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781 Hay Lake Rd NBLDG. PERMIT N0.,1' 01-3210 ? .-- - , ,5Sld/g. e?init, 01-3422 c PlaA Check 01-3445 5urch./Adm. ` 01-3446 SAC/Adm. ? 01-2155 Surcharge 17-3860 Road Unit - 20-2275 SAC C 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. 1n r 11-3855 Park Ded, TOTAL -??/ -) I S r ' CASH RECEIPT , ? CITY OF EAGAN 3930 PIL~JT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEIVED FROM AMOUNT Is I .S`v [:] CASH f-I CNECK BY :e DOLLARS fao White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE• 454 8100 N° 13218 BUILDING PERMIT • Receipt # Tobeuaedta `'F DW;'/GA -4 Est.Value $67,000 Date ?'EB:7UElRt 12 ,19t37 Site Address 781 N0 HAY LAKE RD Erect 99 Occupancy K3 Lot 12 Block 1 secisub. FAk'N RIUGE 214D Remodel ? Zoning R1 Parcel No. Repair ? Type of Const v Addition ? No. Stories W Name KFYLANU HOriES Move ? Length 42 z Demolish ? Depth 48 3 Address 14450 BiJRNSVILLE PK4rY Int. Impr. ? Sq. Ft 0 Ciry B'v I LLFphone 894- 2 6 3 6 Install O = o Name sAIME Approvata Fee; v a Address ASS65Sment Permit ~ City Phone Water 8 Sew. Surcharge _ ?i cc HALLQU I ST N Police Plan Review ` Z ame Fire SAC ? n Address En Water Conn. i W city BLMGTN phone S 31-1$ 7 5 PI nner Water M eter 1 hereby acknowledge that I have read this application and state thatthe Council Road Unit- information is correct and agree to comply with all applicable State of Bldg. Off. Tr. PI. Minnesota Statutes and Citv ot Eaoan Ordinances. APC Parks Var. Date I Copies Signature ot Permittee?_: =+` ? , . 5U Total A Buildin Permit is issued to: KL:YL$4rNp HO?;9E5 9 on the express Condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinancea Building Official -/ . ` • Pwmit No. Permlt Holder Otle TilaphoM Y Plumbina ,?r ?;r "i'.y ? ? ` ? ?ci?? 6•%7 H.V.A.C. F,ectric ` ?- x '' in.pecdon oae insp. comnwmts FooUnys 1 Footinps II Foundatbn Framinq RooAny Rouph PIb9• -?!'1 ? •1 -- ? Rouph Ntp. Insul. P Flrsplace FMd Mtp. O Final Plbp. &dp. Final Cert. Oee. ' Doelc Ftq. Doek Frmq. Well Pr. Dhp. PERMIT # PLUMBING PERMIT -• CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: TRACT PRICE: PHONE: 454-8100 Site Address .7, Z•' Lot Z j Block ? BLDG. TYPE WORK DESCRIPTION Res. New DMult. Add-on Name Address 4L_4 5 -7% ! Ciry ; ,rt4_ ,-S?= c Phone ,?,?•^? - Name ?'*: -oe. 3 Address r[• ? p City Z2.+,..,. Phone FEES COMM/IND FEE - 196 OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE 8 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 Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL _J--Water Closet - $3 00 $ ?Bath 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 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 1 -- L /? _?Rough Openings - $1.50 ? SIGNATURE OF?F?ERMITTE?E y G FEE: II STATE S/C: ? FOR: CITY OF EAGAN GRAND TOTAL• PERMIT # MECHANICAL PERMIT RECEIP7 # ?s 3630 P CITY OF EAGAN MN 55121 DATE: ILOT KNOB ROAD EA(iAN , , CONTRACT PR1CE: PHONE 454-8100 Site Address R % " - iL. gLpG npE WORK DESCRIPTION Lot Block Sec/Sub , w Y R ? N e es. m Name " lt Add M ? Address, "440?vor ^^ N ?:! + i? r??- 1 u -on R i C c City ?'r • r w. )?,? Phone r omm. epa Oth ` er Name l<? ti-? o? •?. FEES ? ? Address • "`? S'? ? `?--? '?' ? RES. HVAC 0-100 M BTU - $24.00 p City ?- -' " Phone ''fi '" ? AODITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK ?? .? y? GAS OUTLETS - 1.50 EA. Forced Air . M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Vent CFM BEYOND $1,000.00) Gas Piping Outlets # Other ? FEE ^ SIGNATURE OF PERMITTEE S/C: ? TOTAL• - FOR: CITY OF EAGAN 6 1 - f (ger#iftra#e uf Mrrupttury titp of eagan fir,praxtmrnt n# luilding Insprrtinn This Certifrcate issued pursuant to the requrrements of SectioM 306 of tlre Uniform Building Code certifying rhaT at the rime of issuance this struciure was in compliance with the varivus ordinances of the City regulating building construction or use. For the following.• _ r Use C7assifiation Bldg. PErmit No. Occupancy Typc Zooing Distria TYPe Cona• Owner of 8m7dim Buildiog Address I.acality - - '' l s "1:. t - - ,.: ??a ?c Daw: -± Build'mg Official POST IN A CONSPICUOUS PLACE CITY OF EAGAN Permit No: 8524 Date: 3- 6-7 3830 Ppot Knob Road Meter No: -3Z(Q Size: 5/S "?lo a(< P.O. Box21199 Reader No: 115?.4V 93 Co Date: !?6 '?' Eagan, MN 55121 Ovvner. ?`e,,'land liomes SiteAddress: 781 ?1o. Hay Lake T?oad .] 7 Rt T T.n ^;dRe 7T Conn.Ch . 525.OOPd?V IARIl 11 T`_t Acct. Dep: 1S ?DO?bl??ijl9&s: Permit Fee: 7r;fC • GIA5 Etc. Surcharge: ?•? u ?? E_ mply with the City ol Eagan - 1<:`??] ? Tr. Plant ? Meter. , 7 619?; Ef /- ? Misc : gvG( ?? ? i r WATER SERVICE PERMIT ' OF EAGAN SEWER SERYICE PERMIT ' Pllot Knob.;Road Box,21198 PERMIT NO.; n F:' S ?n, MN 55121 _ _ T No. of Unib: - 1 Plumber. _ ?' ?- rhs.. 2='12-$7 70642 1 agree to comply wtth fhe City of Eagan Ordinances. ;?O.OOpd Connection Charge: 1 ? Account Deposit: ? Permit Fee: BY - Date of Insp.: Insp.: Misc. Charges: - - -r a - Total: Date Paid- CITY OF EAGAN permn No; 8524 3 -6-E7 3830 Piloi Knot+.Aoad Meter Date: P.O. Bojw21199 . No: Size: ? Eagan, MN 55121 Reader No: Date: Owner. e;r*Iand IIomes Site Address• 7E I Nn _ Na.. r Gann. Chg: 5?'-?• oogd Acct. Dep: --- T-57. 0 pe, Permit Fee: ? • 00pd Surcharge: . 54pd Tr. Plant flJT-.Id Meter. Zoning: R1 No. of Units: I I agree to comply with the Cily oi Eagan Ordinances. WATER SERVICE PERMIT CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 5512, N°- 13218 BUILDINfG PERMIT PHONE: 454-8100 Receipt# To be used for SF DWG/GAR Est value $ 5 7,0 0 0 Date FEBRUARY 12 1987 SiteAddress 781 NO HAY LAKE RD Erect m Occupancy R3 Lot 12 elock 1 Sec/Sub. FAWN RIDGE 2ND Remodel ? zoning FtI Parcel No. Repair ? Type of Const. 6 Addition ? No. Stories W Name KEYLAND HOMES Move ? Length 49 3 Address 14450 BURNSVILLE PKWY Demolish ? ? Depth_?? Ft S ° B' VILL $94-2636 F Int.lmpr. . q. Ciry Yhone Install ? o z < $ 0 ? Name SAME Assessment. Water 8 Sew Fees Address Phone u? HALLQUIST Police _ W w Name Fi ? i re - Address sw piry Ri.MGTN phone 8 41-1875 Planner I hereby acknowledge that I have read this application and state that Ihe information is correct and agree to comply with all applicable State o( Minnesota StaWtes and CEagan Ordi ces. Signature ol Permilte?{,/ Council Bldg. Off. APC Var. Date Permit $ 388. 00 Surcharge 33.50 Plan Aeview 194 . 00 SnC 625.00 Water Conn. 525.00 Water Meter 67.00 RoadUnit 305.00 Tr. PI. 180.00 Copies-TZ,-3T7-. s Q Total A Building Permit is iss d to: KEYLBfND HOMES on the express conditian thet all work shall be done imaccordance with all ap?in ota Stat tes and Ciry of Eagan Ordinances. 8uilding Official ? REQUEST FOR ELECTRICAL INSPECTION E13-000C11-08/ ? See inslmdions 1w mmpleling this brm on back of yellow mpy. ? a 4 513 7 XBelow Work Covered by This Request e Adtl Rep. TypeofBUilding AppliancesWiretl EquipmeniWired Home Range Temporary Service uplex Water Heater Elearic Heating pt Building Dryer Othet. (Specify) q omm./Industrial Fumace arm Air Conditioner ot nerlsyecityi Con[rector's Remarks: / Compute lnspection Fee Below: # Other Fee 8 Service EntrenceSize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps TranSbrmers Above 200 _ AmpS Above 100 _ Amps S19f15 linspecmr5 Use Only: ' Irrigafion 8ooms 0 ? Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 M 5. I, the Electrical Inspector, hereby f Rougn-in `v?o s? _ J certi y that the above inspection has 6een made. F;,,ai t 'u r oa+e - OFFICE lISE ONLY ? Thls request voitl 18 manms trom 45 37 co?r /O o?0 Requesl Det/O ?? ?? ire No. Rough-in Inspection Re iretl? ? ReeEy Now Will NoVly Inspeclor h R tl ? Yes G No en ea Y I_ licensed contractor Xowner hereby request inspection of above electncal work at: Job Atltlr?s;?^??reeL Bor or ute No. City Section No. Tovmship e or No. Fenge No. Courity OccuPan?IPRINT ? Phone No. ? a S Power Supplier Address EI¢Cincal on aclorlComOany Name) COnIraCtors Licen9e No. omfacunE f' Mailing A ss IContractor or Owrier Making Ins1811ationl Autho e 5' nalura Gont IovOwner Making slal tio I Phone umber ?SI -927 2 MINNESOTR STATE BOAND OF ELECTRICITY THI$ INSPECTION 1iE0UE5T WILL NOT Griggs-Mitlwey Bltlg. - qoom S173 BE ACCEPTEO BV THE STATE BOARD 1831 University Ave., St. Faul. NN 5510C UNLESS PROPER INSPECTION FEE IS VMm (812) 66I-0800 ENCLOSED. Th,s ,dauest voia 18 months from -? C 7 6 7 9 3, Requ t Fire No. Rouefi-i?Ansu ion Requua DAeady Nuw 9944N'1"N6tity Inspeo- ? es ?NO tor WheSn, fleady cens d EI cVical Contiaclor 1 herebY nqueet ineDec?on oi e ove ? Owner eieetNeal wo.k inslalled et ?7 % SG j Street Atldr ss, Box or ARyule No, CitV j / / ' CJ ection o. Townsh'o ame or o. Range No. County ? ? OtCUOent IPFIN?11 Phone No. ?? Power Su ' O? AdEress Elecvical C t ctor (Company Nam F ? Canlractor'S Licenso. '?i ? /?? . G/ / Mailin8 J (COmractor or Owner Maki res Instailation) 1• r Authorized Sign lure ?C t or wner Maki n allation) Phon?4y uepEer TMIS INSPECTION PEQUEST WILL NOT MINNESOTA STATE B ARD OF ELECTNI ITY GriqpeMitlwey Bld .- Xoom N-197 BE ACCEPTED BY TME STAiE BOAflD 18I7 Univenitv Ave., bt. N.J. MN 66104 UNLESS PPOPEN INSPECTION FEE IS Phone(612)642-0800 ENCLOSED. ;/3/y 7 REQUEST FOR ELECTRICAL INSPECTION E?By-00001-05 ? See instructions br comvletinB this lorm on beck oi Yellow copY. ///7S -???'l6 3 'X'" Below Wak Covered by This Request ? s4na de 7voe ol Buildino Aooliancea WiroO Equipmenl Wired Water M sw" ServiceEntrenea5iie p'. Fee -. Faetlers/5ubfeedara b Gee Gircuite .LC 0 to 200 qm s 0 to 30 qm s .? 0 m 30 Am Above 200 qmlu 37 to 100 Amps 31 to 100 q y Swimming Pool A6ove 100_Am s Above 100_F.m s Transiormers Irrigation Booms / Pertial-'Other Fee $peciallnspection ? TOTAL ..__°.. .° ? _...° r7 I. the ElacVieal Inapectar, heraby Final /? /.? w n?1 Dnte eF 77 certiiy thet the abave inspection hea been mede. tlMe repueat vol0 78 montM fwm RESIDENTIAt BUILDING / ? 15q ol- : Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan NIN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Naw Construction Reauirements RemodellReoair Reouirements Office Use OnPo 3 reg'stered site surveys showing sq. 8. oF lot, sq. ft. of house; and all roofed areas 2 copies ot pWn CeR of Survey Recd (20% maximum lof coverage allaved) 1 set oi Energy Calculations for heated addiUons Tree Pres Plan Recd 2 copies of plan showing beam & windav sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd i set of Energy Calculations Addi6on - indrrafe ilon-site sepfk system _ On-site Septic System 3 copies of Trea Preservation Plan if lol platted after 717/93 Rim Joist Oefail Options selection sheet (bldgs wifh 3 or less units Date '5T /t ?'1_. / Site Address Descriptlon of Work Multi-Family Bldg _ Y X N Construction Fireplace(s) k p "--e _ Z Q? UniUSte # Property Owner ? im/ UV 1wA"n Telephone #([y51 ) 1 QFC? - 9c? __? a Contrac, RENEWAL BY ANDERSON Add 1920 COUNTY RD. "C" WflST ROSEVILLE, MN 55113 Stati 651-264-4777 LIC # 20130983 _ Zip City Telephone # ( COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet (dsubmissiontype) Suhmitted Submitted . Energy Envelope Calculations Submittad Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone # SEP 2 s 2003 I hereby apply for a Residential Building Permit and acknowledge that the inform?fibn is complete and accurate; that the work will be in conformance with the ordinances and codes of the City f?'yEagan_ancL-t?State??of MN Statutes; I understand this is not a permit, but only an application for a pernut, and work is not to start without a perm ; that the work will be in accordance with the approved an in the case of work which requires a review and apprval of plans. I v - ApplicanYs Printed Name ApplicanYs Signature fdFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? 08 06-plex 0 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 Ot of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage O 06 04-plex ? 12 12-plex Pibg_v or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 44 Siding ? 32 Addition ? 36 Move Bldg. O 42 Demolish (Foundation) ? 45, Fire Repair ? 33 Altera6on ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - 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 Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ Plumbing Foundarion HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fueplace _ R.I. _ Air Test _ Final Windows (new/replacement) _ Insulation _ _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ??...e,4VY1 iuv sc.ov rtu ?Od o!1 -4960 t(GOUSHAL:dS?°41YUtllG7iS11 re al ?? . rme '7, zool Citr of Eagan . 3836 Pilot Suob Road Eagets. MN 55122 To Whom It Maq Coitcern: Eldcr Jottes to ??? ?? b??g ?lts for Renewal by Mdnxsen. PIcase allow P?ide W. sorvicc for us in Hagan. `lhis endtotlzatitin is veiid for aay date beyond 6/6/01: uatii a 1ronawal bY Andersnn manaper mpmss1Y revakea it in wciting tq the City. ourr bu ? P??i ? hobc aacq?ted axpedidously. es to not delaY in the proCascing of contacted at ?63-5 Y ??cs. Elcaac caIl me If thc? arc eay questlona.. Y can l?e 02-4706_ _ 1, Your immcxiiatc aftntlon to tWs matier is adarac?atert. a . Sinceiely, ond R &-Pam uscallation Managcr Ranowal by Audersca CotPotativn C'r.: Kmn-F?Trier 7nne? CiH DNO(wy, ?C?q?qAL MI ,%kM.zom wVU Received Tiu Jun. 7. 1:01PM RESIDENTIAL - BUILDING PERMIT APPLICATION CITY OF EAGAN ?? Q? 3830 PILOT KNOB RD, EAGAN MN 55122 1 l 2) .?j 651-681-4675 ? Naw Construction Reauiremente • 7 registered sile surveys showirg sq. ft of lot, sq. R. of hause; aM all roofed a2as (20°b mazimum lat wverage alloaed) • 2 copies of plan showing beam 8 vnndow s¢es; paured Iwnd design, etc.) • t sel of Energy Calculalians • 3 copies of Tree PreseryaUOn Plan if lot platted after 711193 • Rim Joist OetaJ Opfiom selection sheet (Wdgs with 3 or less unils) DATE (PLS(o2 SITE ADDRESS r 61 TYPE OF APPLICANT R.modeBReoair ReauiremaMe . 2 copies of plan . 1 se[ of Eneqy Calcula6ons for heated additions 1 site survey for uterbr adCitions 8 decks . Indicata if home served hy sepUc system for additions VALUATION -C/220 STREETADDRESS CITY TELEPHONE 650b35-dZ5-& CELL PHONE #&0336?? 5)r- rlD' Fax # ?? - ?32 69C, (4_ PROPERTYOWNER 9' "Y-C, WU(k6A'WLA TELEPHONEA0O????&L Qa 7a- --------------------------------------------------------------- ---°-------------------°----- COMPLETE THIS SECTION FOR "NEW° RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINtiESOT:1 RL)I.F_S 7670 CATEGORY 1 MINNESOTA RULES 7674 (J submission type) • Residential Ventiladon Category t Worksheet Submilted • New Energy Code Workshee[ Submittetl • Energy Envelope Calculatlons Submitted Plum6ing Contractor: Plumbing system includes: Mechanical Coniractor. "vIechanical sys[em include•s: Sewer/Water Contractor. _ Air Conditioning Heat Recovery System ------- °-----------°-----------°---------° ------------•-------°-•----- I hereby acknowledge thot I have read this application, state ihat the with all applicable State of Minnesota Statutes and City of Eagan Or< Signature of Appllcant OFFICE USE ONLY _ Water Softener _ Water Heater ? No. of Baths _ Phone # Lawn Sprinkler No. of R.I. Baths MULTI-FAMILY BLDG _Y ?N _ FIREPLACE(S) _[ 0 _ 1 _ 2 Phone # Phone # Fee: $90.00 P'ee: $70.00 is conect, and agree to CeRificates of Survey Received Tree Preservation Plan Received _ Not Required _ - Updated 4/02 OFFICE USE ONLY ? 07 Foundation O 07 OS-plex ? 13 16-plex 0 20 Pool ? 30 Accessory 81dg ? 02 SF Dwelling 0 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - MuRi ? 03 Ot of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 42-plex ? 10 08-plex ? 18 Deck O 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower l.evel ? 24 Storm Damage ? 06 04-plax ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous 0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FoundaGon) ? 45 Fire Repair ? 33Alteration ? 37 Demolish(Bldg)• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolltion (Entlre Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Siuries Bcoeter Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addirion) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ A'u/Gas Tesu _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulatiou _ Retaining Wall Approved By Base Fee Surcharga 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 1986 BOILDING PERriIT APPLICATIOM - CITY OF EAGAN HOTS: ALL CONTRACPOHS MQST BE LICENSSD WITH THE CITY OF EAGAN SINGLS FANffLY DREI.I,INGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SQRVEY, 1 SET OF ENERGY CALCULATZONS HOLTIPLS DWELLINGS - R&SIDENTIAL INCLUDE 2 SETS OF PLANS, CER 1 SET OF ENERGY CALCUL9TIONS RENT9L 09ITS FOR SALB DNITS OF SQRVBY - CHECH AITH HLDG. DEPT.v INCLIIDE 2 SETS OF ARCHITECTURAL 1 SET OF SPECIFICATIONS AND t ENERGY CALCULATIONS, $2,000 LANDSCAPE HOND & STRUCTURAL PLANS, SET OF To Se Used Fo • o? Valuation: Site Address A Lot LL Block / Parcel Owner Address ? ?/- C/_Sv ??/?C City/Zip Code&,yy_.o-r..?' Phone Contractor Address City/Zip Code Phone Arch./Eng Address City/Zip Code Phone # (,?5''i OOd Date: Ereet V Oceupancy Remodel Zoning ? Repair _ Type of Const Addition # of Stories _ Move Length 42 Demolish Depth ?a _ Int.Impr. _ Sq Ft Install APPHOVAL4 FEES Assessments Permit Water/Sewer Surcharge Police Plan Reviect Fire SAC b Z • Engr Water Conn fjZS, Planner Water Meter (07 Council Road Unit 305, Bldg Off Treatment P1 ?30- APC Parks Varianee Copies TOT9L 5z NOT6: ADDRESSES FOR CORNER LOTS - CONTRAC?OR/HOMEOFiNER lIUST DESIGN6TS WHICH ADDRESS IS DfiSIRED. NO CHANGES WII.L HE ALLOASD ONCE BIIILDING PERMIT IS ISSQED. c?"?l / \ 1 `?' ? • ?Q? f O ? ? a `r?'-' ? ? d . .. 2-o x2_2. = ?46K f2 = J2?o ? ?. ((? ? (O (? k `? `------__._ ?o?4GU . op aosE ?y?uD ??5 leNGiNEft?ING CDHS1tli1N0 Eli61NEfA5 . PIpNNE9S nnd LAHP iUAVEYO!!S COM[?ANS?, INC. < 1000 [x57 (4b3A S7REET, BI)RNSYIILE, YIHHESOU 5SX37 p!i 4=2'3?pO ?eqcl -I.?-.scr? ?iorL• LoT /Z, BLOCK ; FAWN RiOSE 2N0 4DOITION, DAK07A CAJNTY, MINNESOTA C?ZS..T) 1.EN0TES EX1971N6 ELEVAT/oN (92 ?, 5 ) pEA/OTES pROppSED EGEV.4T/ON INDICATES pIiZFCT/oN oF SuRFACE DKAI"AGE 92783 = F/N/SHED 6ARA6E FLOD2 ELEVAT/ON O941n/A46 AND UTIUTY Eq5EMENT 5?y T. ?? " L/ t/7 r i -? ? / j N 88° 25' OS" Hr ii5. io -fi +_-aL? 5) L 5.d8a 627. Itp ! 7.5) ao l ?i o ? u 2z.og 30' FRONT BU/LD/NG SETQqCK L/NE m A /o pO N p ? . ? ?W S i -? 7G ial V'% ? s 1 8 ?? Apv? 8 4i W 5 , o4„4r fbA/D I Iz ScALE : 111= 30' _,. , . . _.......: , ._ I hertby caMify ihat thia ia a t: ue and carrect i•egreeeatition o! 4 'trtct of ? laad.a: ahovn'and_deacribed hereon.• Aa preparad by me on thia ?9? 2 - day ot No --Hinn. =_lteE. . . ,. - CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTS: PAYMFNf OF FEE AT TIIM OF APPLICATION DOES NOr CONSTI= APPROVAL OF PERhIIT. ------------------------------------- P ease Print 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: IF FJffST2NG STRCCISJRE, DATE OF ORIGINAL BUILDING PII2MIT ZSS['ANCE: ? ' ! (Nbn ear?- PRFSENT ZONING/PROPOSID LSE: ? COMRCIAI./Rh'PAIL/OFFICE ? R-1 SINGLE FAMILY . Q iMLISTRIAL Q R-2 DL'PLE}C (1Wo Units) ? INSTITi'TIONAL/GOVERNNENT ? R-3 TOWDII-IOIISE (Three + Units) ( Lnits) ? R-4 APAR7T=/CODIDOMINIUM ( Units) 2) ? F! NAME: r3oDxsss:-?3y?i ..,- CITY, STATE, ZIP: PHONE: V9 Z- lo G Sr? • 3) u r. ?• N?. D(! .. For City L?se . , Pltiunbers License: ADDRFSS: ?/Z ?3 ?Zt/ /5yJ . Active i CITY. STATE, ZIP: PHONE:/ .s9v- z ? s MASTER LI(ENSE# ,s'3Jy//f7J EScpired Not recorded t Inal ; 4) ?•. ..? ?..?.ia?: NA"E: S ADDRFSS: . CITY. STATE. ZIP: PHONE: . 'S? !? Y• ' i 1 M' • 71' G ? • \ ' pi ' ? CONNECTION TO CITY SEWII2 CONNFx`PION To CITY WATEEt OTflER '. . 6) '? ..??. Q PLEASE HOI,D APPROVID PEE2MIT FY)R PICK-UP BY ONE OF ABC)VE _...-- [7?-PLF.ASE MASL APPROVID PIItMIT 10 1, 2, C 4. AH(7VE . ?C ' (Circle ? ' 7) r r• •- ? s ,. - . ? ? it/ 7-7 ?? ¦ •?"u?? one) .- nJ7 IxsPrx.-riont oF sF.WM ANID/ox WAzaz Tr14f'A77ATTQp$ WnL NO'j` $$ $QHED- ULID UNTII, PERMIT HAS BEEN APPRaVID. . FOR CITY USE ONLY PERMIT # ISSL'ED O SZT -I Pd w/Bldg. Permit FEES: l $ $ '4) SEWER PERMIT (INCLDDE SURCHARGE) $ $ /??6 WATER PERMIT (INCLC?DE SL'RCHARGE) $ $ WATER METER/COPPERHORN/OPTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP +S $ / S?O Ci ACCOUNT DEPOSIT - SEWER $ O ACCOONT DEPOSIT - WATER $ d`?Z S ?-tJ $ WAC S sAc $ S TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRL'NK SEWER $ $ LATERAL BENEFIT/TRL'NK WATER 17-D •U v $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ ,iU o S J7` TOTAL / (i ln 5? ? 71.2- 9 2, RECEIPT RECEIPT DOES LTILITY CONNEC TION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES 2F YES, THEN A"PERMIT FOR WORK WITHIN POBLIC Q NO ROADWAY" MUST BE ISSL'ED BY THE ENGINEERING DIVISION LIS . T AS A CONDITION. SUBJECT TO THE FOLL OWING CbNDITIONS: / APPROVED BY: TITLE: DATE: .J?/6 /c?'7 Cities Di2ital Qualitv Control The following image represents the best available image from the original page. Every effort was made to capture the content from the original page. Hd9,@ ?,? 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V ti '.?': ? ? 6 .?? _ ? ._... ._ _ C? - . . ? n- ..9?,. . , w ... .., ..?? .... .. . . ? ? ..,. ?) . aILe Add ess: N1' .4'r' d—WA Li'L Tenant: la Suite RESIDENT /OWNER Name: i Vie, I V f((y 5 :i t f Address City Zip: 1 i° IN 1 all CONTRACTOR Name: ��,v iclie /"G tG;ik/7 C il d rid�/7 Li c e /1 --.L 2 Address: 9 y 7/LL/i >,U /i74 City: 7,4/73 Stater I N Zip:33 Phone: 5/" L// '77 Contact Person: TYPE OF WORK New Replacement Additional Iteration Demolition Description of work: NOTE: Both roof moon be screened by City Code. Planners s i 1 a V {Ci- 4 ed and ound mounted mechanical' equipment is required to Please contact the: Mechanical nspectoror one of the for information on permitted screening methods. PERMIT TYPE RESIDENTIAL Furnace Air Conditioner Air Exchanger Heat Pump Other COMMERCIAL New Construction Interior Improvement Install Piping Processed Gas Exterior HVAC Unit Under Above ground Tank Install Remove) When installing /removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add -on or alteration to an existing unit (includes $.50 State Surchar $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surchar e). TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation /removal OR Contract Value x 1% $50.50 Minimum (includes State Surcharge) If Permit Fee Permit Fee is less than $1,000, surcharge is $.50. If Permit Fee is $1,000, surcharge increases by $.50 for each State Surcharge Permit $1,000 Fee (i.e. a $1,001 $2,000 Permit Fee requires a $1.00 surcharge). TOTAL FEE I hereby acknowled e that th' f x Appl FOR OFFICE USE City of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 4 Pr id am e 2009 MECHANICAL PERMIT ApPJIC�nT N g sin ormation is complete and accura that the work will be in con torm pce with the ordinance nd codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without permit; that the work i be in acco .nce with the approved Ian in the case of work ich requir s review and approval of plans. ai r x Appi ignature Reviewed By: Rough In Air Test Gas Service Test Exterior HVAC Screening Inspection For Office Use Permit (--/-1// Permit Fee: l5 Date Received: C Staff: -'I Required Inspections: Under Ground Dat in -floor I-feat Final Date: City of Eta" 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: In/ ` / f I Permit Fee: Date Received: Staff: 1 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Unit #: J Name: VV -1 CNN a e, EA V2A 04 AN. V\ eb‘A. et- Phone: (7 - l S - FS' -I IA to Address l City / Zip: 7 S ( V -c.) c. Co_ta•n W h) 5 S /2-3 Applicant is: Owner /Contractor Desc option of work: /206-F7 » q - s i D ► h) (a - Construction Cost 3 t- i 4 i u = Multi -Family Building: (Yes / No Company: IA e -17Nlri lc � S ` Q eww,14 (yrs Contact: r6 v•-•14- ��nwt Sots 'on Address: ZZ 8 (0)Z t b Y� \� Oct WO t -y 1a Irl City: ()to. C tyq e State: 1A rA Zip: S.5-0 b S Phone: 710 3 — 'Z Z I - ) q S License #: � C Ln 3 4 336 Lead Certificate #: N PrT - Z to 3\ 1 -1 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes '/No If yes, date and address of master plan: Licensed Plumber Phone: Mechanical Contractor: Sewer & Water Contractor. Phone: Phone: 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.goaherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with h the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x 0J ; INCt..1" S o. Y\ Applicant's Printed Name x Applicant's Signature Page 1 of 3 Citi oiFaQan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: 1 Permit Fee: 1 .53 I Date Received: G q Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1 I l 1 Site Address: 7 l''f , � Unit #: ReSMerit/ Owner Name: GL–/ 74r°8-117/ f / 7 ! G ,l iv ,vF -- Phone: 6/ Z -?/-C- 8 44, '� / Address !City /Zip: 'T �t'7= / �_0ibs'�l") 5-5) 3 Applicant is: 1, -Owner Contractor Type of Work r Description of work: / u K / S A- 1)C e /C DD '-- Construction Cost: SOt . Multi -Family Building: (Yes / No _ Contractor Company: if / if Contact ZA/STM 741710E Address: -yri �'Z ` _ - 4 " - City: .S State: Zip: ,S-5-1 Z3 Phone: 6. / 7 71 ;— 847 License #: ---"'— Lead Certificate #: ------ --^If Ifthe project is exempt from lead certification, please explain why: (see Page 3 for additional information) r ak, CT 1 Pdt;z PP 1°1g1 1 In the last 12 months, Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public infort ition. Por+z� of the information may be classified as non-public if you provide specific r sons Biot would pb it the Ciiy 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. 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 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x / (i<'frs1lrt– �{� Applicant's Printed Name Ap licant ignature Page 1 of 3 74"l N ti -my take rJ DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Single Family __.._ Multi 01 of _ Piex Accessory Building WORK Tl E New Addition ^C' Alteration _ Replace Retaining Wail DESCRIPTION Valuation Plan Review (25%_ 100% ✓ ) Census Code # of Units Fireplace Garage jr-Deck Lower Level Porch (3 -Season) Porch (4 -Season) _ ` Porch (Screen/Gazebo/Pergola) _ Pool __. Interior Improvement _ Move Building Fire Repair Repair 3 oac7 311 # of Buildings / Type of Construction Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile _ Roof: Ice & Water Final Framing Fireplace: Rough In Air Test _Final Insulation _ Sheathing Sheetrock Reviewed By: _ Siding Reroof Windows _ Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous _ Demolish Building* _ Demolish interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant ,Gt'7 PD MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests _Final Siding: __Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings T Backfill _ Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Pian Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL lgKiibeQ /5 Page 2 of 3 7 ( /2/4y 1„.0(LL Q d. - ROBE ENGINEERING CONSUU Ha n HRS . pCAHNtRS codd LAND SURV SURVIVORS COMPRNY INC. EAST t462ti STREET, BURNSVILLE, MINNESOTA 'S.5S37 PH 432-3OOO CiMie ty zaacit jaurheit42252: L07 /Z, BLOC I, FAWN R/D6E "ID ADDITION, DAKOTA COUNTY, MINNESOTA CAST) £ At 7 'S (X/gT/Ng ELEVAT/WV (92 7' s) DENOTES .PRoPa5ED ELEVATION INDICATES O/kEcT/ON OP SURFACE DRA1 JAI.E 92783 = FJN/SHED GARAGE PLOO1 ELEVATION DR0NA6& AND 30' FRONT eau'/NG UT/UTY EASEMENT L.t. 1 -s N 88` 25'OB"W iis: ID 5ETS4CK L!A/E 627,Z) OM 5. °o ,1* en .30 %270 ��°a N D 26. as 1:$1r W X7.5) (275 1 , OD . t a 61-3:-e, slL fa 4.4 " \ 3v / a tri / /, 92 X 33) 0. OAK FWD goN) C9Z544t . I hereby certify that this is a true and coir: ct regraaerit=tion cif 'i tract •:01 Sand. as shown' and _described hereon. As prepared by„_me on this 'kiln, "diy of ..Ts uAlexi /09.61 5 89� 22' o4"E 5CALE : I": ,3o' BY: EAGAN REVI -WED DATE l.Z� 13IY Epi SI G rCT1ONS DIVISION