769 Hay Lake Rd N
t Use BLUE or BLACK Ink
For Offic eUse I
I
City of EaEdR ~ 1 ~ Zoo E Permit
Permit Fee: 3830 Pilot Knob Road 1 1
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 I 1
1 Staff: !
Fax: (651) 675-5694 1 1
2 010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5 -10 - l Site Address: 6~f Ivbf A
Tenant: 1 Suite M
RESIDENT / OWNER Name: II.R R' O Phone: 661-16e 267f
Address / City / Zip:
Applicant is: Owner _,N~Contractor
TYPE OF WORK Description of work: Ft., l! K ~71a OT ~r~w
Construction Cost Multi-Family Building: (Yes . 1 No
CONTRACTOR Name: ' G lNl CLicense _
Address: e?Zw oGX City: S . Lo&
State: _tl& Zip: SSA Phone:
Contact: Email
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
1 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 1 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 /t'f~~14 x
App c is rinted Nam Applic s Sig
Page 1 of 2
CASH RECEIPT
;' ..
C1TY OF EAGAN . ?
• 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
reseeiveo
RNOM • ? "
AMOUNT ? $ I
a ooLtiwws
,oe
? CA5H [] CHECK
roe
i .
BY
?40
White-Paye?s Copy
Yeilow-Pottiny CopY
Pink-Fils Copy
Thank You
BLDG.
?-?-
?
01-3210
01-3422
01-3445
01-3446
01-2155
17-3860
20-2275
20-3865
20-3868
20-3716
20-2252
20-3713
20-3743
79-3866
, ....
PERMIT N0.
V
Bldg.. Per`mi
Plan Check
Surch./Adm. ?
SAC/Adrn. ?
Surcharge ?
Road Unit ?
SAC ?
Water Conn.
Water Trmt.
Water Meter
Acct. Dep. y
Water Permi
Sewer Permi
Sewer Conn.
11-3855 Park Ded,
TOTAL
CASH RECEIPT .?:
CITY OF EAGAN -
,
. 3830 P1L0T 1(NOB ROAD
EAGAN, MINNESOTA 55122
DATE ? '- 19
RECEIVEO . .' ...' . - -
FROM
AMOUNT
& DOL4AR3
1 oa
? CASH ? CHECK
i
.ne '.
? 1 ? ? !? ?-1 c ? •. _, _..Q..?..?C_-? ?.;r'? -.
FUND CODE pMOUNT
Thank You
BY
: , . White-Payers CoPY
Yellow-Posting Copy
Pink-File Copy
---------------
INSPECTION RECURD Controi No. 0491 CITY OF EAGAN PERIIAIT TYPE: BU zL pI MG .
3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55123 Date Issued: 0 s/ 2 2 j s? ? (612) 681-4675
SITE ADDRESS: LOT_ IS BLdCK = 1 APPLICANT:
76A HAY LAKE RD N COl EMAN !aM
fAWN RID6E zNo (612) 466--6496
PERMtT.PBTYPE: TYPE OF WORK: NIEW
krc:F I pi 0
PernfR No. - PermR Holdw Oete Telephone #
S
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inapwdon Date insp. Com+nanti
Footings I
FourKlation
Fremirig
Roanng
Rough Pibg.
Flougll tt9•
Isul.
Flreplace
Flnel Htg.
Orsat Test
Flnal Pkbg- Plbg. Inspector - Notify Plumber
Canst. MeSar
EngrJPlan
8klg. Final
DeCk Ftg.
Deck Final G p L NSP
1Ne11
Pr. Disp-
(ter#if iraft uf (Orrupttury
Citp of eagan
19pVaYftPrif of NltOtM JWPMa2t
This Certificate issued pursuant to the requiremenu of Section 306 of the Unrform Building
Code certifying that at the time of issuance thrs structure was in corespliance wrth the various
ordisances of 1/re City regulating building construction or use. Far the followrng.•
ux ckuifimtk, `7F DW/GAR ewg. r,,,;t r4,. 13913
Occ"-r TYx R3 zoo* n;wm ? I Tyye Cong. v
o.m,otsuud;ng DIET9M BI.UL nmras 625 BiIRNS`.'I(:-V PARNAY. B`VII.I.E
e,aai,S,+aa,,. ?7 F' r]C1RTI-; ?`' i,P-?:: '['?,•" L,,,W;y L 15, B I . FAW r: - -- ' . !
n„w NOVFINiFR 5. ! 9?: :
euaains offici,+ -
POST IN A CONSPICUOUS PLACE
rY
fg.er#i#iraft of Mrrupanry
titp of (Eagan
?ppartmrnf of luiiding JWprlinn
Tiu's Cern'ficate issued pursuant to the requiremenrs of Sectron 306 of the Unifarm Building
Code certifying that at the time of issuance thrs structure was in conipliance wilh the various
ordinances of rhe City regulating building construction or use. For the following:
v: cwibc.ooa >~ DWGIGAC Mdg. nm;i Ho. ; 319 1:
oxun-r Tra R zeaM Du,;d rype c? 1
Owner or Bwlding Addm
guMng Addrm Lapbh, b? CW4 ?..7NE N-D
p.te;
Building OIErid
POST IN A CONSPICUOUS PLACE
?nvu ir ?
. . . , MECHANICAL PERMIT RECEIPT #
' CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
Site Address ' BLDG. TYPE WORK DES?RIPTION
Lot r Block Sec/Sub ?
- r? Res. ? New
? Name ? Mult. Add-on
Address ? • ? % Comm. Repair
c City IC4 1,41 ,r Phone 4" - Other
Name
4' '?
l FEES
RES. HVAC 0-100 M BTU
-$24.00
c Address f ?
-t
l
? '?Ald ADDITIONAL 50 M BTU - 6
00
p City
??'r
/r ?"1
rr lr phone
(RES. HVAC INCLUDES A/C ON NEW .
CONSTRUCTION)
GAS
OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA
TYPE OF WORK , COMM/IND FEE - 1°rb OF CONTRACT FEE
Forced Air M BTU _? t ?• APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater -` M BTIJ - REMODELS
MINIMUM COMMERCIAL FEE - 12.00
2
Air Cond. M BTU R -
0.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other $
? -
FEE:
S/C: SIGNATURE OF PERMITTEE
TOTAL: -
FOR: CITY OF EAGAN
.?
PERMIT # PLUMBING PERMIT RECEIPT # -
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ?
CONTRACT PRICE PHONE: 454-8100
Site Address BLDG. TYPE WORK DES.CRIPTION
Lot `f Block ecr,,8ub Res. x New ?•"?
Muit. Add-on
? Name
w Addre:
? Ciry _
? Name r r : 1 ' .,c I ?
3 Address
O City
FEES
COMM/IND FEE - 194 OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMMIIND FEE - $20.OQ
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF
FOR CITY OF EAGAN
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWINa:
NO. FIXTURES TOTAL
Water Closet - $3.00
8ath Tubs - $3.00
?-Lavatory - $3.00
Shower - $3.00 _
.1_Kitchen Sink - $3.00 -?
Urinal/Bidet - $3.00
?Laundry Tray - $3.00 +
Floor Drains - $1.50
I Water Heater - $1.50 ?• ^?
Whirlpool - $3.00
in
Uet
- $1
'
Pi
50
` • `
G
O
J
p
.
g
u
s
.
_
as
(MINIMUM - 1 PER PERMIT)
Sottener - $5.00
Well - $10.00
Private Disp. - $10.00 _
*;_Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL•
CITY OF EAGAN
4 w~ w3830 Pilot Knob Road, P.O. Box 21-199,
PH O N E: 454-8100
BUILDING PERMIT
To be used tor Est. Value
Site Address
Lot Block Sec/Sub. `u'
Parcel No.
c Name
3 Address , ! ,L:'. ; ;•,,
O
City Phone
°C Name
.o
? s Address
P City Phone
55121 ?
Receipt #
Date ,19
OFFICE USE ONLY
' J
On Site Sewage _ Occupancy
?-
MWCC System _ Zoning
On Site Well _ Type of Const
City Water _ (Actuan
(Allowable)
* of Stories
Length
Depth -
S.F. Tolal
Footprint S.F.
APPROYALS FEES S 363.50
Assessments Permit
Water/Sewer _ Surcharge
Police _ Plan Review
Fire _ SAC, City
Engc _ SAC, MWCC
Planner _ Water Conn_
Council Water Meter
I hereby acknowledge that I have read this application and state Bldg. Off. _ Roed Unit
thet the information is correct and agree to comply with all appliCable APC _ Treatment Pi -
State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks
Copies
Signature of Permittee ~ r0T,4L
A Building Permit is issued to: ?on the express conditlon that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinancea
Building Official
Permit No. Permlt Holder Dste ToIophong it
Plurqbing ••? , ? ;', t'? , _
. _?.. ,?5i! ;1 ?
H.V.A.C. .,
? ; ? r_ .?
--? --r--- - - -
_ , ;?,?;?,, , , 1?-
;.?!?-• -?
Electric ; 11' 8 X
Softener
Inspection Date Insp. Comments
Footings I
Footings 11
Foundation -
?
Framing rtY? C . ?¢, ?
, ?- - .
Roofing
Rough Plbg. -?
Rou9h Ntg.
Isut. ?
Fireplace
Final Htg.
Final Plbg.
Bldg. Final G' o /?L f•'. ??, w a??
CBfi. OCC. S.t qI I ra ? z L SGi.++ ? 0? C/
TBI11p.LP -? 46i'./?.
Deck Ftg.
Deck Frmg.
Well
Pr. Disp.
BUILDING PERMIT
To be used for '`tT
Est. Value :S 1 + SW
Site Address N HAY LAs:E
Lot 1=' Block 1 Sec/Sub.
Parcel No.
W Name ?i•?i, i?t;; d: ?'1LLZ?1.": t;OLf.'MAl
Address -y ! 6$
o City ?AGAN Phone ???-S6$b
o Name - ???
,
?Q Address
m
I..
City
Phone
r
W W Name
; Adctress
u
a
W City Phone
I hereby acknowlege 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.
Signature of Permitee - A Building Permit is issued to: C;i W (.4IE'9AB1
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
Receipt # ?
OFFlCE USE ONLY
OcCUpancy
Zoning
(Actuaq Const
(Albwable)
# of Stories
Lengm
Depth
S.F. Total
S.F. Footprints
On Site Sewage
On $ite Well
MWCC System
City Water
PRV Required
Booster Pump
APPROVALS
Planner
Council
BkJg. Oft.
variance
_ Bldg. Permit
- SurChar9e
Plan Review
SAC. City
- SAC,MCWCC
Water Conn
- Water Meter
Acct. Deposit
SM Permit
- S'W Surcharge
Treatment PI
Road Unit
- Park Ded.
-- Capies
- TOTAL
FEES
36•b0
1 . OiL
.1 /a W
Permit No. Permft Holder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
`Z' °
a
Inspectlon Date Insp. Comments
Foolings I
Foundation pQQ,
Framing 7 a p /Z- ?- -
Roofing
Rough Plbg.
Hou0 Htg.
Isul. 10 ,Ozj
FireplaCe
Final Htg.
Final Plbg.
Const. Meter Plhg. Inspector - Notify Plumber
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
weu
Pr. Disp.
f • • „
' .???? ,; ? ,. , ;• s I
t. ?L•{L?1 c., ? i?-' ?`'?`~'i D PWMBINC PERMIT
CITY OF EAGAN
3830 PILOT KNQB RaAD, EAGAN, MN 55122
Site Address ' '
Lot Block Sec/Sub
? rvan
?o Add
c City
(D
c
3
O
Name _
Address
City _
Phone
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLOGS - COMM RATE APPLIES
TQWIVHOUSE 8 CONDO - RES. RATE ARPLIES
MINIMUM - RESIDEN7IAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
OF EAGAN Z,
PERMIT #
RECEIPT #
DATE: _
?
-?10
BLDG. TYPE WORK DESCRIPTtON
Res. k New
Mult. Add-on
Comm. Repair
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 8ink - $3.00
Urinal/Bidet - 53.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water }ieater - $1,50 -
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
we11 - $10.00
Private Disp. - $10.00
Aough Openings - $1.50 ?
,i -
FEE: ' J
t
tSTATE S/C:
--
GRAND TOTAL•
SEWER SERVICE PERMIT
' PEAMIT NO.:
to comply wilh the C19y ?agan
IP6Q
Insp.:
f OF EAGAN,,, Permft No:_
I Pilol Knob Road Meter No: _
Box 21199 Reader No:
an, MN 15121
.
No.
Connection Charge:
Account Deposit: -
Permit Fee:
Surcharge:
Misc. Ctrarges: -
Total:
Date Paid:
Size:
Date:
.Q
Chg: -'2 S.QOp`' Zoning: _
)eP: _ p ' No. of Units:
Fee: " F
RI
I agree to comply wlth the City of
Ordinances.
WATER SERYIGE PERMIT
CITY OFEAGAN Permlt No: -9914 Dew 7_14-.F7
3830 Pilo3 Knd -- Road Meter No: ?$Z??
PKocl<
.O. Sox . 719g ? S?Ze'
Reader No: Date: g- st 7
Eagan, M`r? 55121 -----
Owner. =... .
Site
Iil Fawn P.idee
Conn. Ghg: ?25. OOpd in pRnVIMv 1
?-
Acct Dep: . , , 00 , .n 58I ? '±'--
Permit Fee: ?-'?` • ? -CW `
? ?
Surcharge: • - • ???[?[
Tr. Plant 7;?? • ?r°i'°y""'plY With the City ot EBgan
Ordinances.
Meter. 67 c oi
Misc.: BY ` _"" 47v??
WATER SERVICE PERMIT I
- -- - - -- -- J
RESIDENTIAL
? r? I ?,lJ 1 BUILDINC PERMIT APPLICATION
?-? CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construction Reaulrements
• 3 registered site surveys showing sq, ft. of b4 sq. R of house; anc611 roofed areas
(20% mazimum lot coverage albwed)
• 2 copies of plan showing 6eam & w(indow sizes; pou2d found design, etc.)
• lsetofEnergyCakulatlons
• 3 copies of Tree Preservation Plan if lot platted afler 7/7193
• Rim Joist Detail Opdons selection sheet (bldgs wBh 3 or less units)
DATE
JOB:
IF MULTI-fAMILY BUILDING,
PROPERTY OW
TYPE OF
APPLICA
REPLACE(S) _ 0 ?7 - 2
PHONE# 9Sa yya - 39110
ADDRESS A6-ae-.tcA- a ZIPCODE '7
PAGER 0 ?3? CELL PHONE # 7/°- 609 7 FAX # 39yo
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1
(check one) - Residential VenGlation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RUI.ES 7672
- New Energy Code Worksheet Submitted
Plumbtng Conhactor: _
Plumbing System Includes:
Mechanical Conhactor. _
Mechanical System Includes:
Sewer/Water Conhactor.
MANY UNITS?
ZGNA.CO SO J?
??0 _C) O
1 i- l q-d )
RemodeVReoairReaulremenls
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
• 1 sile surveyfor exterioraddifans & decks
. Indiple K home served by sepOc syslem far addidons
VALUAfION ??OoO• °b
?
_ Water Softener _
_ Water Heater
No. of 13aths
Air Conditioning
Heat Recovery System
All above information must be submitted prior to processing of application.
Fee: $90.00
Fee: $70.00
#
ws
I hereby acknowledge that I have read this application, state that the informa4ion is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordi
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1l01
Phone #:
Lawn Sprinkler
No. of R.I. Baths
Phone #
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multl
? 03 Ot of _ plex 0 09 07-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacament •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
Footings (new bldg)
Footings (deck) FinallNo C.O.
Footings (addition) Plumbing
Foundarion
Dnin TIle
Roof Ice & Water Final
Framing
Fireplace _ R.I. _ Air Test _ Final
Insulation
FinaUC.O.
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
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
CITY OF EAGAN NQ 16253
3830 Pilot Knobk Road,f.0. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE:454-8100 Receipt # ?
7o be used for BASEMENT Est. VaWe $1, 500 Date APR 5 , 7g-89-
Site Address 769 N HAY LAKE RD
Lot 15 Block 1 SeclSub. FAWN RIDGE 2ND OFFICe USE ONLY
PBfCBI NO. Occupancy - FEES
Zoning -
w Name SUSAN SKAUDIS & WILLIAM COLE (AC1uaI) Const _ BIdg.Permit 36_00
o AddreSS 769 N HAY LAKE RD (Allowable) -
00
1
.
Sumharge
City EAGAN Phone 456-5486 x of staries -
Plan Review
Lengih _
o Name SAMF. Dapth - SAQCity
i
g Address S.F. Totel -
p SAC. MCWCC
• City Phone S.F. Faotprints -
Water Conn
On Site Sewage -
ww Name OnSiteWell - WaterMeler
?? Addfe55 MWCCSystem -
aw Clty Phon2 Ciry water _ Acct. Deposit
SIW P
it
PRV Required erm
_
I herehy acknowlege that I have read this application antl state that the Booster Pump - 5!W Suroharge
intormation is correct and agree to comply with all applicable State ot
Minnesota Statutes and City of Eagan Ordinance . Treatment PI
SignaWre of Parmitee- APPROVALS Road Uni1
A Building Permit is issued to: S SKAIiDT S(1R W(`(1T RMeN Planner - park Ded.
on [he express condition that all work shall be done in accordance with all Council
applicable State of Minnesota
Statutes a
nd
City oi Eagan Ordinances. Bldg. Off. _ Copies
p
y
y,
Builtling Official O I l.0 1!l I I 111 ??
L Variance - TOTAL 37.00
CITY OF EAGAN N? 13 913
3830 Pilqt Knoti,Road, P.O. Box 21 -799, Eagan, MN 55121
PHON E: 454-8
BUILDING PERMIT 7 00
S S
Receivt
To be used for SF DWG/GAR Est Value $60,000 Date SliLY 14 19 87
Site Address 769 NO HAY LAKE RD OFFICE USE ONLY
Lot 15 Block 1 Sec/Sub. FAWN RIDGE 2ND
e
?
?cy R3
MWCC Sys em ?
on g R1
ParcBINo. OnSiteWell TypeofConst V
City Water X (Aduaq
?
a Name PIETSCH BL?RS (AllowaGle)
Z Address 625 BURNSVILLE PKWY # of Stories
Len
th ?_
° City B' VILLE phane 688-0974 g
Depth 44
Total
SF
.
, p Name SA? Footprint S.F.
?? Address APPROVALS FEES
$ 363
50
H City PhOn2 Assessments Permit .
Water/Sewer Surcherge
W W Name Police =
PlanReview lAl.]$
tz
x- Address Fire - SAC,City 100-00
a= Engc SAC,MWCC _579-00
5w City Phone Planner _ WaterConn. 525.00
Councll _ WaterMeter 67.00
I hereby acknowledge that I have read this epplication and state Bltlg. Ofi. _ Foad Unit 3(1 S_!10
thattheinformationiscorrectandagreetocomplywithallappliCable APC _ 7reatmeniPl 180_(10
State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks
Copies a
,
Signature of Permitlee Z
? TOTAL • 5
ETSCH BtiILDERS
A Buildin Permit is issued to:
9
on the express canditlon that
all work shall be done in accordance with all applic/ IIe g(?tJ? te? .of M??in?nes,ot tat?{tes and City of Eagan Ordinances
Building Official
r
Thiz reQUest voia?/
18 nwnths Irom 0 //?/J,?6 ?
D 4 7 2 3
HequesiDate
?J
.?..// " •/ Fire No. Rouph-in Insuer,tian?
Requ ?
t ?
?Feady Now ill Notity Inspec-
[
Wh
<? es ?No m
en ReadY
a A
1!;]_?ceusetl ElecUical Contrac[or G. ?
1 hereby re4uesLi spaction of bove
? Owner elecnicel work inslalled at
Street Address, Boa or floute Na. C{ty
/VA . ft?_49? Xv.
ecbon o Townsnip Name or N. qanee No. County
U
OccaV- (PflINT) Phone No.
?'L 1 S? ???0
Power Supulier Address
6i -c, ltVA).
Eledrical Conhaptor ICompany Namel iintracmr's License No.
? S
Mailinq AtlJress IConV mr or Owner MakinN staila[iunl
sC?I ? G N SS ?2
Au,hori d SiB?eture ICOnh ctor wner Makine nstallati N Phone NumOer
MINNESOTA STATE BCqpD OF ELECTpIGITY TMIS INSPECTION HEQUEST WILL NOT
Griggs•Midway Bldg. - floom N-191 BE ACCEPTED BY THE STATE BpqpD
1821 Universitv qve.. St. Peul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phona(612) 6420800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION y. eaooam?- {7
? See insVUCtions tor completing Nis form on back of yellow copy. %/
9 9 5 9 0 5 X'; Below Work Covered by This Request
ew &dd Re . Typeofeuiltling AppliancesWired EquipmeniWired
Home Range , Temporary Service
Duplex Water Heater Electric Heafing
Apt. Buildinq Dryer Other (Specify)
Comm./Industrial Fumace
Farm Air Conditioner
01her (specity) Contreclor5 Remarks: ?
Compute Inspection Fee 8elow:
# Other Fee # ServiceEntrenceSize Fee # Gircuits/Feetlere Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Sigf1S Inspedor$ Use Ony: 7p ? y0
Irngation 8ooms ?'O
Special Inspection
Alarm/Communica[ion
Other Fee (
I, the Electrical Inspector, hereby
c
tit
th
t th
i
b
i
h Ap'ghin Date ?
y
er
a
e a
ove
nspect
on
as
been made.
• ,?
„? -y?j
OFFICE USE ONLY
TTis request void 18 monMa irom
Ei 95905 °`'
Request Dale Fi Na. Rough-in Inspectio 1 RequireOP ? Reedy Now II NoOty Inspecfor
9
R
tl
es ? No en
ee
Y
I p licensed contractor ..OT42wner hereby request inspection of above electrical work at:
Jo0 Atldress (Sireep Boz or Route No.) Ciy
l?
Secfion No. Townahip Neme or o. Rarge No. Couny
Occupent RINn . Phone N/o`?.,
1 C? /'?
?
? ^? _
l
71V
z
Power Sup er
I Adtlress
L AA RC
A
Elecviral ConVador (COmpany Name) Contrector5 License No.
O n
Mffiling AAtlress (CO
nVactor o Owner Makirg Inalellalion)
/
y
A
A E
a
l W
A /
u n
Authoeixed5i8^ature(ConVa Installation) Pho Number
MINNESOTA $TATE BOApO OF ELECiHICrtY THIS INSPECTION REQUEST WILL NOT
Grigga-MlGway Bltlg. - qoom S173 BE ACCEPTED BV THE STATE BOARO
1821 UnlrMSih A're. SL Paul, MN 55100 UNLESS PROPER INSPEGTION FEE IS
Phone(612)642-0800 ENCLOSED.
fyfj??sl ? REQUEST FOR ELECTRICAL INSPECTION ea/-ooooiS-os
/ See inshuctions lor completinp this form on beck oi yellow ropv. ? 7y'
D 4'7 /_I y,?7 X" Be/ow Work Covered by 7his Request 775'r
AdA Rep. Tyoe oi Builtling Apoliontea Wired Epuiument WireA
Mome Range Teniporary Service
Duplex Water Heater Liyhtiny Fixtures
Apt. BuilAing Dryer Electric Heahn
Commercial Bldg. Furnace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tank
Fdfm Iher pecily (SUCrityl
t er SV?c?fy OI er ??hcr
c.ompure Inspecrion ree veiow
N Fea ServiceEntrenceSize ft Fee Fexders/Subleeders n Fee Gircutts
?( r[} 0(J U ro 200 Amps 0 to 30 qmus 1?.r2?. ? 0 to 30 A ?
Above 200 qinju 31 to 70U qnips /T!np 31 to 100 qmus
gns
TOTAL F' /f ? ?
CL/
NouBh-in Oat I
t?l
i
i
f
?
f () .
s
ec
c?
In
spector, hereby
Final
D{e certify thet the abuve
Q L?
? ••s? ;,,soeciio" ne, eeen
mede.
thierepueatvo101BmontMirom (/vr
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651•681•4675
New CansWetlon Reauirements
• 3 registered sile surveys showing sq. ft. ot IoL sq. R. ot hause; and all raofed areas
(20°k macimum lot coverege allawed)
• 2 copies of plan showing beam 8 window s¢es; poured found design, etc.)
• 7 set of Errergy Calculations
• 3 copies of Tree Preservation Poan if lat platted after 7/1193
• Rim Jaist DeWil Op6ons selection sheet (Wdgs with 3 or less units)
DATE ` ` -AM 1 _D Lr
RamodeVRaoair Reouirements
• 2 copies of plan
. 1 set of Eneqy Calculatlons for heated atldilions
. 7 sde survey for exlerior additions & decks
. Indiwte "rf hame served 6y septic system for addifions
VALUATION
SITEADDRESS?U?? I?. U MULTI-FAMILYBLDG _Y
TYPE OF WORKTE7j1 CA?. 'jt14?? FIREPLACE(S) _ 0_ 1_ 2
APPLICANTTC'?fJ Q-Ons-{'{ lk'-?(Yl
STREET ADORESS ZLV) (/L) Sf- Sk--- I50:ITY?i "njf2,STATEI??? ZIPS'j5VY
TELEPHONE # CELL PHONE #.?'C.IX - (p? - ??'C-?19(FAX # F?I-3IL9?
PROPERTY OWNER?a3J? ?_C?)a TELEPHONE # I9SI '(y R(9" 706
---------------------- ------------------°°---------------------------------------------------
COMPLETE THIS SECTION FOR WNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNLSOTA RULES 7670 CATEGORY 1 MINNESOT-A RULCS 7672
(J submission type) • Residential Vendlation Category t Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: _
Plumbing system includes:
Mechanical Contractor.
Mechanical sysCem includes:
Sewer/Water Confractor:
Air Conditioning
Heat Recovcry System
Phone #
Fec: $70.00
- - ° --- ° -------------------- ------- ° - ° --------- °-....-° ---° --- ------° ------ ° ------ ------ ---- --- ----- ---------- • ---
I hereby acknowledge ihat 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.
n - .
Signafure of
OFFICE U5E ONLY
Water Softener _
Water Heater _
No. of Baths
Phone #
Iawn Sprinkler
No. of R.I. Baths
Phone #
Fee: $90.00
???1 11 n 9002
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
lTpdated
OFFICE USE ONLY
0 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 70-plex ? 19 LowerLevel
? 12 12-plex Plbg_Y or_ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
0 25 Miscellaneous
? 30 Accessory Bldg
? 31 E#. Alt - Multi
? 33 Ext. Alt • SF
0 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 38 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Altera6on ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demalition (Entire Bidg 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
_ Footings (new bldg) FinaVC.O.
_ Foo[ings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Dnin Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Fcaming _ 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
Water Supply 8 Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: Lor: 16 BLocK: i APPLICANT:
769 HAY LAKE RD N COLEPIAN
FAWN RIDGE 2ND (612) 456-5486
PERMIT SUBTYPE:
DECK
TYPE OF WORK:
..,.,REMARK3s RECEIPT •
?
Control No. 049 1
BUILDINO .?_
000620
05/22/92
WM
NEW
? -
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT `
SITE ADDRESS:
769 HAY LAKE RD N
LOT: 15 BLOCK: 1
FAWN RIDOE 2PID
DESCRIPTION:
Building Permit Type OECK
8uilding°Work Type NEW
: Building..length 24
Building Width. 12
tI
i ,
,
.,
? ? -?,/? ;'??? ,? •; i ,? ?
V2f
REMARKS:
RECEIPT M L ('?
FEE SUMMARY:
ease Fee =25}M1 ?
_ Surcharge S"t
Total Fee . . . ,.. .., . t26.-50 .
CONTRACTOR:
Control No. 0491
OWNER: - APPlicant -
COLEMAN WM
769 HAY LAKE RD N
EAGAN MN
(612)456-5486
I hereby acknowledge thaC I heve reatl this epplication and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutec and CiCy ot Eegan Ordinances.
L
APPLICA E MITEE SIGNATU
PERMITTYPE: BuiLoiHG
Permit Number: 000620
Date Issued: 8 5/2 Z/9 Z
E'Y `(?? "
ISSUED AIGNATURE
PEltMIT #
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
? ?.
SINGLE & MULTI-fAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural.& structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typin? of permit is requested, but not picked up by tast working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date 2- Yaluation of work
, R00.d EGtQG-n MlV
?kf 5-/23
S
-
Site Address: _
STREET STE /
Tenant Name: (comnercial only)
LOT ? BLOCK T_ SUgp.6 tT"N P-\UQ?sE ZND P.I.D. N
/4b? n1 .
Oescri tion of work: CUns4rCiC'b61!?
The applicant is: '0 Owner ? Contractor ? Other (oes«;be)
?? us Pho ne 46
?
Name
Property LAST FIRST
Owner ?C0A
?b a 4 Ha?/ ?
qddress
?
STREET STE R
City ??oState _ MN Zip 55123
Company Phone
Contractor Address License # Exp.
City State ZiP
Company , Phone
Architect/
Engineer Name Registration #
Address
City State ZjP
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowled9e that I have read this application and state that the informatiion is
correct?'fia d agree to comply with all`applic le State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? O1 Foundation ? 05 Apt. Bldg ? 09 Basement Finish
? 02 SF Dwg. O 06 Garage/Accessory ? 10 Swim Pool
? 03 Two family. O 07 Fi
:replace ? 11 Res. Add.
? 04 Multi-fam. T.H. _
? O8 Deck ? 12 Res. Porch
WORK TYPE
j3lr? O 33 Atterations 0 35 Nove
32 Addition ? 34 Tenant Finish ? 36 Demolish
GENERAL INFORMATION
Const. (Actual
(A1Towable
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
Building
Variance
O Site ? Footinq
? Wallboard ? final
O Framing
? Draintile
U3L/
17 Insulation
O fireplace
Permi t Fee Q5• ° ° vaiuBcian:
Surcharge ,sr
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Mater Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
Basement sq. ft.
lst fl. sq. ft.
n- 3 2nd Fl. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
iz• On-site sewage
s
? 13 Comm/Ind New
O 14 Comm/Ind Add
? 15 Comn/Ind Rem
? 16 Public Fac.
? 17 Agricultural
MWCC System
City Water
PRY Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
SAC %
SAC Units
. ? _
cNGiMEC3i1NG
? CoMPANY, INc.
< 1000 EIrT 14bL1 nEE'.
CONSUITIHG E!iC3iHE£?i5,
PLANNE9S ond LAHD SURVEYOflS
fluR4SV1LLE, Y1HHEi07Jl 51337 PH 412'5000
C?r?Z?'Z Ctt?e o ?SZ[.?'Ye t?
???c7 ?-?cr?Pt=cr • L07- is, &OcK i,
pP,KJ7'A
FAwN KiD6'-- 21vG Ao?i?c.,;;
n? r ti?niEscTx
CEQG -E-5- EXI<7ll:6
(97_.?I.o) DEh,`C',-? FROFO.Sc: E..E`i?,TlGti
(NGiLA-...c C?iZ=? ?!.: G? <_?2.AG?? DRAI?!P.6c
FL?GK GL.C`?147i ^.l?
30' G,eoA/T 6U/G61,V6
??,;;??? UNE 1
i?
pRR1uA(? At?1D ?,r'~? , q5'' E
-7"4` 0?,b /
(qzr"> / _- ,?
?? o
Q w 5? 7? ?50
? ? /? /} SI z?'?C D J?
00
J"^y
0
rbs73o. oo vn
CL2? c ?
tv N ? m
N m ?
t''?,
a, ?s ? I`1 7Q'
J
iJ D IZii
`y
I her:by cari3fy that thia is a t:ue and earract reprzaentatioe of a tract of
land a: $hcwn'and descr3be3 hertan.• Aa prapared by mn on this 2??,'day of
Ju,vE , 19 87,
Hinn. lsS...;Fo.1Ga8S'-
_,_. _ <, .._.. _ . .
v
,
? . -
/:3
' 1987 BIIILDING PERMIT 9PPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANSO 3 CERTIFZCAiSS OF SORVEY, 1 SET OF ENERGY CALCOLATIOBS
NOTE: ADDRESSES FOR CORNBE LOTS - CONTRACTOR/HOMEOWNER MQST DESIGHATff WHICH ADDRESS
IS DFSIRED. NO CH9NGfiS WILL BE ALLOWED ONCfi BOILDING PERMIT IS ISSIIED.
MtTLTIPLE DWELLINGS - R&SIDENTIAL RENTAL OPITS FOR SALE DNIYS
INCLUDE 2 SETS OF PLANS, CERTIFICAYB OF SORVBY - CHECB WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COf9M6RCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Valuation:?G?OT Date:
Site Address ?6'0( /Up" e a ;'I{fl?o?Ak? - OFFICS DSfi
Lot 15- Block On Site Sewage_
MWCC System ?
Parcel/Sub On Site Well
,• City Water ?
Owner
Address
City/Zip Code
Phone
Contractor ?z j rG
Address
City/Z3p Code
Phone Arch./Engr.
Address
City/Zip Code
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Couneil
Bldg Off
APC
Variance
Occupancy
Zoning (G I
Type of Const
(Actual) v
(Allowable) ?
# of Stories
Length ?
Depth
S.F. Total
Footprint S.F.
FE6S
Permit ?
3GJ.
Surcharge 30.
Plan Review 181 . '75
SAC, City IGb
SAC, MWCC SZS
Water Conn 525
Water Meter 6'7
Road Unit 3oS
Treatment Pl 180.
Parks
Copies _?SO
TOTAL 2, Z"I 0.
Phone lf
2C-x 3? ' °I ?Z? ?v = ?2???
2? ? 2? - 1.(qC?? (2 = SZ?c?
?
a
r ?
v GI -7 1 V
R0 B E
ENGIMEERING
COMPANY, [NG.
< fOCO E,LT 146iA 5'.i EZ',
PiEru-i 13u I
#? s4z,of
CDHSUL7IH6 EH6iHEf95,
pIANHEAS end IAHD SURYEYOf15
8UR4-JiLLE, Y{HHE=GTx 5!!Z37 P4i 122-5060
C4CY-Zz?z czz?e o?' Yef-f
L07 is, ewcx
DAKoTA Ca v,v7Y
Cg4-e•3?) DEUOitS ExISTIfv'6 EL-S-VATICN
FAwN R/DIE. ZND ADDITIC,tf,
M I k NE.soTst ,
0Zf3.o) DEtJ0 c5 PROPOSED ELEVA?lati`
?,ri INDICA''?..5 D?tZE:.TiGL GF 5?2=AG....? DR??ti?A6E
928.33 = F?uis yE;? ?A,eftE? FLOG,F ?..??A ? io,cf
N oRTti ?
scsiC.E : /° - ?c% r
30' F,P_DA/T 6U1401.V6
L INE 1
i/
PRAIUA6E AND 1? ri I 45E
DO
UTIUTY EASEMEA/T
pb i?
kjl-?
0
A °J
_ j
m
m
N 152? ?
?/
? ? m?
`o k.5 c
m? ? j55o
tLa
- s- ?
/
/
?
?
o
??t?.•9? D,oo ?
`y
?
S
1 ?
\1 . qd
u ?
9 \ /
,4.o IS
m S _ 1J .
\ \l r-? ? ??5
I beriby cart3fy that this is a t:ue and cor:YCt rapraaentition ot a traet of
land a: ahown'and described hernon.• Aa prepcrad by me on thia day ot
19 87. -
Hfnn. _RsE_'_;l1o.l?affS'"
Page
. ,, ? • ,. ; , ? fi ?? ? i .
,.
{?' I CITY OF?
1.
?i F.XTERIDR ENVELOPE AVERAGE "U" COMPUTATION .
•' i ; „ . ?. /?Uk'NSUi??'? , ,
ner PhoneW?SPW?
. -r • a
?. ?i
gal Description of Property: Lnt./?."?Block _, A Additio,,-, 6.xJ ;(?'urZ .vc :-.,. Date_
te Address???? ?1JU???? %i?/?/?-?l1?'- ??/iCtt,t"
AVERAGE LINEAL FEBT OF
EXPOSED WALL AREA ASOVE GRADE PERMIT N0.
An level
Lineal ft. of framed wall above gradl;?5 a heighE of wall
.m joist area
Lineal ft, of rix height of rim
;
?, .
)wer level
?7?.Jr =
Lineal ft. of framed wall above grade 710 x rieight of wall yz
Lineal ft. of masonry wall above gradef/? x height above grad? s.9 .'
K 1?t1? _ 1 ?/
TOi wa area a ove gra e including window9 an ooza _?Io
CNDOWS: Area_x "U" se7ue I
ike & tYPe S ft. x nU?? e (U) ?A)
._i. mCo
n n . Ai i. ?? 3''J.DfL/sO By. fC: 25' X r?U?! -57 ?U? EA?
sq. ft. 4f:x x "U" . yla ° (U) (A)
,? ?- aq. ft. /H X loU„ , ?iG ° (U) (A)
n n. /• ' a NJt'f? 8Q. ft. E nl1° Z i6 ` (U) (A)
n u .. • '? 3' a 3a Sq. ft. /5' x nUn (U) (A)
u.. „ a ? ,2_?3G eq. ft. /I- x ^Dlf 5-,5-;L (U)(A)
a-aux3G eq. ft. I? x??Un4° S..S?. (U)(A)
u _ n ; . N .. r! a- ?.,c 3G eq. ft. /?- x rrUIi • ?rG a ?: S?. (U)(A)
n n sq. ft. x nU° m (U)(A)
sq. ft. x (U) (A)
tt to " sn_ ft, X (U)(A)
ft. X aUn m (U) (A)
'? . • eq. ft. x tiUli a (U) (A)
u eq. ft. X1.1U14 a (U) (A)
n. It' eq. ft. ?. X nUn ° (U)(A)
it . : : eq. ft: . . . . . . . . . . . X $lUll:----a . . (U) (A)
eq. f5, X nun .ii.?.G...?.?. U?(A)
DORS: Area x nOn value (t1) (A)
ake 6 type - S? ?.n ?fs?ss?ons_s4• "
sq, ft ?iUrr??a 7 .2 (U)(A)
u
n u ?.. i .. • ?' 3a3eC .eq ft °Uu (U) (A)
q
ft, 37 U' = s- (u)(A)
9.9.
PAQUE RALL CUNSTRUCTION; Area x"U" v$lue
FRAMED WALL (total area leee , . • ,.
opening, framiug membezt, in -
ietail refer- wall, rim jo1eG area 6 tp46rniry) '
:nce from eq. ft. _ ._._x „Ull • 04 = ?'7 ?? ?u) (A)
ittached U) (A)
iheets FraminA membera in wall sq. tt.f?x lU^
Rim ioiet area sq. ft, d% x"ll" ,py 3.S tU)(A)
. Macnnrv ?A ahnne ¢?si?d? . . . . 8C1. ft. . 1. 7? ::Lr:1? ?1 (ll) (t1)
TOTAL Wall Area Iacluding /
, Windowe & Doora /(0TOTAL (U) (A) I? .?
l 7 ?
I'OTAL (U) (A) VALUES
)IVIDED BY TOTAL WALL AREA
?VERAGE "U" Minimum .17 or leae for 1 S 2 family dwellings
Mlnimum .22 or less for all other buildinge
90TE: If average "U" values ae calculated abdve do not meet the Energy Code requirements, the
"Alernate Envelope Design" ae indicated,on Page 5 may"6e used.
nt1L1. JL4l1V1Vb
11se ' lOX of opaque,wal-l area
, r lo r Framing members,
i ` FRAMING MEMBERS IN WALLS
? . .__._ . __..?__.?.___,_..._._._....
; Top View .
L
?I
;.. : R-Value
Extgrlor alr filg_.
Siding
Sheathing
A--A" aoft wood
Y" dry wall
.45
Interior'air film .68
TOTAL R = IO^
u ' i/R . u . . O?
FRAMED WALL
_ ,.
Sxterior air film .17
Sidi
ng
Sheathing
?,
batt ingulation
r ?9 0?
dr5+ wall - -- .45
Interior air il _ .68 -
TOTAT. B
U . U _ ,ay
_ RIMiTQIST AREA
Exterior air fiim
? ?
Siding •
SheathinS '-
1lif" soft wond -- 1.88
inH ltn ie
.68
Interior e? f?m ,? - --
TOTAL R = ?Y ?9
U - 1/R U
MASONRY WALL
Exterior air film
12" concrete block
Insulation
.17
Interior air film •68
TOTAL R = ? /3
• _ _.. _--- -
U - 1/R u
t--
i
?
?
Outeide air f11m .61
Ineulatlon
Drywall .45
Interior air film .61
TOTAL R ?
U - 1/R
U @•
Outside air film •17
Ineulatioa
Wood decking
Interior air film ,61
U + 1/R
TOTAL R -
U w
t00F/CEILINC: /JQ
fOTAL AREA: sq
' . ft....-
A)
9
)e[sil reference ,. 02a x aq,
U ft. y?0 (U) (
Erom above. "U" x eq, ft. s (U)(A)
)eacribe openings -"U" x sq. ft. ? CUjiAl;
Ln toof. "U" x sq. ft. ? (U)(A)
flUll x aq. ft. _ (y)) (A)
"U"---- --'--x sq. ft. ? (U) (A)
' rU" x sq. ft. ° (U) (A)
TOTALS ft. (U)(A)
fOTAL (U)
(A) VALUES
,
DIVIDED BY TOTAL ROOF/ AVG. "U"
;:EILINC qRF.A
AVERAC:E "U° .OS fur venti.lated roofs
.10 for all other conetruceion '
NOTE• ` avorage °f'" values ea cal culated above do not meet the EnRergy Code requirementa, Che
-nate Envelope Design" ae indicated on Ye$e 5 muy be :lased.
f ?
1989 BDILDING PERMZT 9PPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS ? ? ?f,3
/' .
? - ?
% i
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS S-
NOTE: ADDRESSES FOS CORNER LOTS - CONTRACTOR/HOMEOWNER MDST DESIGNATE WfiICA 9DDRESS
IS DFSIRED. AO CHANGES WILL HE ALLOIiED ONCE BUII.D2NG PSRMIT ZS ISSUED.
MOI.TIPLE DWELLINGS RENT9L UNITS FOR SALE IINIT9 i OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECS WITH BLDG. DEPT., 7 SET OF ENERGY
CALCULATIONS
EONAERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY C9LCULATIONS
' ?I N31?
To Be Used ForT?? Valuation: Date: q 1'? I v l
Site Address ? i A p
Lot Iy` Bloek "
Pareel/Sub
Owner
Address
City/Zip Code-?XQA r?IV j5?Z?j
Phone
Contractor
Address
City/Zip Code
Phone
Areh./Engr. _
Address
City/Zip Code
Phone 0
/sz)rl>-
Oecupancy
Zoning
Actual Const
Allowable
lF of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage_
On slte well _
MWCC System `
City water _
PRV required _
Booster Pump ?
APPROVALS
Planner _
Couneil
Bldg. Off. k2ld 2/1
Variance
Council
FBB3
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acet. Deposit
S/W Permit
S/W Sureharge
Treatment P1.
Road Unit
Park Ded.
Copies
TOTAL 3-?2?
NOTE: Serrer & Water Permit fees and acnount deposit fees will be ineluded in the building
permit fee. Procesaing time For sewer and aater permits is trro days onee a lieensed
plumber has applied for a permit at City Iiall.
I 1)
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
?4(YP6: PA)M1BNS OF FEE AT TIME OE'
???? ? ? ??
APPRaVAL oF PErrEr.
nErncriorr oF sFwM Arro/Ct WTM
IIS'i'AT.i.ATTONS WIId. N]dP BF'.. .SCHED'
ULID i]@TM PIItNIIT HAS BffiV
APPROVED.
lYlease Print) ----71
PROPERTY ADDRESS: ji 61 OV-1,?-? LEGAL DESCRIPTION:
. Lot B ock Subdivision or Tax Parcel ID )
IF EXISTING STRL'CiVRE, DATE OF ORIGINAL BC'ILDING PERMiT ISS['ANCE: '
(Mon Year
PRESENf ZONING/PROPOSID LSE:
q CA'+P9ERCIAL/RE'PAIL/0FFZCE R-1 SINGLE FAMILY
0 IDIDC'STRIAL ? R-2 DUPLEX (Tro L?nits)
? INSTITUTIONA,/OO1ERN"ENT rl R-3 T'OWN[IOC?SE (Three + Units) ( Lnits)
, Q R-4 APARTHENT/CONIDOMINILfii ( Units)
Z) ?
[VAM?E: -J'l `i.7?'XF3' ? 6/J1
ADDRESS: (o2-ri ?i_&
CITY. STATE, ZIP: ?<?cl(? ?.(?/
PHONE:??-
3) • m?• - (
?,p
- ? For City Use
NA"!E:
?691?TT
wt.J 1 ? ?
) ? f t5 nL Plumbers License:
AMREss: Active
??a
CITY. S2ATE, ZIP: Not recorded
PxoNE:_ Vz3-3 13o MAsTm LicErrss# ?3o99Ft -
?
s
?tia
4) •• • i04•
NAN]E: aru-c
ADDRFSS:
CITY. STATE, ZIP:
PHONE: .
-5j '? a' ' ?' : ? • ? ??
?J CONNECPION DD CITY SEWEE2
7T ?j CObIIJEX.TION TD CITY WATII2 ?
J'°'C OT'HER '
6) n• • r ? PLEASE HOLD APPROVEa PERMIT FDR PICK-UP BY ONE OF AHOVE ----- ---
[?] PLEAS? F?7AIL APPROVED PERMIT TO 1, 2,0, 4. AHOVE
(Circle one)
7)
: f4R :.CITY USE ONLY
PERMIT $ ISSUED
Pd w/Bldg. Permit FEES: ,
$ $ SEWER PERMIT (INCLUDE SURCHARGE )
$ $ WATER PERMIT (INCLUDE SURCHARGE )
$ (0 7•D-7? $ WATER METER/COPPERHORN/ODTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ `??'? ? ACCOUNT DEPOSIT - WATER
$ ? z S ' ?D $ WAC
$ C? zO--d $ S
C
A
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ ?06 0-0 $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER;
$. d l 7?Z7 $ o??` Q Z? TOTAL
- 2 6
4
RECEIPT?- -
RECEIPT •
DOES UTILITY CONNEC TION REQCIRE EXCAVA TION IN POBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MUST BE I
DIVISION
LIST AS SSLED By THE ENGINEERING
A CONDI
ION
. .
T
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE : Ijt 7
?
'1 (O`?a
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
?(V3 ?=?
Date A_!ae)/ ?
,r
SiteStreetAddress ?X`?1l ttiaL/ cj? 2? Unit#
PropertyOwnerC4!9?4 c?- Q14,rR LlC' rrjaXl Telephone# (jt 1)CIl1&zDL19
Contractor ?-4-?n • PI Qso.JcxES Telephone #( )
Address bodC'1 Q_(] City 0--f%qc, n State_pjjC?_ Zip?
The Applicant is: wner Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes putting in a water softener and/or water
heater. at the same time. lf ??ou are instaUinq onlv a water softener and/or water
?\
heater, do not complete this section. Move to the next section and check the
appliance(s) you are installing.
Septic System Abandonment O
_
_Water Turnaround (add $125.00 if a 518" meter is required)
_Other.
Water Softener kl?Water Heater $ 15.00
new ?replacement
_
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Totai
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is compiete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan i required to be reviewed and ap ed.
Applicants Printed Name plicanYs Signa ure
$ IS ?? ?
7,2S,6-i
2006 RESIDENTIAL MECHANICAL rERMiT arrLicaTioN
City Of Eagan -)Ojgp /JA?a
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when permits are required for each unit
W•,5D
Date _? / 30 / 6(,
Site Address Unit #
?n sS ?
Property Owner Telephone #(6f/ ) I
?
J 7401
Contractor
StreetAddress City 4?,J
State YhA-) Zip Telephone #(64/ )X9 Y - 9P?,P
Bond #: Expires:
The Applicant is _ Owner l/ Contractor _ Other
Add-on or alteration to existing dwelling unit _ $ 30.00
/
V f
Additi
l
?Re
lacement
New
umace
- _
ona p _
airexchanger
air conditioner
heat pump
other
State Sureharge $ .50
T
t
l $ 132-
a
o
I hereby appty for a Residentia] Mechanical Permit and acknowledge that the information is complete and acwrate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but onty 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 approva] of pl?ans.?
?{L1L?i-? rLaU E--A- l t, .
Applicant's Printed Name Applicant Signature
2006 COMMERCIAL MECHANICAL rExMiT arrl,icaTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone #t 651-675-5675
Please complete for. rqmmerciaUindus[rial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date / I
Site Street Address Unit #
Tenant Name (i£applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove *`see 6elow
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
"When installing/removing underground tank, call for inspecfion by Fire Marshal and Plumbing lnspector
PCI'[Iltf Fees: $7050 Underground [ank ins[alla[ioNremoval
$50.50 Minintum (includes State Surcharge)
or
Contrac[Value $ x 1% = $ PermitFee
$ State Surcharge
[f ermit fee is less than $1,000, add $.50
If oermit fee is more than $1,000, surcharge
is $.50 for every $1,000 owed.
$ Total Fee
I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work
will ba in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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
Approved By:
Inspector
Required Inspections: - U.G. - R.I. - Air Test
Applicant's Signature
Date:
Gas Service Test Infloor Heat Final
Use BLUE BLACK Ink,
r '`.per" Use € C'e.F.lit sr: J ~ ✓ f
t of EaF i €
8880 Pilot Knob Road
an s s ai 55122 €
i Date Received: i
Phlone: (651) 675-5675 € €
Fa,,: (651, 675-5694
€ E
- - - - - - - - - - - - - - - -
- TI -
aa~ a: Site Address: ~o1 /~t7~T34 ) +(~~(-f~
Tenant: its
FR ZE 7-i D SEN T I OW N E R Name: Phone: lal Z' ~7(cS 2- 4::'~ 7
Address / C;Ty / Zip: ~lsa~1 f 2 Z) } { [ Ac)~ ~Z~
Applicant is: Owner Contractor
TYPE OF ORS Description of work: I -a-- 2- L
Construction Cost
Ivulti-Family Building: (yes No 11>11~
CONTRACTOR Name: WELL.11J~T®t~"~ ifCst~r►~ E/YIC~Qc~l~r rn ~rC License _Cj2 (aLj7
4(4 9
Address: 31326 M~ DUZ~S~,CZ.rg QD City: cal 1013 i S ~A~2
State: Zip: Phone: 9S2 3 3 - ~OC~
Contact: Email Wl El 5
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEV BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
y
_Yes _No If yes, date and address of master plan:
Licensed 'lumber: Phone:
I3vchsnical Contractor:
Pl~ene:
Seaver & Mater Contractor: Phone:
O" : Plans and scrpporfistc~ d0csrrnents that you submit are considered to be public
F7
the information may be ciassifie" a z rior-pub'fc of you prcWd specific reasons xftaf
d,, aye trade vccre .
O LL ~ YC~J ®lta. Call Gopher State One Call at (651) 454-0002 for protection against underground Ca1€ 48 hours before you intend to dig to receive locates of underground utilities.
www.cooherstateonecall oro utility dcr~aga
i hereby acknowledge that this information is complete and accurate; that the work will be in confomlance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an appl ca ,on r a permit, and work is not to start watt out e arrr
G cordane,surth t ap, =wroted elan in tha case ofwori perm that the work U~ l4 be it
k v rhich requirns a . if and. proval cf plar .
a
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA140995
Date Issued:02/07/2017
Permit Category:ePermit
Site Address: 769 Hay Lake Rd N
Lot:15 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-150
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Raymond Richason
769 Hay Lake Rd N
Eagan MN 55123
(651) 686-7019
Wenzel Heating & Air Conditioning
4145 Old Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162316
Date Issued:07/08/2020
Permit Category:ePermit
Site Address: 769 Hay Lake Rd N
Lot:15 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-150
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Raymond Richason
769 Hay Lake Rd N
Eagan MN 55123
(612) 968-2671
Wenzel Heating & Air Conditioning
4145 Old Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature