4571 Hay Lake Rd SCASH RECEIPT -'?
? CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DA7E 19
R6C61V6D ? t
FROM ?.a4AMOUNT $
,
& 40LLARS
+oo
? CASH ? CHECK
FOR ? 1 J J ./''• ,f? /? ???j
J ?
FUND CODE pMOUNT
L 0 ts L u G J
7 y'? : v U J
J? 2) Z Z?' G L)
91/ys 03
Thank You i ?
;
? f.??.
._: 63g07 BY ,
I
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEI V ED
FRpM
AMOUNT $ I
& OOLLARS
f0•Q
E] CASH 0 CHECK ` _•?
i i •
POR
=?'? i J. •• t
FUND COOE ANOUNT
Thank You
BY
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
- -.,aairilY
Addition /OVERHILL FARM
Owner //!wj?Z ,
f 4571 St Hay Lake Road
5treet
10-56150-090-02
5tate
Improvement Date Amount Annual Years Payment Receipi Date
STREET SURF. l Z 1981 310.74 15.54 20 -2 l7. 5[o CO //5D a.Z
STREE7 RESTOR. 1984 3243.64 64$.73 $ /eZ Jr D ? S? 2
GRADING 983 1985 1769.51 353.90 5 /o bl, 7/ 4fzg
Z
I
SAN SEW TRUNK 575 1981 359.28 17.96 20 ?. y.'Z. Q /Sn 27
89QtSEWER LATERAI & W3t. x1985 55n1 ,15 Z10 i.? i 5 ,00, s 0 ffsQ 2- 27
$i z.su sEa? TRx rAT BErr 1984 372.17 U. 81 15 a 97. 7 o 1'M 2-9,
WATERMAIN
WATER LATERAL 71 1981 172.42 $.()2 20 Q. 0 e? ?IS-0
WATER AREA 1981 359.28 17.96 20 B//S ID t Q Z7 .
STORM SEW TRK I 1984 714.39 47.63 15 671, S3 6o //,S'b ? z7l?t
STORM SEW LAT ?, 7I ?, 198/+ 128. 33 8.56 15 ' dd (I eO ?? f G
eSQ* SS L& Sexv e )t 198 ;
CURB & GUTTER
I
SIDEWALK I
STREE7 LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
Slie?
'? MECHANICAL PERMIT
RECEIPT #
?
az7 CITY OF EAGAN
3830 PILOT KNOB RDAD, EAGAN, MN 55122 DATE:
/
CONTRACT PRICE: PHONE: 454-8100
i Site Address ' 5 % / S u f 4;, !
`
BLDG. TYPE WORK DESCFiIPTION
Lot f Block Sec/Sub _
Res. New
Name Mult. Add-on
m Address
' Comm. Repair
?h
c City - ? Phone - er
Name FEES
A RES. HVAC 0-100 M BTU -$
ADDITI
NAL 50 M BTU 24.00
6
00
3
O ddress
City 'Phone O
-
(RES. HyAC INCLUDES A/C ON NEW .
_ CONSTRUCTION)
GAS OUTLETS
MINIMUM
1 PER PEFirA1T 1
50 EA
-
(
) - .
.
TYPE OF WORK COMM/IND FEE - ia/o OF CONTRACT FEE
Foreed Air M BTU APT BLDGS. - COMM. RATE APPLIES
` Boiler
M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
G Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU $ ? MINIMUM COMMERCIAL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERMIT -
PER
T PR
E
O .50
I MI
IC
GOES
Gas Piping
Outlets # YOND $1ppp)
BE
Other
FEE:
SIC: SI EE
TOTAL• I
FO : CITY OF EAGAN
?•-----?---?-
.
BUILDING PERMIT
To be used ror, SF
CITY OF EAGAN q t?
ot Knob Road, P.O. Box 21-199, Eagan, MN 55121 92
PHONE:454-8100
Receipt #
70
19
Site Address 4571 80 fiAY LAKE Rll Erect O X Occupancy g 3
Lat9 Block _ 2 Sec/Sub. OVERHILL Ftl"i j;opdel El Zoning H>
Parcel No_ Repair ? Type of Const.
Addition ? No. Stories
a Name BLILIE CO?ti7STRUCTION CO Move ? Length a?
Z S _ I CT Demolish ? Depth
3 Address Int Im r? 54. Ft
0 ?'?i1tjH+' P ?
City - 'Phone 454-1438 Install ?
Water & Sew.
Police
Fire
Eng.
Planner
I hereby acknowledge that I have read this application and statethatthe Bl9. off. 5/118 6
information is correct and agree to comply with all applicable State of
MinnesoYa Statutes and City of Eagan Ordinances. APC
Signature of Permittee i o/ A.? Var. Date
iHSTRUCTL CO
Surcharge 35.00
Plan Review 171.50
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit 290.00
Tr. Pi. 156,00
Copie
Total $2, 1 4, if J
A Building Permit is issued to: BZ+ILIE CO - 0&V on the express condition that
all work shall be done in accordance with all appjicable State
and City of
an Ordinances.
1 I PrrmN No. I awmtt Holda. I o.to I TNephons M I
Piby.
Occ.
Ftg.
Disp.
MECHANICAL PERMIT
• CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
PRICE:
Site Address -
Lot _j
? Name
? Addre
? City L
Name - ?Y
c Address
?p City< ?? -,?--?-- Phone`
TYPE OF WORK
Forced Air M BTU 2
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets # ? / S o
Other
' FEE
? S/C:
TOTAL•
00 II
PERMIT #
RECEIPT #
DATE: ??_
'BLDG. TYPE WORK DESCRIPTION
Res. ? New ?
Mult Add-on
Comm. Repair
Other
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMMIIND FEE - 146 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYQNq $1,000.00) ,
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
CONTRACT PRICE
Site Adc?r,ess 51-6
Lot Block
'?v- , 'i
? Name ? '% "
.51 Address 6;
c City
Name ?
3 Address
o ciri ?
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S!C !F PERMIT PRICE GOES
BEYOND $1,000.00)
OF PERMITTEE
FOR CITY OF EAGAN
PLUMBING PERMIT
GTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
PHONE! 454.8100
PERMIT #
RECEIPT #
DATE: _
BIDG. TYPE WORK OESCRIPTION
Res. New
Mult Add-on
Comm. Repair
Other
NO FIXTURES
? Water Closet - $3.00 TOTAL
s '
?Bath Tubs - $3.00
? Lavatory - $3.00
,LShower - $3.00 1 ?
? Kitchen Sink - $3.00 '
Urinal/Bidet - $3.00 _
I Laundry Tray - $3.00
/ Floor Drains - $1.50
' Water Heater - $1.50
Whiripool - $3.00
/ Gas Piping Outlets - $1.50
'
Softener - $5.00
weli - $10.00
Private Disp. - $10.00
?
"
Rough Openings - $1.50
FEE t'
3TATE S/C:
GRAND TOTAL:
Phone
r
BUILDING PERMIT
?
Ta be used for
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt #
;1,OOU
Site Address 4571 a NAY LAKE RY3
Lot " Block l SeciSub.?')VERHILi. FAJM 1S'
Parcel No.
W IName ?? & ? p?ExSON
3 Address 4571 S IiAY WIPCE RU
° City EAGl1N Phone 4 54-017 C !
o Name DAVII? SP(1NSEL
?Q Address 450 S HAY LAKE ItD
? City LAt°AN Phone 4 Sb-G81 R
Name _
Address
Phone
I hereby acknowlege that I have read this applfcation and state that the
intormation is correct and agree to comply with all applicable State of
Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Permitee
A Building Permit is issued to: j'^v EU
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
.
OFFICE USE ONLY
Occupancy - FEES
Zoning -
(Actual) Const - Bldg. Permit ??•?
(Allowable) - Surcharge • ?'
# of Stories
Lengih 2iW6 Plan Review
Depth SAC, City
S.F. Total - SAC, MCWCC
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System _
_
City Water Acci. Deposit
PRV Required S.NV Permit
Booster Pump - S,'W Surcharge
Treatment PI
APPROVALS Road Unit
Planner Park Ded.
Council ?
'
Bld9 ? _ Copies
1°?'?
Variance - TOTAL
Permit No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Dete Insp. Comments
Footings I
Foundation
Framing
Rooting
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Const. Meter Plbg. Inspector- Notify Plumber
Engr.lPlan
Bldg. Final
Deck Ft9.
Deck Final
Well
Pr. Disp.
CITY OF EAGAN SEWER SERVICE PERMR
3830 Pilot Knob Rwd
P. O. Box 21199 PERMIT NO.:
Esgan, MN 55121 DAT'E;
Zonirg: No. of Units: -
Owner:
Address:
SJte Addresv
PlumbGr.
1 Mm h, tIr wft !M G!y of le"w
OdiMnew
By
Dote of Irup.:
67 S [M..rl
Pem+it FM:
Surchorpe:
Misc. Charpes:
Tdd:
Date Pold:
? CITY OF EAGAN INATER SERVICE PERMIT
3830 Pilot Knob Road
I P. O. Box 21 i99 PERMIT NO.:
' Eegan, MN 55121 DATE:
Zo+ir+D: - No. of Units:
,, -
pwns?:
/lddrass:
? SHr /lddrcst: 457? YuuLi' - : _ ?, -- ;r' ? ---?..
- - -
Plumber. -71 -
Meur No.: ConnecHon Chorye: ?
Slze; Accou,n Oeposit:
Rsodar No.: Permit Fee:
1elm le oowplp wllr tlr Qhr oi LAW¦ Surcho?pe:
OrilMwas. Misc. CFarpm
TotoL•
By pote Poid:
Oote of Irup.: Insp.:
; CITY OF EAGAN
3830 Pilot Knob Rwd
; P. O. Ba.; 21199
' Eagsn, MN 55121
Zonlnp: i
Owner,
llddrom
Sits Addross: - l T '
Plumbar: 7 t -
Meftr No.: 37° LZ2
Stza: c f?
ee oa.vy whh +b.
I nsp..
wwrEx sEvIcE PERWr
PERMIT NO.:
DATE: ;
,
No, of Units:
'on5t.
L9 B2 E'verhill Farm
' - e
i ion Chnrge:
,gWcA0il?t ?Nposir•
? Fw
?
Total: m,
-Dote Paid:
g." 6 - g?
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
• PHONE:454-8100
BUILDING PERMIT
Receipt N
N2 11892
Tobeusedfor SF D47G/GAR EslValue $70,000 pate 19AY 5 ,1986
SiteAddress 4571 50 HAY LAKE RD Erect 13 Occupancy R3
Lot 9 Block 2 Sec/Sub. OVERHILL FARM 1$Wnodel ? Zoning &l
Parcel No Repair ? Type of Const. Vn
. Addition ? No. Stories
BLILIE CONSTRUCTION CO Move ? Length 47
? Name
? Demolish ? Depth 38
; Address ?
? mpr.
Int. Sq.Ft.
Ciry Phone 454-1438 nsta
I ?
o SAME
Name
0 a
Address
:
?
Ciry
Phone
.Q
w w
Name
z
? Address
a W City Phone
I hereby acknowledge that I have read this appl Ication and state that the
information is correct antl agree to comply with all applicable State of
Minnesota Statutes and of Eagan Ordinancesn. ?
5ignature of Permittee ' '?, G"P
A euilding Permit is issued to: BLILIE CONSTRU ON
all work shall be done in accordancev all 'licable State f Min s8uilding Official ?
Assessment
Water & Sew.
Police
Fire _
Planner
Council
Bldg. off. 5/1/86
APC
Var. Date
Permit $ 343.00
Surcharge 35.00
Plan Review 171.50
SAC 575.00
Water Conn. 5 0 0. 0 0
WaterMeter 63.50
Road Unit 290.00
Tr. PI. 156.00
Parks
Copies
?
T..._I 4 G!
1-)'S . V O
CO on the express condition that
5tet-utes and Ciry of Eagan Ordinances.
S? CITY OF EAGAN N9 16695
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # ?? f?\ ? ? L f C
G• ? 7 ?
To be used for DECK Est Value $1,000 Date JIJNE 23 , 1989
Site Address 4571 S HAY LAKE RD
Lot 9 Block Z Sec/Sub.OVERHILL FARM 1S
Parcel No.
W IName MIt & MRS PETERSON
?zc o Address 4571 S HAY LAKE RD
City EAGAN Phone 454-0701
o Name DAVID SPONSEL I
gp Address 4567 S HAY LAKE RD
? City EAGAN Phone 456-0818
? W Name
?,-? Address
aw City Phone
I hereby acknowlege that I have read this application and 5[ate that the
iniortnation is correct and a ree gto comply with all applicable State oi
Minnesota S[atutes and Ci " f Ea aq?prdinarl6es.
Signature of Permitee ?? %?:jh?se??
A Building Permit is issuetl to: 11AAVID SPOPSEL.
on ihe express condition that all work shall be done in acwrdance wilh all
applicable State of Minnesota Statutes and City oi Eagan Ordinances.
Building O(ficial
Occupancy
Zoning
(Adual) Const
(Allowable)
# ofStaries
Lengih
Depih
S.F. Total
S.F. Footprints
On Site Sewaga
on site wan
MWCC System
Ciry Waler
PRV Required
eooster Pump
APPROVALS
Planner
Council
81dg. OH.
Variance
OFFICE USE ONLY
_ FEES
24ct6
lZx4
Bldg. Permit
Surcharge
Plan Review
SAQ City
SAG MCWCC
Water Conn
waler Meter
Accl. Deposit
SNJ Permit
SNJ Surcharge
Treatment PI
Road Unit
Park Ded.
Copies
TOTAL
26.OD
.50
wr.
.50
Z7.OD
?3ydO /SS
M 5 614 8L 9 i3 ,9
Request Date y, -
?_ y? O Fire No. Rough-in Inspeclion
Repuired?
VReatly Now ? Will NotiFj Inspeclor
Wl
P
0
7
W Q O ? Ves J?Tlo ian
ea
y
IX licensed contractor O owner hereby request inspection ot above electrical work at:
Job AGtlress (Stteat B? or RoNe No.)
?
? Ciry
? <4-G f1 tJ
,s ? t s, /
Section No. Township Name or No. Range No. Counry 1-k
?
OccupaM Ptrome No.
yt
? J -P h „5 d ?
Power $upplier Mdress
Electn onVactor (COmpany Nama) ` ContractorB Lbense No.
Maling AAtlress (COntracfor or Owrrer Ma?klingrI7anlallation)
127 s??J iC /Y L-1--
/-G V Gb //2
Aufh ' gn (Contr tMaki stalla[ion) PhOrre Number
Y
MINNESOTA SA BOARD OF ELECTNICRY THIS INSPECTION FEQUE57 WILL NOT
Griggs-Mitlwey BWg. - Hoom &173 BE ACCEPTED BYTHE STATE BOAFD
1821 Univeniry Ave., &. Peul, MN 55100 UNLESS PROPER INSPECTION FEE IS
PM1Ore (812) 643-0800 ENCLOSED.
8'/`??/?p ;EeQUESToFO REP EOTIRI?CAo b?SPECTION ?- ee-aoam-o7
?
? 56 14 s `X" Below Work Covered by This Request
e Add Rep. Typeof6uilding AppliancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. 8uilding Oryer Other (Specity)
Comm./Industrial Furnace
Farrn ' Alr Conditioner
Other (specify) Comrector5 qemarks:
Compule Inspection Fee Below:
# Other Fee # ServiceEMranceSize Fee # Circuits/FeeOers Fee
Swimming Pool o to 200 Amps 0 to 100 Amps
Transforrners Above 200 _ Amps Above 700 _ Amps
SIgnS Inspec[or§ U. Only: TOTAL
Irriga[ion Booms f
Special Inspection
AlartnlCommunication (?.
Other Fee y
I, ihe Electrical Inspector, bereby
ce
tif
th
t th
i
i
b Romyndn oam
y
a
e a
ove
r
nspect
on has
heen made. Final
OFFICE USE ONLY
This request wid 18 montha Irom
1il II III?I RE4UEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Elec[ricity
1821 University Ava., Rm. S-1 8, t. Paul, MN 55104
*I2 5 5 34 4* ahone (st2) saz-oeoo ?j??(o °?-'-
g Home Duplex Api. Bldg. Other: New Addn
Commercial Indusirial Farm Remod Re ir
Air Cond. Htg. Equip. Water Hfr. Load Mgmt. Other.
Dryer Ran e Elec. Heaf Tem . Service
"X" above the work covered 6y fhis requesL Enler remarks in Pois space and on the bock of the white copy only.
wire whi.r.lpoo7.
Calculate Inspection Fee - 7his InspecM1On Request will not 6e occepted wifhouf the correct fee:
Ofher Fee # $ervice Enha?we Sae Fee S Grails/Feeders Fee
Mobile Home Park $tall 0 to 200 Amps 0 to 100 Amps
$}reet Lig./(raffic $ig. Above 2( 0 Amps Above 100 Amps
Transformef/Genefotor INSPECTOH'SUSEONLV L
Sign/Outline Ltg. Xfmr. q
Alarm/Remofe Control ) 0
f
Swimming Pool N?e dahs smrod
I hereb cerfi thot I;n: eckd e I al ins ?
Irrigation Baom Rovgh-In ' - 4
Do C?^
Special Inspedion ?
?
Investigo}ive Fee Final dktl ? 1
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 18 MONTHS
2 5 5- 3 4 4 41 _7A??j7?/ T OFyFlC/g??USE/?Q NLY?his requesr vaid 18 manths fmm validallon dote prinkd in V Ih?is?o/yw&
v?
n I?•An ?,. OD
?
PLEASE PRINT OR TYPE l?'AeR.U.1.YX '
Re9
CP?b 1/ 96 Rough-i inspetlion reqoired2 ? Yes 0 N. Impedion Other Than Roogh-In: p Ready Now 0 WII Call
?You musl coll ihe iapedor when reodyj Dale Ready: `?
I, 55 licensed conhodor ? owner hereby request inspedion af fhe a6ove eleciri<al work of:
kb Address (Sheel, Box, or Raok Na.) Ciry Zip Code
4571 So. Ha Lake Rd. Ea an 55121
Secrion No. Tawnship Name or No. Ronge No. Pire Na. Counry
nqknt-n
Oaupon} PMne No.
Power Svpplier Addren
• W. Farmin ton
Elednml Confmcror (Company Name) onhanor 4cwsa o. Mmkr Lic. No. (Plant Elect Onlyi
Joos Electric Co. CA00961
Mailing /ddmss (Contmcror or Owier Performiig Inaialianon)
3980 Beau D' Rue Dr. Eagan MN 55122
AuManzed Siqnowra (CoNmcror ar O»nr Fedorming Ins ion) Phone No.
EB-OOOOlA-106195 STATEBOMOCOEII?SiEUCT10NSONBACKOFYELLOWCOPY'????QQ,
This reques[ void `
e months from _C7?
? 082139
Reques't Oale ? Fire o. FouPh-in Insper,[ion
'I , ?? ?? R.epuired? nN ?HeadY Now Will Notify.lnVpe.o-
? ?O "? ?es r When Nead
?'licensedElecVical Contrector , I hereby request inspection of above
BOwner electncal work installetl aY
Sveel Add,.ss, 6oz p[ Rwie o. CitYi!
ecuon o. Township Name mQP- flange No. County
Oc. nTt RWTI
FeIVL?
Phe Nn. - [ ?r
P r POIi r ?? Atldr
EI Con actor ompany Namel var.tor's License No. '
6
-7
?
MailinB' ?Adress 1 tractor or Own r Making Instailau,m) ?33
L aYC.?
.QU[horized na r ?Contracmd ner aki 1 stalla[i n) Phone Nom?bqe.r
- U `- ? ? Ok1
p
MINNESOTA S E BDAA? OF ELECTNICITY THIS INSPECTION flE4UEST WILL NOT
Grie9s-MiAwey Bldg. - Floom N-191 BE ACCEPTED BY THE STATE eOARD
UNLESS PROPER INSPECTION FEE IS
.1821 University Ave., St Paul, MN 56104
Ph -w (812) 29Z2117 ENCLOSED.
,-. 1?' .?.._...' _.?._ ... . . .
REQUEST FOR ELECTRICAL INSPECTION EB'°°°°'-°"
'V C;01 " See instructions tor completing this torm on back o1 Vellow cooV. ?-7
? 82139 " X"" Below Work Covered by This Request
tld ?ep. Type o1 BuilEing Appliancea Wired Equipmen! Wired
Home Ranye Tempoiary Service
Ouplex Water Heater Liyhtiny Fiz[ures
Apt. Building Dryer Electric Heatin
Commercial Bldy. Fumace Siio Unloader
Industrial BIAy: Air Conditioner Bulk Milk Tanlc
Farm innr Soea v Umc, (sp,.tfy)
t yr Specify O! er Othcr
Compute Inspection Fee Below
p Fee ServiceEntrencaSize tt Foe Faeders/SU0leederx # Fee Circuits
0 to 200 Am s 0 l0 30 Am s L . 0 to 30 Am s
Abave 200 Ainps 31 to 100 qmps - 31 to 100 Am s
Swinvning Pool Above 100_Ainps Above 100_Am s
Transformers Irrigation Boorr?s Partia6'Other F
Signs Speciallnspection $ ?
TOTAL F
Rem3rks - ?//
t? ?P
Pough-in ?..... ?ye I. tha ElecVical
? Inspectoq here6y
certify that the aAove
Final )
C
' ???rtw
?? - spection has been
a du
v
?
i Q .
Tfiis requesl voitl 18 monltie trom
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
1 3830 Pilot Knob Road, Eagan MN 55122
io,)- %--- Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reoui2menls RemodeVReoair Requirements Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. R of house; and all roofetl areas 2 copies o( plan Cert of Survey Recd _ Y_ N
(20%maximum lot coverage allaved) 1 set of Energy Calculations for heated addiGons Tree Pres Plan RecG _Y _ N
2 copies of plan showing beam & window sizes; poured found tlesign, etc. 1 site survey for additions & decks Tree P25 Reqd _ Y_ N
lsetofEnergyCalculations Addifion - indicateNon-sifesepticsysfem On-siteSepticSystem _ Y _N
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Defail Options selection shcet (Wdgs with 3 or less units
Datelc? / 17
Site Address
??e? / 0-3 ConstructionCost ?5?n0• Od
-1*1 {I' L.a/z f?UCtc!` 5 UniUSte #
Crr1 /?7rv .55 /c73
Description of Work
Multi-Famity Bldg _ Y? N Fireplace(s) _ 0 J'?1 _ 2
Property Owner IjebiZ"{ L , Telephone #
Contractor
Address
State
Zip City
Telephone # ( )
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
• Residential Ventilation Category 1 Worksheet
('J submission type) Submitted
• Energy Envelope Calculatlons Submitted
Have you previously constructed a buiiding in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Y_ N If so, 25% plan review
Telephone #( )
Telephone
Telephone M,li QFf?Y
I hereby apply for a Residential Building Permit and aclrnowledge that the inforWkiaxtis=csmi?tete-and=hccurate;
that the wark will be in conformance with the ordinances and codes of the City of Eagan and the 5tate 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.
/?d)ia L , /,?ei-sov? ?&, x, Q?Gla?
Applicant's Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y w_ 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 (Bidg)' ? 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement *DemoliUon (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
_ Foorings (new bldg) FinaUC.O.
_ Footmgs (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
_ Fireplace _ R.I. _ AirTest _ 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
*?***?************Y%Y?FxxxFxrxnn????......
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 012
DATE: 04/14/00 TIME: 10:15:03
ID:
NAME: THOMAS & DEBRA PETERSON
3210 9001 4571 HAY LAKE R
2155 9001 4571 HAY LAKE R
Total Receipt Amount:
?)e3-71
181.25
5.00
186.25
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
r. •? 3830 PILOT KNOB RD - 55122
851-681-4875
? 3 reglalered flfe surveya ahowlnp eq. tt, o( lot, aq. M. ol house
antl gp rooled areas C2QX, maximum lot coveraae ailowa0f
> 2 coplea oi Plans (ahow beam & wlndow alzes: poured Intl. tlesign; etc.)
? 1 se10l anergy catculaflona
? S coples ol hee pretervatbn plan II lot plalted aHer 7/1 /99
DAlE: Ar)Q I L / U i 2 D a p
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: --1-
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
yS7r
OLoG 't SC2EcN
So. N,9 V LAL-G
BLOCK: ? SUBD./P.I.D. A:
dv Goo D
Name: 1"C T02 So4,/ %I-foMAS Phoneg: Gd!- `i?`/-d7d?
Lasf Flrst
Sheet Address: `7/S 7 /
Clly E'AG P9nJ
D4O
State:
m A--,
zip: 6_?F ? 2 3
Company: S EL F Phone i:
(area code)
Slreet Address: Lkense N Exo.
Gy
Sfpte:
Company: Name:
Telephone M: ( )
Skeef
Cfly
State:
Zlp:
Lp:
Sewer/water licensed plumber (H fnstallina sewer/waterl: Phone #: (?
an app6cabie State
I hereby acknowledge ttwf I hwe read this appikalbn, sfate Mat 1he Infortnatbn fs cortecf, and 7777
of Minnesota Slafutea and Ctty ot Eagan OMinances. ?? ? Signafure of Applk
ant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes V No
Tree Presenation Plan Received _ Yes _ No Not Required ? O
?
Z 9 ,?z?'
-90. l??l Y 29
? 186.25
C'allec? 1??11/bD
2 caples W plan HYY%
1 set of energy cdculaHOns for heated addlHOna
1 aite wrvey tor exferlor adtlitlons A decka
CONSTRUCTION COST:
P'3 2 ? 1-4
ReglshaHon #:
OFFICE USE ONLY
. ?:
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 OSplex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext Aft - Mutd
? 02 SF Dwelling ? 08 06-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Att - SF
? 03 01 of _ plex ? 09 07-plex A 18 Deck ? 23 Poroh (screened) ? 36 Mutti
? 04 02-piex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg _Yor_N ? 25 Miscellaneous
? 06 04-plex O 12 12-plex ? 20 Pool ? 30 ' Accessory Bldg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
X 32 Addition ? 37 Demolish (Bldg)• ? 44 Siding
? 33 Alteration ? 38 Demolish (Inte(or) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code _[P # of Stories sq. ft.
No. of Units
- Length sq. ft.
No. of Buildings ? Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable)
UBC Occupancy M in level sq. ft.
sq. ft. ? MC/ES System
City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building ?•? Engineering Variance
Permit Fee Valuation: $ O m 0
Surcharge
Plan Review
License
MC/ES 5AC /
?fJ? L E'F a t/?
/
City SAC
Water Conn.
Water Meter
Acct. Deposit 4, /
Z.?L-
S/W Permit
S!W Surcharge - --- - -
Treatment PL
Park Ded.
-.
9 S"?2 D
TrailsDed. 343•00+
Oth@f 35 • 00+
Copies 171 •50+
i 575-00}
Total: 5 0 0• 00+
63•50+
SAC Units 290 • oo+
% SAC 156•00+
2134•00#
• .GoT ?t3La?/C Z ?v'?,?l.?l F?ar? r ?•¢-?Sf'
PLOT PLAN Scale -1 inch -20 feet
y
'1"_.._.
,7W
:{
Q = :?,:::- - -- - - _ - - - - _- '-r : - ' -- - - _ . :'
i -- " - - - '
- 1 '
_, - -- ___ - - - - -- =
? _ _
--
S _ __ : _ - - -- - - - - -
)loz _--
__
r -'
? ?i8
-- -
- -
-- TEE
--
=
..
S .?
?8
1
? --
- - - ? -
- - - _.
)yo _
_
=
7-7:
- =,
-
?
?:
_ -
- - -
- --
- :.,.. = -
-
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_ -. y
-- :
- ? -
` :_i ?- - _- -_
? --?
t
- _ ?_
"' - - .:
;. - - - - - . - -
' -
--
,w -
RNE
?"I?.-, : -:.t---t--?-' `?" • _}-'}--?-''-?? ? ??`?.: _-? -?
Must show location of streets, lot and proposed buildings, give lot di
are to be staked before appraisalis requested.)
--?`-?-•r---r-n---r-^-r""n
(Lot corners and buitding site
-
?
.,, ,. _. ...
. . .:.. . , 4 , ^-v
.:?,. .. ?.. _ ..:?. .r
.
. . " .. ,F .:<l? , (. .d .•-? w' _ r+ ._ i" ?r . .Li.'... YJ .?...'.-.. . 4}r' %'}
. .._ ...... .-. .. ?l. ..: t; .. r. . .?- ?
1
1986 BOZLDING PERlIIT 9PpLICAYION - CITY OF EAGAN
HORB: ALL CO9TRACrOES MIJST BB LICENSSD IiITH THE CITY OF EAGAN
SIBGLE F9lIILY DHELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
M[ILTIPLS DiiSLLIAGS - 9ESIDENTIAI, gENTAI, ANITS FOB SALS DNITS
INCLUDE 2 SETS OF PLANS, CSHTIFICATE OF SDRVER - CHI?CB iiITH BLDG. DEPT.,
1 SET OF BNERGY CALCULATIONS
COrMERCIA[:
INCLUDE 2 SETS OF ARCHITECTURAL
1 SET OF SPECIFICATIONS AND 1
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For:
Site Address 45 ? / S-. J4? t4
Lot ? Bloek -a
& STRUCTURAL PLANS,
SET OE
7UCCO •
Valuation: :
1?4=
Pareel/Sub (,)VPi, yi//
Owner 4 44 yG7ti-
Address
City/Zip Code
Phone
Contraetor (3
Address
City/Zip C o d e
C 0?-•'
Phone Cf 5 ?r- / L( 3 ?j
Areh./Engr.
Address
City/Zip Code
Phone 0
Date: '--f z S ' 9(O
Erect ? Occupancy R-3
Remodel Zoning
Repair _ Type of Const
Addition # of Stories
Move Length
Demolish _ Depth 3
Int.Impr. Sq Ft
Install
APPROVAL3 FSES
Assessments Permit 5r
Water/Sewer Surcharge 3?5"
Police Plan Review /7l.50
Fire SAC S7S
Engr Water Conn }SG?O
Planner Water Meter 6'3 ?°_
Council Road Unit ?
Bldg Off-
Treatment P1
?
APC Parks
Varianee Copies
iOTAL ':;? 13r
NOTE: ADDRESSES EOR CORHEB LOTS - CONTRACiOR/HOMEOfiNfiR MQST DSSIGNATE iIHICH ADDHfiSS
IS DESIRED. NO CHANGFS ftILL BE ALLOiiED OACS BIIILDING PERMIT IS ISSOSD.
1Z ?czz = Z?'?
I z x ? ? _ \ ClZ
?X18 ° t4?-
? k \3 =
Z 4 x ZZ =
vyZV ? \ Z -
-, t? (?ZqrD--f c'o .
:?
n- )1&C
3 }99'
e ; )ozs
O ??QZS
g$ s
? } 90 ?
(4)EQ -
' .(?oT 9 .Cg1c>c?L '? (9!/'-e-I r
PLOT PLAN Scale - i inch - 20 feet
_ .__ _ __. . _ _ .. . _ _r ... __ ,... .. ... ._. .
?_ 1-. 't(-[ ? •f,' ' 'i ''? K ' ? ? -^j'' ,.?rt
. .. ?+_ ' . ?. ? .. __ - -.. _.. _.__ .__.. ... _ ..._.. .., .. .
,
Must show location of streets, bt and proposed buildings, give lot dir
are to be staked before appraisal is requested.)
:- p r7 :=-T:'?-'•?'•.?t+•."i ? '
(lot corners and building site
a? ,?r .?M::' ?? r dE:'J 'S•.i':,r, .
? : ;L • .,? . ,. _ _
. . ?• ? ? ? y • ? , ? ..y. ? ? ? e? ? f .
w EXTEi?1O? f.tNELOFE IIVEPAGE "b: COtaPUTATiO7t
?, s . . r . . ,.
? ''• i°-•ea ? . ... ? A
T 014NEib .. . .
?,.. . '. , _
?,,..
SITE ADDRE55
?. .
r, CONTRACI'OR •?1/E ?fT ' DA7E 6?'/EY P}IONE. 5W
?:.,.
F4?
2.
?. ..
Determi#e mrNing square footage of each.
Tota}•expds d Vu1fi area ..... .2252.33 sq. ft
TQtal roof/cei}in? area „ sq. ft
x •? _ ?,
. au
x
,
TQtal exposed wati arsa aboye floor
a. Total wa71 wipdow area :..........:...... . ,224
b. Total door area .....,....,....................... 37,17-
c. Total sl iding g}ass. door irea .... . . . . ... . .. . .. .. . -7370- -
d. Tot31 fireplace:t?ral:l area....... . :.......... . ?p
e. Total wal.l Pramirtg arek (average lOA) ............. ,)03,z;
f. Total net:'irall area abovd floor .................. /
g. TotaT riar joist ar4 . .. .................... S o
? Total ezposed faundatzcn area = 96.33
h. Total foundation window area ...........:......... -
i. Toal net foundation area abcve grsde ............
Deternine "U" value of each wall segment.
a. _') 21o g IV„
' 6. 7 7
X "U"
C. ?JQ X „u„
d. ag X llull
e. ???•.Z X ,iu„
93 sc>
N
.0 9 = -29
f. /SOS.o3 X Hu° (6-2B
9. /30 x IOu° •s?! _ ?.2g
i. 90,33 x„?„
3.........:;y ..........................Totai
If item 013 is tlte same as, or less than item ,u,l, y-h3ve-fiet ihe intent
Of SOC 6008(c)2.
.. .
1 .
?^ ' . .. . . . ; . . . . •'r . .. .?':.-?. . :? .' 1
! ?.• a . . ' ' .J ?1' .. ' _ . ?
1 . , Y.
i .. ' ' ' . ' . 4 .
1 .i? •
; ?' •, Total exposed ronf/ceiting area = /30 ? • •
" Tetal skylight area.............................
-
k. Total roof/ceiling frzming area (average lOS):.. /?p, y
1. Total net insutated roof/ceiling area........... 1173, (.
' Determir,e "U" value for each roof/ceiling segment.
, j X liull _
? k. ?.30.,?/ X"U" , 02G = 3 39
?.
? . 1: //73•G x ,.ui.
4................................... Total .'7 '.?
.??
. If total of 14 is the same as, or less thzn.=2, you have met the?intent of
S6C 6006(c)l. -
Alternate 8uildirg Env=lop2 Design
io utilize the total envelooe systen ra.?od, the values?established by the
sum of 4t2ms '3 and ;'4 shali not be greater than the sum of items A1 and a2.
+ z. 33. 90
s. ?27, + a. ,3?. ??? _ ?6a,Of ;
,
- ,' .C-.` _..? ?H•?,,, ? ? r.. d-'
, , ? ??' .; ±l? ?
, . %J,• r,r:' .:?GOu. ?.-A.?{j? ?$?7:
;
? '. _.
'
i?? . .
??..
C. ?
?
a .
Venced
.... . ; : .. , . ?
xoor/csiiiNC • • ?
f? ?"? Conalruction a-V,tuc
4 ..
air fi
3 r? 1. Intcri r lm 0.61
' . S?
ylr,i;??.'ri?? 3. /O? 6r&,'1L#T5 • ?Il,?l? ;'1•,~?,ii41?I??(?? 4. Extcrior air Yilm (.^•tti1)
U?
.G
Totai 3q ?
tleec floca
up •
FIG. MS •
t I .
! 1 Y.eaE iloti up vented
?
FIG. M6
?
1. Interior ai film 0.61
2. /
3.
4. Er.tczior air?lm still'??
Tutal
Tusidc air tilm / 0.61 0
• - Z. .
77.
? A. ?
5. Outsid .ir. Film 0.17
TOta
` . .
t . -.
?: .
Ii.olc:' Usc additionnl shects if more spacc iS
nui?-t a.?e ??.1v
t,> ' .. ?• aeodecl for details and calculutions.
Hast ' • • -
. flow uP • •
. ? lT.f., ?07 . • ?' ? . ' ? ? ..
Y? ? T
.
?_ _ .
? p` _...-. :.. _ .
VME•: 'uicc 15% of cymqttc va11 Ii'r? fer' F
. lsame constSti+etfon
! ? ( - -----0
BASIC ?
VALL `?` ---?
?.:.
Tnpvieta OF•
FAdrLE . i'1AI.L
,_u
??41.y a? .•,?? ti,. ??? ?.: ? ,. . ..
? ?'?. - ?+ ' . r? .
'
.. . . ,..
? " ... .
i
'.
. _ *': ° - •
?. ?,, •
" ?
Con?iruet4en ?-?aloc
'-
; .. r
1• ?
f ?
;i
4. z
j
a
{?;?j !_(Fl1LG
z
'
'
T? - -?z
6. Extcri---r air film = G.17
----- ?;L,i 10-91
Q.r ,69
i. Intcrior air fi'.n; 0.68
2. I', wv
3• '''L--------- ? ?fo
4. Z z 7/4;, Znl ?. GoG
arir! _ ;
5. i ?.Z
6. Sxterior ir fil.r+ 0•17
zocdl z3,o3
a- ,oy
; S?tL ?Se?C:
1
?car,»'zcx
i-/..
1. ,
Intezior air film
_ 0.68
2. ./3Q1 010
3. / '.kf" v /.B8
4. 2 cr " ?.OG
5.
6, SRterior ir film 0.17
Totol
4= , oy
1. Intcrior air fil.m O.GB
2. /" 7PsArTY S. ?G
3. /?'
4. "
S.
6. Exterior air film 0.17
motal 7 ?9
!C= ./!V
SLAH ON GRADE
• • r •
? - ?
,c
, fIG. #3
i,
? v
'..K
?-•-.??? • , • ,a -
~ J(( ? . ' ?
/[I • ?. I(I
FIG. I{4
f
O
= ? • ,.
K?/ll _ 1rr = u, _
NOTE: Indicate ty,oo, "•^•" vnlue, deqth and:;.,
plaecnent oi Snsulation.
1989 B[JILDIPG PERMIT iPPLICATION
CTTY OF EAGAN
SIIiGLS FAMILY DiIELLIHGS
2 3ET3 OF PLANS
3 HEGISTERED SITE SDRPEYS
7 3Ef OF ENERGY CALCS.
1?49S
MULTIPLE DWELLINGS
2 SEfS OF PL?N3
REGISTSAED 3ITE 3DRVEYS -
(CSEC% III'1'8 BLDG DIP.)
1 3Ef OF EAERGS CALC3.
COYMRCIAL
2 SETS OF IRCHI'lECTiTEtAL
6 STAOCTORIL PLAN3
1 SEf OF SPECIFIC9TIONS
1 SEf OF F.NERGY CALCS.
MULTIPLE DWELLINGS RENT6L UNTfS FOH SILB ONITS # OF UNTTs
60TEr IDDAESSFS F08 CORNER LOTS - COPTRACTOA/HOMEOHNER !lOST DFSIGNITE 1iHIC6 IDDRFSS
IS DFSIRED. 80 CSAN6FS AILL HE ALLOiTED ONCE BUILDIIiG PERMIT I3 I35DED..
3EWER d i1ATEA PE18iIT FEFS AND ACCOUNT DEP03TT F6FS itII.L BS INCLSIDED WITH THE HOILDIN6
PERMIT FEE. PROCESSING TIME POR SEWEA AND AATEA PESIiITS I3 TWO DAYSIONCE d PERMIT 8AS
BEEB COMPLETED INDICATIPG A LICENSED PLtAMHSR.
PENALTY APPLIFS WUN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED.
LOT CHANCE IS REQOE3TED ONCE PERMIT IS ISS[JED.
.JUN 2 0 1989
To Be Used For: Yaluation: ) oo0 Dates
Site Address 1 5 FW-Q Lq14.1- Rfl
Lot ? Block Z
Pareel/Sub j6?1?N?u?af?1?
Owner hAix- , ?n, 1?-rtC_SLS.aa'l
Address
45? \ 'S u,i?
City/Zip Code CALtitr,] 55 sz7,
Phone -A.54 -d`l61
Contractor Uot11 S`pa„9s?_
Address 4S1.7 5 NA4 IRkS NA
City/Zip Code SSIZ
Oecupancy
2oning
Aetual Const
Alloxable
0 of atories
Length 24xiG
Depth 12 x J
S.F. Total
Footprint S.F.
On site sewage
On site well _
MWCC 3ystem _
City water _
PAV required _
Hooster Pump _
- lPPA0V9LS
Phone 8tt Planner _
Council
Areh./Engr. Bldg. Off. ?b/2?/
Variance
Address
City/Zip Code
F'EF.S
Bldg. Permit a(0,00
Surcharge i.5b
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Aect. Deposit
S/W Permit
S/W Sureharge
Treatment P1.
Road Unit
Fark Ded.
Copies ,50
SOBTOTAI.
fenalty
SOTAL
Phone A
;
^
?
?j -?'I
;JaLs
\/oLS
)162. diia
,LoT 9
,- ?
-;-? -_ --- _-
-?-
-_ -- -_
= -_ - Lw imy_Z,a,
t3Lo?K L Ov'.C,G4// r4roAr
PLOT PLAN Scale -1 inch - 20 feet
- - -
- -- - _ - - - -
- ,._
?-- _ = --_ -- - -- _ _- _ -
r ,?_
\('?
G
5 ?
5
? )9, - -- - ?
T- .r ry? ?- ?T
(4 ._ ;
?
= ---
?
-
.
-
-
- ?.r
. t ..;.: .
.. - - - + ..._ - .,..
77
.
?
_ - . . -.__ .. " - - . _ ' 1
Must show location of streets, lot and proposed buildings, give lot dimensions. (Lot corners and building site
are to be staked before appraisal is requested.)
. . _. .F,_„-n,'. ",3j.k .;r,y, ?s....,?, .,`.'.'?'.- `••?:.?.. Y.'::.. r x-'M"' 7?te?.,- . xy?..?`_=_.1?_: _.x,.
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
. •• * ***rr*+e** ** * *,e*+r ** **?* x+**,r*+r:***,rx
P ease Print)
? 1) PROPERTY ADDRESS: ?15- 71 1 /7 /? p, /V
LEGAL DESCRIPTION:
Lot Block Subdivision or Tax Parcel ID )
IF E7QSTIAIG S'IRL'C.`lVRE, DATE OF ORIGINAL BL'ILpING PII2MIT ISSCANCE: .
PRFSEr7r ZONING/PROPOSID USE: Mon Year}
0 MNRCIAL/RETAIL/OFFICE
r-7 INIIJC?STRIAI,
n INSTIT[]TZONAL/GpVERIZENT
rAME:
ADDRESS:
CITY. STp.TE. ZIP:
PHONE:
2) 1??
3) ' u r ?• / /
N11D9Ea?/Y/Cf?h?/./ P l/
aDoREss: Azir
i CITY. STATE, ZIP:_ l?ro??v?: ?i?ff
PxorE: /5 P2 MASTER LICENSE# 32 36
4)
??• • • i?-
NAME:
ADDRESS:
CITY. STATE, 2IP:
PHONE:
( Onits)
( Uni.ts)
Active
Ecpired
Not recorded
Staff u,,tial
'5) _ ° ? • ?• : ? • aa - ??
? CONNECTION TO CITY SE,WE12 Z Cp?,TION TO CITY WATER ? pmm
6) ?? •' ??[? PLEASE HOLD APPROVID PERMIT FC)R PICK-UP BY ONE OF ABOVE
PLEASE MAIL APPROVID PMiMiT TO 1, 2, (9 4. .A&7VE
(Circle one) '
7) r.sr....
M R-1 SINGLE FAMILY
Cj R-2 DOPLEX (1t,o L?nits)
? R-3 7OWDIIIOL?SE (Three + Units)
? R-4 APARTi?RW/CONDOMINICT4
? rt ep-? 3,/ _
*ATF': PAYMF'NT OF k'EE AT TIME pg
APPI.ICATION DOES N02 COD1S`PIT(JTE
APPROVAL OF PERNIIT,
INSPEXTION OF SENE2 ANID/OR NL9TII2
INsTALLAmzoNS wu.r, NOr EE scHED-
ULID UNPII. PEE2bffT AAS BEQ9
APPROVID.
?- _.
.
FOR CITY USE ONLY _
PERMIT # ISSUED
?7S,f 3
Pd w/Bldg. Permit FEES:
$ $ /1n "J?') SEWER PERMIT (INCLODE SURCHARGE)
$ $ /?? -? O WATER PERMIT (INCLUDE SURCHARGE)
$ $WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLLDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ???'O C% ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ J OC+ • c?-c, $ WAC
$ ?S 7S . Cr Z? $ SAC
$ $ TRLNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ • LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRONK WATER
$ $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
$ 152 $ V?? ? C) TOTAL
6 Z 3 ??s 7
RECEIPT RECEIPT
DOES UTILITY CONNE CTION REQDIRE EXCAVATION IN PDBLIC RIGHT OF WAY?
F__j YES TF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SOBJECT TO THE FOL LOWING CbNDITI0N5:
APPROVED BY:
TITLE:
DATE:
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
-%-7o'?e
New Construction Reaui2men15 RemodeVReoair Reauirements Office?.WseDnl?e
3 registered site surveys showirg sq. R of lot sq. ft of house; and all roofed areas 2 copies of plan CeirfcTSurvey Recd? ? Y
(20%mazimumlotcoverageallowed) 7setotEne CakulationsforheatedaddiGons TreePresPlao'Recd ' 'YN.
2 copies o( pWn showing beam & window sizes; poured found des'gn, etc. 1 sile surveyfor addNOns 8 decks iTee Pres Re"quved
1 set of Enert?y Calcula4ons Addrtion • ind?cate if onsRe sepfic system pp s¢e Sepllc?System Y ;???i
3 copies of Tree Preservation Plan H bt plaqed after 711/93
Rim Joist Detail Options selection sheet (bldgs wifh 3 w less unl6
Date 21
SiteAddress co
D?l Construction Cost ?P y`{ o
Z13Kt (Y UniUSte #
Description of Work -7EL7 /'? c/t
Multi-Family Bldg _ Y Y\ N r Fireplace(s) _ 0_ 1 _ 2
Property Owner ?t L? /-C T?/' So lf Telephone #(65-1
Contractor J?C?70 /zT ,Coo Ivc? ?NC
Address
State A 33(, W
/? LJP,TL-?C ?%.
Zip 6,?57 o7 City 57. ?i.?"l
Telephone # (6,$/ )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Categorv 1 Mirmesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submiked
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(; ; I'); i ri i?J i2 ',
Telephone fl )- - . - . I I' .
I hereby apply for a Residential Building Permit and aclrnowledge that the information. is _complete_arid accurate;
that the work wil] 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 pemut, 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.
/a eq ZEaic d, C. r &,P'lir PrXj
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck 0 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_v or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move 8uilding ? 42 Demolish Foundation ? 45 Fire Repair
? 33 AlteraGon ? 37 Demolish Building• O 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolitlon (Entfre Bldg) - Glve PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Foorings(new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ SNcco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
UtilityConnection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
411? City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone:(651)675-5675
Fax:(651) 675-5694
---------i
? r-t y I
? Permit
I Parmit Fee: ?
I
? Date Received: !1 ?
I Staff: •---t
2008 RESIDENTIAL BUILDING PERMIT APPLICA
Date: Site Address:
Tenant:
?EP.O 2 2008
RESIDENT I OWiVER Name: / {{r{7 PP ?cl'.SU h _ Phone:
Address / City / Zip: q S -7 I S- A-E-7
Applicant is: _ Owner ?Contractor
TYPE OF WORK vi n d(??z aeDlacewe kT
Description of work: c
,
Construction Cost: Multi-Family Building: (YesNo ?
CONTRACTOR Name: ?f???FY7'c ? v KS _ License #: ? 0 SSt US (o
1? s-j?7 / C? vVigGe br
Address:
_
State: Al/li Zip:
City:
6
Q
1"L
S'
Contact Person:
J
6
'7
Phone: -16
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submi55ion type) • Energy Envelope Calculations Suhmitted
In the last 72 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: Plan§ and supporting documents thaf you submit:are considered?to be publfc lnformabon- Pordons of `.
'
" fhe informaU'on m?ay be classified as-non pub11v ifeyau provide spec?c reaso'ns that would permit the Cliy?to
, conclude thaf the 'aretraile secrets.
I hereby acknowledge lhat this information is complete and accurate; that [he work will 6e in conformance with the ordinances and coAes oi tne c:iry or
Eagan: that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X V ?-?-
ApplicanYs Signature
age 1 of 3
LS I F
2007 RESIDENTIAL PLUMBING aERnniT aPPLicaTioN J S?
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existinca residential dwellinas.
Date o 2/ 0 11 0 7
Site Street Address 4571 SOUTH HAY LAKE ROAD Unit #
Property Owner OEB PETERSON Telephone #( 651 ) did_n7(11
Contractor GENZ-RYAN Telephone# (952 ) 767-1000
Address 2200 W HWY 13 Clty BURNSVILLE State MN ZiP 55337
The Applicant is: _ Owner 8 Occupant X Licensed Plumbing Contractor
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Fire Repair (replace burned outfixtures, etc.) $ 90.00
This fee a lies when extensive lumbin re airs are made to a buildin .
Alteratlons to existing dwelling $ 50.00
_ Add plumbing fixtures to main level lower level. This fee includes
installation of a water softener and/or water heater at the same time. If you are
lnstallfng oRly a wafer softenei and/or water heafer, do not complete this section;
move to the next section and place a checkmark next to the appliance(s) you are
insql ling.
_Septic System Abandonment
_Water Turnaround (add $136.00 if a 518" meter is required)
Other:
Water Softener X Water Heater $ 15.00
_ new x replacement
_ Lawn Irrigation _RPZ _PVB _new _ _repai?, wilu $ 30.00
State Surcharge $ .50
7ota1 g 15.50
I hereby apply for a Residential Plumbing 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 plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start wi`hout a permit and work will be in
accordance with the approved plan in the event a pian is requireP to e review and appkoved.
KIM RENVILLE
ApplicanPs Printed Name pplican na re
City of EapIl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
F _ 15Of _ _ _ ' _ _ _ _ - _ i
?(fl¢?;? I
? Permit #:(;/
?
I Permil Fee; ?
I / ,(
? Date Received:
I ?
? Staff: C I
?-?
L
2008 RESIDENTIAL BUILDING PERMIT APPLICATI'P'N
I III DEC 08 2008
Date: 12 S O O Site Address: ?l 5-7 l
Tenant
RESIDENTIOWiJER Name:T()m Phone: LOSI- NSq
Address / City / Zip: 41? / 1 Lal 9-d
Applicant is: _ Owner V1,Contrador
TYPEOFWORK -P, ;? /.)/P?l'.?/0!/L/ C
Descriptionofwork:renl
,
Construction Cost: --3S0O Multi-Family Building: (Yes No)L)
CONTRACTOR
?P
Name: ?aj-),'1gifKT ?X //7 ()ILicense #: ?vSSS 695
Address: 1 I 5 ?Ee-"C f !/ilvlf-
Ciry: goSP ? r State: _Ll _N Zip:, SSI ??
Phone:[D_5/=67R5? -?40 d v Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer 8 Water Contractor: Phone:
-':`NOTEi'P(ans and supporting tlocuinents that you submit are cons?de?ed+to 6e publrc informapon.,,: PorUOnslof >.
` the idformation m`ay'be classifieii a's non putilic`if you provrtle spocific reasons that would perrnit the Crty:;to ,-
,
conciutle_that ihe `"'are frade seerets .
I hereby acknowledge lhat this information is wmplete and accurate; that the work will be in conformance with the ordinances and codesof the City of
Eagan; ihat I understand this is not a permit, bul 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 W'u-? x /?
IicanYs Printed Name ? App icanYs Signature LI/ Page 1 of 3
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4571 Hay Lake Rd S
Lot: 9 Block: 2 Addition: Overhill Farm 1st
PID:10- 56150- 090 -02
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
Fee Summary:
Contractor:
Angell Aire
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746 -5200
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Owner:
Thomas Peterson
1 145 Edmund Ave
St Paul MN 55104
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA091816
10/28/2009
ePermit
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA132141
Date Issued:07/27/2015
Permit Category:ePermit
Site Address: 4571 Hay Lake Rd S
Lot:9 Block: 2 Addition: Overhill Farm 1st
PID:10-56150-02-090
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
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 -
Thomas Peterson
1145 Edmund Ave
St Paul MN 55104
(651) 454-0701
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature