
12461 o e s an ve. o.
STREET ADDRESS: 5avage, MN 55378-1122
CITY:
STATE: ZIP:
Place a check mark next to the permit work type
Add-cr, i!1CdIPIC3.E0f1 Of 2I}°C3tl4n to existina dwelGng unit $ 30.00
• furnace replacement
• air exchanger
• air conditioner AM 6 ?
. • other
Natureof work:
?
State Surchar e $ .50
Total 6,50
EE
?
1102
RESIDENTIAL
BUILDING PERMIT APPLICATION 2S
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
NewCoostructiun Reauiremanla
•3 ragistereA sile surveys showing sq. ft. of lot, sq. R, of house; and all mofed areas
(200/6 maximum lot coverage allowed)
• 2 copies of plan showing 6eam & windax sizes; poured found design, etc.)
• 1 setof Energy Calculalians
• 3 copies of Tree Preservafion Plan if lot platted afler 717193
• Rim Joist Detail Options selection shcet (bldgs wdh 3 or less wits)
DATE (D -420-W
SITE ADC
TYPE OF
IULTI-FAMILYBLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
APPUCANT 4C", Ci? C`rPiFJ C'e) L.IA_ ,
STREET ADDRESS 7 Ci I? -Ml iT. CITY? rLZF STATE /ZIP
TELEPHONE # CELL PHONE # FAX #
PROPERTYOWNER OM1L 1a41FSki' TELEPHONE#
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ vIINNESO"PA RliLES 7670 CATEGORY I MINN
(J submission type) • Residential Ventilalion Ca[egory t Worksheet Submitted • New
• Energy Envelope Calculations Submitted
JUN 2 0
Plumbing Contractor:
Plumbing syscem includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Contractor:
_ Air Conditionuig
_ Hcat Rccovcry System
Phone #
Phone #
Pee: $70.00
---------------° °--°----------°-°------....---------------------°--°-- ° °------ °----------° °---°------------°
I hereby acknowledge that I have read this application, state that the information is correct and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. h ? I
Signature of Applicant
OFFICE USE ONLY
_ Water 3oftener
_ Water Heater
No. of Barhs
RemodeUReoair Reauiramants
. 2 copies of plan
. 1 set of Energy Calculations for heated additions
• 1 site survey for exterior additions & decks
. Indicate if home served 6y septic system for additions
VALUATION < r ?. , 0
Phone #
_ L.awn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 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 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04•plex ? 72 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 Windows(Doors
? 34 Replacement 'Demolition (Entire Bldg only) - 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 W idth
REQUIRED INSPECTIONS
_ Foorings (new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & W ater _ Final _ Pool _ Ftgs _ Au/Gas Tesu _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement)
_ Insulation _ Reraining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
1989 BOILDILOG PERMIT APPLICATION - CITY OF fiAGAN
SINGLE FAMILY DWEL6ING3 IIV! I
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SORVEYo 1 SET OF ENERGY CALCULATIONS
NOTEs ADDAESSES FOA CORNER LOT3 - COATRACTOA/AOMEOWNSR MU3T DgSIGNATE WEiIC$ ADDRE35
IS DFSIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT I3 I330ED.
MULTIPLE DWELLINGS RENTAL UNTTS FOR SALE UNITS # OF tl6ITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OE SURVEY - CHECK WITH BLDG. DEPT.t t SET OF ENERGY
CALCULATIONS
COMMEHCIAL
qd l6 z5 (
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND t SET OE ENERGY CALCULATIONS
To Be Used Eor:
Site Address
Der'v' Valuation:
7crN. Nar.4ke- fZJ F-
Lot _t? Block I_
Pareel/Sub ^i fii, ?", LIlia,
Owner rn/a4-} PYld2iu63
Address 765 ti. 'AAi Nqk?e-
City/Zip Code t A\kj M a SS113
Phone Wrao0 L
Contractor l{" e pW NUL
Address AS N, 14Ayt l¢Ah.C,
City/Zip Code t q,Prj / Z3
Phone A) Q)g -000 I
Arch./Engr.
Address -7 ?a4kQ
City/Zip Code ? A? flA1 3M0 5'5'11 ?
(U0d r
Date: -'I, - `7 ? b !
Occupancy F6Is'9
Zoning
Aetual Const Hldg. Permit
Allowable Surcharge .s?
# of stories Plan Review
Length SAC, City
Depth SAC, MWCC
S.F. Total Water Conn
Footprint S.F. Water Meter
Acet. Deposit
On site sewage_ 5/W Permit
On site well 5/W Sureharge
MWCC System _ Treatment P1.
City water _ Road Unit
PRV required Park Ded.
_
Booster Pump Copies
_ TOT9L ;2 ?J sv
APPHOVALS
Planner _
Couneil
Bldg. Off.
Varianee
Yhone 0 6 65 -00 d (
NOTEs Sewer & Water Permit fees and aecount deposit fees will be ineluded in the building
permit fee. Proeessing time for sewer and irater permits is two days onae e liuenaed
plumber ha9 applied for a permit at City 8a11.
/??AOBC t ncr?vw
ENGINEEfi1NG COHSUlT1H6 EH61HEf95
PIAHNE9S ond LAHD ?UAYEYOf15
, COMPANY, INC,
L 1000 EJlST I461A STpEE7, BtIRN=VILLE, YINHESOTII 3!337 P41 112'5000
C4E rZ icczZ e ?SZ?i"Ye c?
j,Agc1 .,Drm cr-1,,02i o n•
HomEs
LOT 16, BLOCK /, FAWN RID6E 2N0 ADD/T/O/V,
DAKUTA CoUNTY, MINNE607A
Cq;L-$_D DENOTES EXISTING ELEVATIOIU
(9s4•8) DEN07;5$ P/ZOPOSED E"LEVAT/ON
r? lNDICATES D1RECT1aA1 Of SURFACE DR.41NA6E
9z5.83 = FlNlSNED 64RA6E FLOOR i5LEVA71oA1
NA-P} II- t_; 5fl iN1a2;,.-?)p
76 S7 10• 11?1 IqKe. R0
t???? ?N _5_s113
DKAINA6E AND
UTILITY EASEMENT
? ?-.-r ? I
I5' oo,. E
I q'6• 25
?
.y ' 25.67 I J
G,9
°
V% NOUSE 53i
LoT
?
N ?ti, 9z"s_:S' "r i-
?
ob „
2-
0000 ?-! !5 • ¢3
f/73??
?9 21.0)
n71
N
? .r5 o ?
3 N f? '? _
N f, ?
?
0
?
z
y5.00
30' Ff70N7' Bu/LO1 Ne,
9ET6ACK L/ti/E
i
I hersby cartifyZthat thin is a t:ue and cflrrzct repr'aaentation of a tract of
ljnd as shown' and deacribed hereon.• Ae prepared by me on this day ot
??XdAe,f , 19 g7 . ,
liian. llaS. Xo. /Gogs'
---?
SCALE : I"=30'
3? ? a
?
1987 HOILDING PERMIY 9PPLICATIOH - CITY OF EAG9N
SINGLE FAMILY DWELLINGS
I9CLDDE 2 SETS OF PLANS, 3 CERTIFICAiES OF SOHVEY, 1 SET OF ENERGY CALCQLAZIOHS
HOTE: 9DDRESSES FOE CORNER LOTS - COHTRACTOR/HOMEOWNER MIIST DESIGHATE TiHICH ADDRESS
IS DFSIRED. NO CHANGES AILL BE ALLOWED ONCE BQILDING PERMIT IS ISSIISD.
HULTIPLE DWELLINGS - R&SIDENTIAL RfiNTAL IINITS FOR S9LE OAITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SORVSY - CHECB GTITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COfIliERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
1 SET OF SPECIFICATIDNS AND 1
ENERGY CALCULATIONS,
$2v000 LANDSCAPE BOND
To Be Used
- _a7?-
Site Address -
e2g::? -1i .
Lot Block
? -4
Parcel/
Owner _
Address
& STRUCTURAL PLANS,
SET OF
City/Zip Code
Phone
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Address
CitylZip coclitt-
Phone # /ez5
??t oorD
ion: ?
On Site Sewage_
MWCC System ?
On Site Well
City Water ?
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Date: ?
Oceupancy ?•3
Zoning (Z I
Type of Const
(Actual)
(Allowable)
af of Stories
Length
Depth
S.F. Total
Footprint S.F.
FSES
Permit ?S
Surcharge
Plan Review 2-0 9
. ?5
SACp City pO.
SAC, MWCC SZS.
Water Conn SZS•
Water Meter (a?.
Road Dnit 305
Treatment Pl 1 f30.
Parks
Copies
TOT9L .?.c
3
i -
?x
L K
'Z2 ? ZZ = ?04 x (2 ?
?ox IO ? ?c)(D K 6 -
i
?? 08
? S 1 -7 (o
i ?
??.
sE kEY?N
NGiNEE?ING CaHSUlilHO EH61HEf9S
pIANNE9S nnd LAND ?URVEYOltS
PE ao
COMPRNY, INC.
? 1000 G5T 146a1 5TAEE7, BuRl7SVILLE, YtHHE50TA 5:137 PH 422-2000
CeT?Z?Z CCL?e S?1LT"'Ye.l.?
?QCI 17e'??rfp?zan• LOT 16, BLOCK /, FAWN RID6E
DAKOTA CouNTY, MtNNE607q
NDMEs
2N0 ADO/T/ON,
CEE'Ll7 DENOTFS EXlST/NG ELEVATIOA/
074.8 ) DENOTES PROPOSED ELEVAT/ON
f? IND/CATES p/REC-PoA! OF SURF'ACE DR4lNA6E
9z5.153 = FINlSHED 6ARA4,47' FLWR ELEVS17/oA/
DkAlNA6E AND
UTILITY EASEMENT
?-7
? r ) I
L.?. 1
8?^ l5' 00
N
?
E6
i
o
67
?9?0,5) ? ?925?i 25. IC?
y?? ?yLZ.s)' ?
Ln P ?/OUSt 5•3,
1' a PROPOs?L
L Z_o 7- ,6 t o ?33Z?-, ?r
$
N93'00 Qp l
J 'V
? GO ? ??1 1 y.j- ?1
, v
. ?, 9p
N
10 ?
,o
?
i
?9?3 i
.i?
30' FRONT 4SvILD/N6
SETBACK L/NE
I hereby cartify that thia is a t:,je and correct nprzeentxtioa of a tract of
ljnd a: ¦hcwn'ind deacribed hernon.• Ae prepared by me on this ,!rW day of
10?"AeN , 19 87 .
144 ? Hinn. Res.
scALE : i", 30•
Ez7ERtoR cNVrt.oPr: nur.rinrr "u° corirurnTroN
OWNER
SITE AODRESS;
µa9e 1 oP 4
?33Z7 ?,
nn rr
?,.
f'IIDPIE:
CONTRACTOR: .
l-W ------
Determine worl:ing square footage ofi each
l. Total exposed wall area..... ZD$$ __sq. fr,. x. .11
2. Total roof/ceiliny area..... _??? ? sq, ft. x_0 26_
Total exposed wal] arca abovr. tloor•= ??7 Z
a. Total wall window area ......................
. . . . . . . . . . . . . . . . . . . . • ---?-??-_----
b. Total door area..,....... ?
c. Total sliding glass door area .............. . . . . . . . . . . 4 D
d. Total firepiace wall area ............................ . .
.
e. Total wall framin9 area (avera e 10"„,
9 ) ............................
f. Total rim joist area ................................ __? ?_
.............
g. net wall area above floor.........
.. 0
.........................
1?. wall area above floor............ ?
...................
i. wall area a6ove floor .......... . . .
................'
•
J. frame wali area at foundat.ion . . . . . . . . . . .
....................... -
........,..
Total exposed foundaCion area= 110
k, Total foundation window area ....................... ,,.
l. Total net foandation area above grarie ..............
-? `--"-
? ---??--____
? Determine °u" value of each wall segmenC
, (e.g, window, door, each separate wa)I secCion)
a. X
„ b •. X
?. c•?D x
d. '- X
U??---=?--- ?L_--
Hul, • ?1-- ---r! -?__
i,u,i ----_?9---------?g?-
HU„ _
e. R U??--_? -- A q
----?-=?-1-
f._ X Hul,
.04
---
9•____?_?5[7 _ x H u.,
n. x Hull _
j, x Hull _
j , X UH _
k. X
--- ? -- - --?' Z---
3 . .................................7oCal ?
C I' i tem H3 1 s tlie sam
as, or less than item
N1, ynu havo m0t the
tnCent oP SoC 6006 (t
e
Pat?rior Envelope Average "U" Computation
Total expo:;ed root/ce.ilinh nrca = r+q(p
M. Zbtal s}:yli.ght area, ............................ ?
n. Total roof/ceiling framing area (avcragc 102) ... 17-0
o. Total net ihsulated roof/cciling ;area........... p?!o
, Determine "U" valuc for each roof/ceiling segment
M. x "U,. o
Pagc 2 of 4
?
n. x „U" = 2 .g
-=Q?--
o, x„U„ , oZ__ __ 21 • 5
4 ........................... . lbta1
if.tota.l of :I9 isLhe same as, or less than 112, you have mel- the inL-ent of
SrtC.6005 (c) 1.
Alternate Iluildin9 L'nvelope Desi9n
To,ntili,ze the total enyelope 'system metliod, the values est:ablisliecl by the s:un of
i.Cems 43 and 114 shall not be 9reater. L-han the sum oP items ill and if2.
1• 2.?.7 + 2. _?7(•O = ? _f???
3. + 9. Z43
0
,.
a
PLA Q ? 3 3 Z?
? Urv EAL FT, F-Xpos?C) WALL
?LOGIZ II; z?od- 4l? t' 2.?ot?? co = t?
z4P4 q(o = Iq9
;
=uLLi;i?? ?-k4CP4 2(p -Jct(,g= ?44
=uLl.2 : ? -
il
? SG?z
?.
t3Loc? ;
W. 0 . !%
?ULL'i? ?
, ?
FuLL??i2 ?
T?7T, Sk.i!'oSED WA LL ,4iz.EA
144 x , s = -7Z
144 X 5 = 7zo '
K g ` (8TZ
l 41 K. 8 ? ( ts2
k ? -
x =
144 x 1 = ???
To tA L. = Zb s8
1,150-.F*, EKPoSE--D GEILluq 24Ox4c0= 1rq(o
W DxrS t?
7Dl-3fo 1'
i't-u 1
2444
, Zofoo Il( ,
ZS44 i t
Doo?s r?
3c,
? Za ? 3 S
?PAT? I O D(z,j
'
.?---
F35M4 Uui+s ?
:3'?
I • !'.U?r .`wi1
' • tint.r, sr.r.l•_ 0a.9
"t: u:.r jSt ?oi' ap,??iue w,yll nren for
frnm, eonrcruci 1un t'nw ,cruci inm r -vnlll,:
.
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FIC. M1 TOI)ViE:iV OF INSUI?•
. FINitE l4nLf. 1. inCrrlne' air 'ililt O.GR
----
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4. _
??o'?.?x ...... ..... ...---..._ --- •---6..?
4-?
G. ErCcrinr air Cilm
-------_.. 0.17
FIC. 42 ? TO i.al
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ScALz;? a. __??.l.??x?.----- - ---- - ---G---Qa
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"??:•--?----0 ---0
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:nLed flea[ f.toct ?
. up
TIG. @5 ?
Con9tCUCCI Ort R__VA],IIQ
].. Intcrior nir film . 0.61
'
z. 13p
3. I,vSu4_----- - Q'?
'
4. Extcrior air fil.n (still p?j
-- Total (Z ^ S oO
.oZ
F?4+rt a: • •
1. Intcrlor nir filin 0.61
2.
3• f NSu t=__ 3 8. 3.s`
4. ::zt:crtor : iC 1`i1l1 (SF-7.l?r`"?"6r
'rotal
' ^ _ ? . . ? a?l. Sr,? v c ri ml•,__? . ? •
„??_.w7.v,:.+.-ti-.. .,?-...r_-•,._.n?..cs..a?? :
- ---- -= ?------ __ ? 1. Insldc .ai.7r filln 0.61
? : - - 7'a==-T' ---- -
2' 4
, ?------- ,
4. - - -- ---- ---
ti ? 5. Oul-sidc air. film 0.17
Total .
O? 3 1. Tnsidc air filin 0:61
? . . , ? 2• -'
? YeGt flov ap . , _ j"v¢nted 3- . . .
4_
` ? . ? • ' 5. OuY.sidc air filin 0.17
• . FTC. f6.' . _. ? •. ... . Tota1
. • ^? ? I ?? Ynsidc air filin ? • • 0_E1
• . • ? _J.??? .?. __ ?.-.??.?.
3- • .
a .
,?...•?.?- .. _:.:.:?. :'?-; ----- --
--?'J;??,•:::;?•,?: •• - ,? ? ? ? ? ;. OuL.idc ai.r filin 0.17
? •.. ??~? / _.?- TOta1
' .,' , . - • ? • ,
Nutcs Usa additional sher[s if morc rpaco i:
neceled for deGails and calculations,
' . ? Heat ' • . ?
• ' . , - ilov up • • ? ' . •
. ... • . .. . •
' 711,. 27 . .. '• . .'
. . . , . • . ,
C1TY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
l_.?s
P ease Print)
? 1) PROPERTY ADDRESS:
LEGAL DESCRIPTION: , •-
_ Lot Block Sub ivision or Tax Parce ID )
IF EXIST2NG STRCCIS.'RE, DATE OF ORIGINAL BC'ILDING PERMIT ZSSL'ANCE: . ?
i
.
PRESENP ZONING/PROPOSID L'SE: (Mon Year
? CCMMERCIAL/RETAiL/O?cE R-1 SINGLE FAMILY .
F-7 j?'STRIAL r-I R-2 DOPLEX (1Wo C?nits)
n INSTIZL'TIONAL/GOVII2NMEN'r ? R-3 70WDIIi005E (Three + Units) ( Units)
. ? R-4 APARTMENT/COIIDOMINIL'M ( Units)
2)
NAME:
ADDRESS:
CITP. STATE, 2IP:
? PHONE:
3) • u r a-
NAME:
ADDRFSS:
i CITY, STATE, 2IP:
MASTER LICINSE#
4) •• • ??•
NAME:
_ P,DDRFSS:
CITY, STATE, 2IP:
PHONE:
?
f..___..________.. . . ._...."".._
F*IOTF': PAYMF.NC OF kEE AT TIME pg
F APPLIcATZoN mE$ Norr cownTuTE
F APPROVAL OF PFRhIIT.
h
t INSPDLTION OF SESdSt APID/OR WA'lFd2
M IIVSTAIS.ATIONS WIIL NOT BE SQKED-
F UI.ID [INi`II, P.F[tMIT F1A$ BEQQ
F APPROVID.
.
- Plumbers License:
Active
FScpired
Not recorded
? ?al
t
•5) n "• ? a• • ?• : o • o? ??
CONNECPION TO CITY SEWEE2 CONNECTION 1U CITY WATII2 Q OTfER . .
6) ?? • - • i- .
m
PI,EASE $OLD APPROVID pgtMffT FOR PICK-C?P BY ONE OF ABOVE
ASE L APPROVID PEE2MIT TO 1, 2, 3, ¢, p,HOVE
J ?? (Circle one)
FOR CITY USE ONLY '
PERMIT # ISSUED
la -?,S -
Pd w/Bldg. Permit FEES:
$ $ IO' S--Z) SEWER PERMIT (INCLODE SURCHARGE)
$ $ ZD•52 WATER PERMIT (INCLODE SL'RCHARGE)
$ (t'??G?72 $ WATER METER/COPPERHORN/OOTSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ?S • ?? ACCOC'NT DEPOSIT - WATER
$ $ WAC
$ $ SAC
$ $ TRDNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRUNK SEWER
$ S LATERAL BENEFIT/TRUNK WATER
$ ?d'?"L) ' D tD $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ ? 3 % 7• C9? S TOTAL
. -?? 9,f ? : ,; _3
.
RECEIPT RECEIPT
DOES OTILITY CONNEtTION REQLIRE EXCAVATION IN POBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
ROADWAY" MUST BE ISSUED BY TFiE E[VGINEERING
Q
NO
DIVISION. LIST AS
A CONDITION.
SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED SY:
TITLE:
DATE: 7%`7 /af 7
CITY USE O\LY
LOT lk? BL I RECEIPT #:
SUBD. RECEIPT DATE:
MECHAIVICAL PERMTT # 3I O U D
1999 MECEi4NICAL PEiMIT (MII3£NTIAIa
cirY oF EAsnx
3930 PII.OT KNOB [{D
E4fiAN MN 551 E2
Date• (651) 6$1-,4675
Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occunied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BN
$ 30.00
6.00
• Gas outlets (minimum of one required @$3.00 ea.)
State Surchazge .50
Total $
Complete this section onlv if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alterarion, or repair.
New Alteration Repair _ Other
-IL-
Reminder: Ca11681-4675 for inspections.
_ Fumace ? Air conditioning
_ Air exchanger _ Other
$ 3CA0
State Surchazge .50
Minimum Total Due $ 30.50
SITEADDRESS: '100 /V j?iV 4-14vec /l..L,-/
OWNERNAME: /s-//"f0/J PHONE #: ? -C?a O S77
?? ? /J?
INSTALLER NAME`': ?GL-rAt ? ;/..p , yt .
[ K? b-4fiC _ PHONE
STREET ADDRESS: C cl Yd'/ f?/Zd d? -L,;? (L2? // _ J. J
CITY: -e STATE: /--/,?-7 ZIP: S S? 7
?? ?---?
`SIG ATURE OF PERMITTEE
4??11 ??? y 'Y'
L BL
SUBD.
APPROVED BY:
CITY USE GNLY
INSPECTOR
RECEIPT #:
RECEIPT DATE:
MECHANICAL PERMIT #:
1999 MECH+4NICi4L PERMIT (COMbtERCIAL)
C[TY OF E4Ht4N
S$SO PILOT KNOB RD
EA6M,14IN 551E8
(651)681-4675
Please complete for: all commercial/industrial buildings
multi-famiiy buildings when separate permits are not required for each dwelling unit
DATE: Cf1NTRACT PuY'Er
WORK TYPE: New construction Install U.G. Tank
_ Interior Improvement Remove U.G. Tank (Minimum Fee)
Processed Piping (Minimum Fee)
**NOTE: When installing/removing underground tank, ca11 65 1-681-4675 for inspection by fire mazshal
and plumbing inspector.
DESCRIPTION OF WORK:
FEES: I% of connact price OR $30.00 minimum fee, whichever is greater.
CONTRACT PRICE x 1%
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLl):
INSTALLER:
($.50 per $1,000 of ?ermit fee due on all pemuts.)
PHONE #:
(AREA CODEj
ADDRESS: PHONE #: -
(AREA CODE)
CiTY: STATE: ZIP:
TURE OF PERMITTEE
oa 3 Z
?Y RESIDENTIAL BUILDING
? -7
Permit Application 0 -00
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion ReauiremenLS RemodeVReoair Reauiremenis OKce Use OnH
3 regislered site surveys showing sq. R of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cerl of Survey Recd
(20% mazimum bt coverage allaved) 1 set of Energy Calculations for heated addNOns _ Tree Pres Plan Recd
2 copies of plan showing beam 8 window sizes; poured fwnd desgn, etc. 7 sile survey for addNOns & decks _ Tree PreS Not Reqd
1 setofEnergyCalwla6ons Adddion - iMkateif on-siteseplicsysfem _ On-sde5epticSystem
3 mpies ol Tree Preservation Plan if lot pWtted aker 717l93
Rim Joist Detail Optlons selection sheef (bldgs wiN 3 or less units
Date (c)_ -0? Construction Cost ?&,!"J0 ?
Site Address
/n .? UniUSte #
Description of Work Sh C?/ ? J? C(- ()/?S /3( rYC'i? J/G?H
?(Y/? 4 ?'UN /'/trS
Multi-Faroily Bldg _ Y_ `l
N ?
X?$
Fireplace(s) _ 0 e? 1 ? 2
Property Owner va(i7 / 60 Ir,( ,C K! Telephone # (?D,;/ )
Contractor `- j "' /7 GJYIj V-
Address ? ???'J ? ?? ` ? City 4 .2!/ i ?
State ??f . Zip Telephone # (91a-)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate orv 1? ???? esota Rules 7672
Energy Code Category . Residential Ventilatlon Category 7 Wo t • I'ew Energy Code Worksheet
(JsubmissiontyPe) submittee ?k? AUG 2 G 2003 I!I?ubmitted
. Energy Envelope Calculations Submi a
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(q5p) P4( -1 a2a
Telephone #( )
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
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
approval of plans.
,?2c?vZ?.?
ApplicanYs Printed Name
ApplicanYs Signature
T
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling 0 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 OB-plex ? 18 Deck ? 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_r or_N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 ReplaCement 'Demalition (Entire Bldg) - Give PCA handout to applicant
Vatuation Occupancy MCIES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinallC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & W ater _ F inal _ 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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115092
Date Issued:09/23/2013
Permit Category:ePermit
Site Address: 765 Hay Lake Rd N
Lot:16 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-160
Use:
Description:
Sub Type:Reroof & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Windows/Doors: If altering the opening size, a framing inspection is required.
Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed,
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Alison Galaski
765 Hay Lake Rd N
Eagan MN 55123
(651) 485-1062
Majestic Custom Construction Inc
8800 Royal Ct NW
Anoka MN 55303
(612) 419-2173
Applicant/Permitee: Signature Issued By: Signature
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA144358
Date Issued:07/24/2017
Permit Category:ePermit
Site Address: 765 Hay Lake Rd N
Lot:16 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-160
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Alison Galaski
765 Hay Lake Rd N
Eagan MN 55123
Monarch Builders & Commercial Services
4820 W 77th St, Suite 150
Edina MN 55435
(952) 896-6227
Applicant/Permitee: Signature Issued By: Signature