4723 Hazeltine Lane; -CASH RECEIPT
?
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122 •
DATE ? ? \ `? 19 ?
f110M
AMOUNT a ? ?, ?l ? ? ?- ?
a DauuRs
,m
? CASH YCHECK
,O, `-;( C' - L
1A-
--
,, ,
BY
C 14732 While-PsYers C°PY ?
Yelbw--POating Copy
Pink---FAe Copy
Thank You ??
qF119V
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd. "
Eagan, MN 55122-189-l-,
s"
? •
DATE
OFFICE USE ONLY
METER # PERMIT DATE - ' ` - i
CHIP # PERMIT # METER SIZE B.P. RECEIPT # L 14732
15SUE DATE B.P. RECEIPT DATE 021 11- ")
- PRV ? BOOSTER PUMP
SITE ADDRESS " ,1-70:S 1.M
LOT ? BLOCK i SEC/SUB FAIRWAY HILLS 3R1)
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: _
PLUMBER: PEINE PLijNBItJC
ADDRESS: 1' 0 box 23
CITY, STATE VERHILLIOH hfN ZIP 55085
PHONE: 437-9532
CITY, STATE APPLE YALL!.Y MN ZIP _
PHONE: 131-5GC.n
ZIP
PERMIT REDUESTED
- SEWER =- WATER - TAPS
- COMMIIND
_lL NEW
-2- RESIDENTIAL
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
, CONTACT ENGINEERING DEPT.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897 .
DATE Ju1l 30, 199
OFFICE USE ONLY
METER # 1 F PERMIT DATE U 7/ 31 / 91
CHIP #?114 4' qS a 9 PERMIT # 12188
METER SIZE Qff seA) B.P. RECEIPT # C Z 47 " .1
ISSUE DATE B.P. RECEIPT DATE 07 30 _ PRV x BOOSTER PUMP ,t/J/.tcce-cC
I SITE ADDRESS ?'" '=?'.'.r •`'-? `;? LN
? LOT '' BLOCK t SEC/SUB ?'?AIRWAY HILLS 3kD
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: -
ZIP
I PLUMBER: YELNE YLlf?z?i.d(,
ADDRESS: P 0 BOY. 23
I CITY, STATE VERMILLIOtd ifT+ ZlP 55085
f PHONE: 437-9532
OWNER: 0714UN-PEUERSON IIvC
ADDRESS: 15136 GALAXIE AVE
CITY, STATE ?PPLE VALLi:Y t9N Zlp
PERMIT REQUESTED
x SEWER
- COMMiIND
X NEW
X WATER - TAPS
X RESIDENTIAL
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WIL L NOT be given for Deduct Meters.
,
I AGREE TO COMFLY WITH CITY OF
EAGAN ORDINANCES -'-) •.
SIGNATURE WHEN METER ISSUED
....-
PLE'Mk ALLOW TWO'WORKING bAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
-_ ` . ? .,. .• . . " . _.; .. -.a,µ+-v - .:- -
? 1 v<:+l? ` . ? ?
Y ?
QCitp of (eagan
Wprhtcrtt# o# Nuildircg inwrtinn
T1iis Certificale iuued pursuant w!he r+aquirrnunls of Sertion 306 of ihe Urriforrn Building
Code ??YinB dim at the time ofissuance lhis struclun wns in ovmpliance *ilh 1he Narious
ordixanctis of !lu Cih' relubdKS buddin8 ourutrucdon or use For the followiRg:
uxa.nvomw. sF nvr.,IcAR ma& 14, :rra. 1o5U0
o=V.nq r,pe R_ 3 M-t zooing n-buicc R- 1 Tyac cV. v_N
pwaaa(g,.b;m [l7MIiN_PR[]FRCnN jUrAftm t ril 36 Gs_!hKIE AKE
Solfin Addma 4791 HA7Ri.TTNR i_A LocRft 1.5, R1 , gpi,gwey git_t_c ?jjD
(k l'1 ) . ji r f ! i}? p, (]('.TnRF.R 99 } 19t] 1
mlft 10"POST pV A CONSPICl10US PLACE •
.-:,?. ?..-sn+?-Aj, }wA,, a.,.-c4t•:s+.,• *o w.--af J Sr +. •..a. , E"P
D/? 91 452-6126 CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT ? 'I PHONE: 454-8100
• Receipt #
To be used for SF m4/G4a Est. Value $157,000 Date_,L(Q. i[f , 1991_
Site Address 472-1 NA81.°1-7'iWl
Lot 5_ Block I SeclSub.
Parcei No.
W Name _
o Address
Name _
Address
Name
Y HILLS 3R OFFICE USE ONLY
Occupancy R-3-Ji-1 FEES
Zoning ?-1
fBSS
Phone
? I hereby ac4
information
Minnesota S
Signature ot
A Buildina P
that the
State of
all
Building
(Aclillial) Const Bidg. Permit 839 _ ?d
(Albwahle) SUrcharge 78_ S[]
# of Stories
Lenglh Pfan Review 345.?
Depth SAC, City 100-00
S.F. Total - SAC, MCWCC
S.F: Footprints _
On Sile Sewage _ 1^later Conn 660.?
On Site well water Me1er 95.f10
MWCC System ?
Crty Water ? Acct. Deposit 30-m
PRV Required S/W Permit 30.00
Booster Pump x gM/ Surciiarge •?
Treatment PI 276,00
APPROVALS Road Unit 370.?
Planner
Council -
? Park Ded.
81dg.Off. _ Copies
Variance - TOTAL 3+ 674. QQ
I • Permlt No. Perm(t Holder Date Telephone #
WATER
SEYYER-
PLUMBING VIg 91
H.V.A.C. O I! / T`? /' Jr.3
ELECTRIC
tnspection Dste Insp. Comments
Footings ? L" ? t 2-114
a ?• ?
Foundation
Framing y?ll? W
Roofing
Rough Plbg-
Rough Htg. 1?111j1-ll
Isul. -*7', ?/ $'
Fireplace 9
Final Htg. A, 041
Orstat Test Q 17-V
Final Pibg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bidg. Final
Oeck Ftg-
Dedc Fin31
Well
Pr. Disp.
130
? G? sl
?
BUILDING PE5I
To be used for I?
Site Address ?
Lot S Block
Parcel No.
Phone
this application and state that Ihe
)mply,with all applicable State ol
W Name S?M DSHM
Sim
# Address
° City Phone 452-%33
o Name MS'I1GS t00LS
;¢ Address Z*s It ROS61.AYN /11IS
? City s= rAUL Phone 488-6726
Name _
Address
I hereby acknowleg
information is cOrre
Minnesota Statutes
Signature ot Permiti
A Building Permit is
an Ihe exoress conc
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eag;
PHONE: 454-8100
? Rec
? POOL Est. Value :10.000
13 NAZELI'IMB
Sec/Sub.
in accordance with all
MN55121 19734
SA VT?MIIt! 91 O 1
OFFICE USE ONLY
Occupancy - FEES
Zoning _
(Aclual) Const _ Bidg. Permit 11 O V
(Albwabie) ,
- Surcharge
# ol5tories -
Length 1606- 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 _
Ciry Water _ Accl• Deposit
PRV Required - SMY Permil
Booster Pump - Sryy Surcharge
Treatment PI
APPflOVALS qpad Unit
Planner - park Ded.
Council
Bldg. Off.
_ Copies ??
•
Variance - TOTAI
Permif No. Permit HWder Date Tekphona k
WATER
SEWER
PLUMBING
H.VA.C.
ELECTRIC
Inspection Date Insp. Commenta
Footi^gS 1 c 3-ji Ds ~o /
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg. ? ? qj
Isul.
Fireplace
Final Htg.
Orstat Tesl ,(/ 3 .?
Final Plbg• Plbg. Inspector - Notify Plumber
Const. Meter U?f9 ?
je&
EngrJPlan
Bldg. Final
Deck Ftg.
Dedc Rnal
Well
Pr. Disp.
•. . s -- DATE:
JUL 31, 1991
RE: 4723 HA2ELTINE LN (OZMUP!-PEDEBSON INC)
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Worys Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer 8 Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
- COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed byf Bill Adams or Dirk House (Plumbing Inspectors-454-81DD) before issuance.
WARNING: BEPORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BV LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
Address: 4723 HAZELI"E I,QE Lot.S Blk I Sec/Sub FAIWAY =S 3RD
? fihese items were/were not complete at the time of the final inspection.
10/23/91 Yes No / r
Final grade (6" from siding) ?
Permanent steps - garage ?
Permanent steps - main entry ?
Permanent dciveway c?
Permanent gas ?
Sod/seeded grass
Trail/curb damage
Porch
Basement finish ?
Deck
Please verify wlth the builder the removal of roaf test caps from the plumbing
system and the shut-off of water supply to the outside Latcn faucet before
freeze potential exists. ?
mcraeoartn
White - City copy Yellow - Resident copy Pink.- Contractor copy
CITY OF EAGAN N! 19500
3630 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
' PHONE:454-8100
BUILDING PERMIT Receipt #
To be used for SF DWG/GAR Est. Value $157, 000 Date JUL 3 0
Site Address 47.23 HAZELTINE LN
Lot 5 Block 1 Sec/Sub. FAIRWAY HILLS 3R OFFICE USE ONLV
P8fCel N0. Occupancy R-3 M-1 FEES
R
1
Zoning -
w OZMIIN-PEDERSON INC
Name (ACtual) Const ?=IV Permit
Bldg R49 _(1(1
3: Address 15136 GALAXIE AVE (miowabie) V-N .
R
S
° City APPLE VALLEY phone 431-5000 xofstories surcnarge _
n
7
70' Plan Review
0
545.0
Length
o Name SAME pepm 52' snG ciry 100.00
"
g Address S.F. rotai
-
F SAC,MCWCC
o
650_0
City Phone S.P. Footprints -
t
w
C 660
0
on Site Sewage - er
onn
a .
F
ww NamO On Sile Weil 95
00
i? AddfQSS MWCCSystem -
X water Meter .
°z Acct
DePOSit 90-00
aw City Phone arywater -X- .
' 30
00
PRV Required Permit
SM .
I hereby acknowlege that I have read this application and state that Ihe Booster Pump X SMI Surcharge - 5n
information is wnea and agree to coryryry ply wiih all applicable State of
Minnesola StaNtes and Cily'Qf ?a*Oinances.
!/?
' 7reaimem PI 276_ nn
?
•
SignaWre ol Permitee #- APPROVALS qoad Unit
0
370.0
A Buildin9 Permit is issued to: f)7.MIIN- FDF.R SON T N Plenner - Park Dad.
on the express condition ihat all work shall 6e done in accortlance wi[h all Council
applicable State of Minnesota Stalutes and Ci[
y of Eagan Ordinancea BIOg. Git. COp'?
?
Building Official ????,Q? ,1 ( ?Ll
? Variance - TpTAI 3,674.0
0
CITY OF EAGAN yo - 19734
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt # C I'5531
Tobeusedfor INGROUND POOL Est.Value $10,000 Date SEPTEMBER 25 19 91
Site Address 4723 HAZELTINE LANE
Lot 5 Block 1 SeGSub. FAIRWAY HILLS 3
Parcel No.
11 W Name STEVE DEMUSE
? Address SAME
° Cify Phone 452-9635
o Name PRF Ti .. p00 ,
?a Address 245 F. ROSEL.AWN AVE
U¢ City ST PAUi. Phone 488-6726
?w Name I
Address
gw City Phone
I hereby acknowlege that I have r Ihis application and state that the
iniormation is correct and agree 1 comply ilh all applicable Slate of
Minnesota Statutes an4CIE an Or nces.
SiqnaWre of Permitee A Building Permit is issPRESTIG POOLS
on the express condition thal all work shall be done in accordance with all
applicable State of Minnespt St s and Ciry of Eagdn Ordinances.
/ / I r"
Building Official ? /?-e
OFFICE USE ONLY
Occupancy _
Zoning -
(ACtual) Const _
(Allowable) _
# ol Stories -
Lengih 16x31i
Dep1h _
S.F.7otal _
S.F. Foolpnnis -
On Si1e Sewage _
On Sile Well _
MWCCSystem _
Ciry water _
PRV Required _
8ooster Pump -
APPROVALS
Planner _
Council _
Bldg. Oil. -
VarianCe _
Bldg. Permil
Surcharge
Plan Review
SAQ Ci1y
SAC,MCWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
SNJ Surcharge
Treatmenl PI
Road Unil
Park Ded.
Copies
TOTAL
FEES
$117.00
5.00
y122.50
9/? /n_/ REQUEST FOR ELECTRICAL INSPECTION
/7 ? See ir.s!vcLOns for compleung IDis form on baci ol yellow copy.
Q ? 7'? 2 "X" Below Work Covered by This Request
EB00001-08
A0a999
ew Add Rep. Typeof8uilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplez Water Heater Electric Heating
j Apt. Building oryer Other (Specity)
Comm./Industrial Furnace
Farm Air Conditioner
OICer?suecify?
Compute Inspection Fee Below: ConM1eclor's Remarks:
# Other Fee # SarviceEntrance5ize Fee # Circuits/Feeders Fee
Swimminq Pool O to 200 Amps ,!! 0 to WO Amps
Transformers Above 200 _ Amps 0_ Amps
SignS Inspeclor's Use Onry? T TAL
Irrigation Booms `7
Special Inspection
Alarm/COmmunication THIS INSTALLATION MAY BE ORDER6D ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 HS. ?"w
I, ihe Electrical Inspector, hereby R°°9n-'" _ aie ._ p
certify that the above inspection has
been made. F,,,ai
OFFICE USE ONLY
TM1is request void t8 montns Irom "
95? °t??oo
?
p
0732 A66 ,
ReQUest Dale
???( F/?
J Flre No. po I Inspeclion
Re .
? ReatlY Now ?'When FeaOyPactor
`
v :Ves - N.
IXlicensed coniractor J owner hereby request inspection ot above electrical work aC
Job Atldress (Slreet. Box or Route N ?
? 2 3 f?,¢2?/t.:? ? .!.?+h ? C?N
?&q-s/
Secnon No. Townsni0 Name or No. Range No. Gounry
OccupantlPRINT Pbone No.
<e ; j'0 a 6
Pawer SupplierK'/?
??iw? ??L Actlress p
Eieanca) Comracm: (COmpany Name)
A .l v a ConVadors License No.
Mailing Atl ress IConhacmr or owner Making Installaiion,
L 51 Z? i 11 !?.a ?oJ•c?.-o cJ?S'J?6P
HutM1On 5I ore IGOnhaclo^Owner M g Inst Iletion)
- .?0 PM1One Number
MINNESOTA STATE BOARp OF EIECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-MiEwey BIUq. - Poam S-173 8E ACCEPTED BV THE STATEBOARD
1821 University Ave.. SL PeW. MN 55104 UNLE55 PROPER INSPECTION FEE IS
Phone(610) 642-0800 ENCLOSED.
r-p RESIDENTIAL
sq l Ivb BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConsUUCt(on ReauiremeMa
• 3 registered site surveys showing sq. ft. of lot, sq. ft. M house; and all roofed areas
(20% maximum lol coverage allowed)
• 2 copies of qan showing beam & wirWow sizes; poured found design, etc.)
• lsetotEneryyCalculatlons
• 3 wpies of Tree Preserva6on Plan if lot platted after 7/1193
• R'vn Joist Defail OpGons seledion sheet (bldgs with 3 or less units)
DATE !9-- & "0 Q
SITE ADC
TYPE OF
APPLICANT
STREETADDRESS ' /'l01 14 4l/1 ??
TELEPHONE # %3-????ELL PHONE #
?/<s a?--
RemodellReoalr Reauirements
• 2 wpies of plan
• 7 set of Energy Calculatiom for heated additions
• lsitesurveyforexlenoraddNOns&decks
. Indicate'rf home served by septic system for additions
VALUATION u? C?x on_
ULTI-FAMILYBLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
CITY_jj STATE)QZZIP
FAX'#
PROPERTYOWNER TELEPHONE# &5,-415
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNrSOTA RULES 7672
(J submission type) • Rasidential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calcula6ons Submitted
Plumbing Confrador: ____
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Conhactor.
_ Air Conclitioning
Heat Recovery System
Phone
Fee ' 0
o???
? AUG 0 8 2002
? Fee: ?70.0
Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all appiicable State of Minnesota Statutes and City of Eagan Ordi nces.
Signature of Applicant
Q
OFFICE USE ONLY
Water SofCener _
Water Heater
No. of Batlis
_ Phonc #
Lawn Sprinkler
No. of R.I. Batt
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
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 EM. Alt - Multi
O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 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 Replacement *Demolition (Entlre Bldg only) - Give PCA handout to applicant
Valuatfon 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 bidg) _ FinaUC.O.
_ FooCings (deck) _ FinallNo C.O.
_ Footings (xddition) _ Piumbing
Foundariou 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
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Piant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building inspector
RESIDENTIAL
? BUILDINC PERMIT APPLICATION r'?r?
? ? I ( `?' I CITY OF EAGAN ' ? 0 'v `-'
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConstructionReauiremenh RemodeVRenairReauiremenM 1 \ ? ?-?c '0 ?-
• 3 regislered site surveys showing sq. ft. of lot, sq. ft. of fwuse; and all roofed areas . 2 mpies of plan
(20°,6 marzimum lot coverage aliowed) . 1 ut o( Energy CaICWa6ons kr heated additions
• 2 copies ol plan showing beam & window sizes; poured found design, etc.) . 1 site survey for e#erior additions 8 decks
• 1 set of Energy Calculaliora • Indiwte it hane served by septic syscem for additions
• 3 copies of Tree PreservaUon Poan if lot plafled after 7I1193
. Rim Joist DeWil Optbns seleclion sheet (hldgs wiM 3 or less units)
DATE 1?2-0 ?UZ VALUATION
SITE ADDRESS 4 1,2 3 NsE Ztz7 yNE Ln) MULTI-FAMILY BLDG _ Y ?
TYPE OF WORK 164-SE-Mf1VT I?iA11Sf-f FIREPLACE(S) _ 0_K 1 _ 2
APPLICANT y` 9U D y J4V+IP_77/II
STREETADDRESS 41723 774ZtF7_77A/a W CI7y ?llGA ^? STATEM?YZIP 9 12-3
TELEPHONE # l.Sl EIoG 4¢65-CELL PHONE # 69?_/ 45-7, 5`!' a9 FAX #
PROPERTYOWNER /4e`2f + Ju Oy ll/V.I<Vitl TELEPHONE# o S'_ 06 S.f
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUZES 7670 CA1'L'GORY I MI VNESO"fA RliLBS 7672
(J submission type)
Plumbing Contractor: ___
Plumbing syslem includes:
• Residential Ventilation Category 7 Worksheet Submitted • New Energy Code Worksheet Submilted
• Energy Envelope Calculations Submitted
_ Water Softener
Water Heater
i vo. oe Barhs
Phonc #
Iawn Sprinkler
No, of R.I. Baths
Mechanical Contractor.
Mechanical sys[cm includcs:
Sewer/Water Contractor:
Phone #
Phone #
Nov Z o ?opI ?y
1?
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan(64inan?e:,??
1?J i l
SlgnatureotApplicant 4L W`
OFFICE USE ONLY
_ Air Condilioning
Hcat Recovery Syslem
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 76 Fireplace ? 21 Porch (3-sea.)
13 03 01 of_plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened)
? 05 03-plex ? 11 10-plex 1?- 19 LowerLevel ? 24 StormDamage
? 06 04-piex ? 12 12-plex Pibg_Y or_ N ? 25 Miscellaneous
? 31 New ?
? 32 AddiGon ?
x 33 Alteretion ?
? 34 Replacement
Val uatlon ? t7
Census Code
?-r
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const 14j
? 30 Accessory Bldg
? 31 E#. Alt- Multi
? 33 Ext. Alt - SF
? 36 Multi
35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Daors
"Demolition (Entire Bldg only) - Give PCA handout to apptlcant
Occupancy
Zoning
Stories
Sq. Ft.
Length
W idth
MC/ES System
City Water
Booster Pump
PRV Fire Sprinklered
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) Plumbing
_ Foundation Y 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)
X Insulation
T- _ Retaining Wall
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
Approved By Building Inspector
,
!/(/ d?- ,1
!?'a`?
' ) t ?t
a?f
?? °??
'??l l (? 2-
PERMIT# ? RECEIPTDATE:
EOOE RnIDENTIAL PLUM$INfi PEiiM1T APPLICATION
crrY oF FAsM
3$30 PILOT KAOB iiD
SikBAN, MA 5818E
651-681-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITEADDRESS: ?'7 23 AiFZ CL77lv L )AJ
OWNER NAME: : &-6t--V T- J u n y /L?71nI TEIEPHONE #: 6 S( 6 Sy-
?- (AREA CODE)
INSTALLER NAME: CYEyL"r' /V1/r//'r]/? TELEPHONE #: e, S-I - G " ss,-
STREETADDRESS: ?7a3 11q2tZ77Ng?- L,Aj (AREA COD )
CITY: E146r4n? STATE: t-v,.1 ZIP: S1712-3
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existlng dwelling unit (+ 5/8" meter ff needed -$118)
Other:
_ RPZ: new installation/repaidrebuild $ 30.00
_ lawn irrigation system ?uv 2
ReplacemenVadditional: _ water softener _ water heater $ 15.00
State Surcharge $ .50
TOtaI
$ Sr.
5? J
I hereby acknowledge that I have read fhis appliption, sfate thatthe information is correct, and agree to complywith all applipble Cityof Eagan ordinances. It
is the applicanPs responsibility to notify the property owner that the City of Eagan assumes no liacccb???ility for any damages caused by lhe City during its normal
operational and mainlenance activities to the facilities constructed under this permit within City ertylright-pf a lease eqt.
c?v ?
SIGNATURE OF PERMITTEE 1/02
a RESIDENTIAL ?
BUILDING PERMIT APPLICATION ?
cirv oF EAcani
3830 PILOT KNOB RD, EAGAN MN 55122
681-881-4875
NewConstruMbn Beaulrementa RamaleVReoalr ReauhemeMs
• 3 reglstered site surveys slwwing sq. tt. of kt, sq. ft af house; and II roofed areas • 2 copies ot plen
(20°/a rnexdmum lot coverage albwed) . 7 set of Energy Catulatbns for heeted add'Aions
. 2 copies of plan Showing beam & windav sizes; poured found desgn, etc.) . 7 site surrey for e#erior add'Abns & decks
• lsetofEnergyCalculetions . Intlicate'rfhomeservedbysepticsystemlaradditbns
• 3 copies ot Tree Preservation Plan H bt platted after 7/7193
. Rim Joisl Detail Optbns selectbn sheet (bl0gs wRh 3 or less unMS)
DATE VALUATION l ?
SITE ADDRESS `? ? 23 I??2e?f? ?-e L k\- MULTI-FAMILY BLDG _Y
NPE OF WORK ?roc7 fl FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
!t. C('?-f? t o r
STREET ADDRESS
TELEPHONE # CELL PHONE #
S
A( ^'ZIP S .S3
FAX #
PROPERN OWNER S11 F_ F-A `C'. V Y TELEPHONE #?P 77
----------------------------------------------------------------------°-----------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RLZES 7670 CATEGORY 1 MIA'NFSOTA RUIFS 7672
(4 submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor: ___
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Conhactor:
_ Air Conditioning
_ Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
I hereby acknowledge fhat I have read This application, state ihat The information is correct and agree to
w'rfh all applicable State of Minnesota Statutes and City of Eagan Ordlnanc .
Signaiure
OFFICE USE ONLY
_ Water Softener
_ Water Heater
_ No. of Baths
_ Phone #
L.awn Sprinkler
No. of R.I. Baths
Certificates of Survey Received - Tree Preservation Plan Received - Not
OFFICE USE ONLY
? 01 Foundation ? 07 OSplex O 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06plex 13 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage O 22 ?orch/Addn. (4sea.) 0 33 Ext. Att - SF
? 04 02-plex ? 10 08-plex O 18 Deck O 23 Porch (screened) O 36 Muki
? 05 03-plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex O 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
O 32 Addition O 36 Move 81dg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Akeration ? 37 Demolish (Bldg)' O 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Glve PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning Ciry 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.
_ 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 Stucco _ Stone
Fireplace _ R.I. _ A'v Test _ Final _ Windows (new/replacement)
_
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Building Inspector
Total
. i?.?Ofl
1991 BUILDING PERMIT APPLZCATION
CITY OF EAGAN
SINGLE FAMILY DWELLIN6S
?2 SETS OF PIANS
3 REGISTERED SITE SURVEYS
? 1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
CO?tMERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PIANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WFiICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER t4UST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL SE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: 4 l?% Valuati Date:
Site Address ? 3 ? `? •?
Lot 15 Block I
Parcel
Owner
Addres
City/Z
Phone
Contractor
AddYess
?l
City/Zip Code
Phone h "
Arch./Engr. rt
Address q
OFFICE USE ONLY
? S
Dccupancy
Zoning
Actual Const
Allowable
a of stories
Length
Depth
S.F. Total
Footprint S.F.
FBES
Bldg. Permit ip39,00
Surcharge 78.510
Plan Review 545,oa
SAC, City J pU. o0
SAC, MWCC A 5-y,00
Water Conn. 660,00
Water Meter o0
Acct. Deposit 30,00
S/w Permit 30,00
S/W Surcharge 1S1O
Treatment P1. 2,76,oo
Road Unit 314"06
Park Ded.
Trail Ded.
Copies
SUSTOTAL
Penalty
Lot Change
TOTAL
R-3 M-1
T2-I
V-N
v- N
_6 T
52'
On site sewage_
On site well
MWCC System ?
City water r/
PRV
Booster Pump ?
APPROVALS
Planner _
Council
Bldg. Off. ?S ?z9 s?
Variance
agrees that all work shall be done in accordance with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
I?
Citv/Zin Code
. , ll .* t??I
V A l,u, A-r10 N
GA??Gs
Z2 x 3Z ; '?04
'? K ) L = 2 y
?--
"72`6ki5% ?b°l2o
I?SMi ,
.?---
Z" 3v_ lo61-r
3 u IL7L : 3s!
1ZItILs I`a?l
2 X L
?
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1 ?T ?'LaolZ.
..??_
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ZN'n ?UUI`
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C.'X Iu = ? U
•13
?S3'- 6Z 5??53
It?L
oj2
? * * * ? 2422 t tIO MN 55120
* PIOeNEEFI LANDSURVEYORS- CIVILENGINEERS Mndota He9hts
? enf71?"?ee?+?ng?• LMNOPLIINNER9•LANP'..CAPEIIRCHITECTS
** ?* ?r16121681-1914
Certificate of Survey for: VZMUN - PED,rRSOA/ ?
? -V-- NORTH
ioZ9.i \ b '?CC?
e 1,y?•'E 34,?°
? S i 6r? N ?
hl ? 4?'9S r a °eR- YL,
o ?
tyZ aL
N'$
0a '•s, ? d3 `0
!} f ? ? ? 6) e?'? ? 0 8
? •p?_, S,s. aa' / ??'I
NA I ? : e M1a ? M
q m •'h
`?? ?• ? . ---- "` -
1045' ? • - --?._..._ c?/P .....v
?
¢OO ,v F.N ??r3Fa?,33TNG
Flu m?
x 900.o Denotes txislin? Elevation PROPOSED HouSE E1EV4r1QV
• oo.o bernofes Propo ed Elevafion Lowes loor Eleva ion io24. S
-?------ Denotes Ur,aina eE Ufil?ly £asemenf Top oBlock Elevation to;z, c
--?--- Denales Drnin Oe Flor+7'Direclion Garagt Slab EleValiOrl - 10.32,
0 Deno}es Monuffien l BearIs shown are assumfd o De?tes o? fisef I-?b
LOT 5, BL 4CA1 I, FA i?QWQY E-lILC S 30) A DDITI o nJ
vqKplp COUNT}', MINNfSOTA
I hereby cerNfy ih t thls Survey, plen or reparl prepered by mg- r un r my direct super/y/?e i`on and t 1 nm duly Regis red EAl
urveyor
under the lewf of the Stete ol M(nneeota, Oated thisay of ? 19?LL.
/ 41 V Q s?ale • •?'-IVicl /J/?A_w . R.RERiB.51KC111__.RF.G.N .14P91
-? i-i?f
Ozmun - pederson, Incorporated . . .. Average "W.Cbmputatlon
• Job Site Addreas 4, - 1 --;:4n to --,in
Legal Dascription: '
Lot Bloek 1 Addition Y=_aIi- V.?1 I I IS Date I"?73 ` I I
AVERAGE LINEAL FE73T OF E}CP03ED WALL AREA ABOVE GRADE
Main Lavel " •
Lineal' £t of frsmed wall above:grade?x heiqht of walla I?Ov
Sacond level
Lineal ft 'ot *framed wall abode gradel4jx heiqht of wal l,?m
Vaulted Area
Lineal ft of framed waIl above grade f x height of wall
Rim Joist•Axlha. . u?
'Lineal ft of rim
Lower level x height of rim?a
Lineal ft of framed wall above grade ' xheight of wall
Zineal ft of framed wall above grade-f-'x height of wall
Lineal ft of.masonry wall above grad=ex hy?:iAbo?e?gr?de?m?
Total Wall •area.above grade incl`udinng windows and doors
WINDOWS :$rand 811d Tvn,%`f;) I I_z,
f,l-Ii- l}?17 I 1 ?.
I1 s
III.! . G
?
.ft
.ft
.ft
.ft
.ft
.ft
. ft
.ft
.ft
.ft
, sq.ft
sH.ft. X
sq. ft'. x
. . sq.ft.. x
DOORIS?• ?Ar,g X"U" Valuq /
??ov "?_LiS?_?l12' I?'???`?'b 1???, sq.
S ? $q.
C?''? q.
SQ.:
OPAQ[)E WALL •CON3TRUCTiON:,, Area
Fraiqinq members Framed wall
Rim Joist Area
Masonry wall .
Total wall area includ3ng '
' Windows and•Doors
Total(U) Valuas
Divided . by7tota wa 3 drea
xllull
sq.
sq.
sq.
sg.
::u?: ,5 Ila
uVu a?
u U u
nVu a D
u U n
?
uVu a
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?
u V u?'-=
uUn a
uUu?a
olU" a
uVu . e
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uUn a
ltull 31 m
o.Ur,
u V n-?--a
uUu??a
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11 usl,6?1 ? a.., 3-1
uUn n
?
uUu a
?
uVu ? a
b. Apg • " ' 0,54-Co
a. ?3JQ'
AVERAGE °U" Minimum .ll:or less.£or 1& 2 family dwellfngs
?x're?io?z p.irz FIWM ' .17
hl bl IJlm ??-i
SHEATHI IJfi 2.0[0
e5l/2u SvPT Woop lo ,S?5
v-:2 vV P• BD . 4,5
I!-I'T'?12IOR F I LM .!oS
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? U`!P• eD•
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ul
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?,ee
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;
, 17.
, 2.45
'r 1/"V.• F Y ? % r % % .
V .. . ??
P ODF Crail..li?l? ? vP?LUE.
? GYR av , y?o
•?io? ai? ?i ?.?t .??
I/F- U = , 02 l
2 F Ca 1 l-J5L1 ?.A"Il oµ ?"JS. G?
?/6 ? GY P• ? ?' ? 5l0
?-3'?ER?otz PI I? i= I L.M ,?o ?
-1'oTA?. R = ?,-18
R l:lc ,022
ii
lv2_
A*
zX-r?Riat?-lS-iV- T=IL4M m I
?i
UNDERGROUND SPRINKLER SYSTEM
PLUMBING PERMTT
Date:
Permit #
. : Date.. S $9??
. . ' . rf . . . ', . , t 'k ,.. a ??aW Q:. C? ?:.
.' . Receip,t # ,.
_ Commercial: $25.50 + water tap if required. (City installs a11 taps up to 1"). If
adding new service, a water permit will be required, as well.
Aef?E?dsting residential: $15.50 (Plumbing permit not required if backflow preventor was
previously installed).
_ Residential developments: Fee to 'be determined oy buiIding inspections department.
May require payment of water permit, plum ing permit, WAC, and water treatment
plant fees. J 3?
?I7a3 ?IQr?l?n?e [.r1
(Address to be sprinklered)
Homeowne /Plumber 1?-r1 '?eL , L -k j
Phone #: gqD' 377C1
Street Address: 102 (p51 zen ?'APtHS-J;*v
Ciry, State, Zip: ALtrl'LSVl 1 le 1 rX41 5533 7
Owner Name: De- met4-6E
Street Address: _??la 3 f7CC-2e/4in@ Ln
Phone #: (p$(o - $$73
Irrigation Contractor: 1-6?t. (AA-x
? pr- -
P
Phone #: ?/ 0 0 -7 3
C-s 7 Z l ?/3 C 0 7??-? ,!/R
I hereby aclrnowledge that I have read this application and state that the infor tiSi? is
correct and agree to comply with all applicable City of Eagan Ordinances
J
cc: Engineering Depanment
CITY OF EAGAN
3830 PILOT KNOB ROAD
• EAGAN, MN 55122
PHONE: (612) 454-5100
maxrrc mm
FOR CITY USE ONLY
PERMIT #
RECEIPT #
940
DATE: 8 9 9/
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
--------------
WORK DESCAIPTION
NEW CONST _
ADD ON _
REPAIR _
OWNER NAME:
SITE ADDRESS:Tmp ki?-???
LOT: ? BLOCK SUBD.
INSTALLERd",^ t/./""'i? '
ADDRESS:
CITY: ZIP: J?S b Y.5v
PHONE #:_ 3 2
?
SIGNATURE OF
DWELLINGS &
----------°------------°-----
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
? SHOWER 3.00 3.00
.? WATER CLOSET 3.00 (n•00
7 BATH TUB 3.00 3 00
? LAVATORY 3.00 ?0
? KITCHEN SINK 3.00 3,00
LAUNDRY TRAY 3.00 3•OD
HOT TUB/SPA 3.00
/ WATER HEATER 3.00 3.00
7 FLOOR DRAIN 3.00 3.00
GAS PIPING OUT.
? (MINIMUM - 1) 3.00 L0 C70
ROUGH OPENINGS 1.50 tF, 50
_ OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL S HDi 5?
ST. SURCHARGE .50
%
TOTAL: S
-------------
CONTRACT PRICE:
OWNER NAME:
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
__________________
SITE ADDRESS:_
LOT: BLOCK
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
SUBD.
ZIP:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $_
STATE SURCHARGE $_
TOTAL:
(SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN FOR CITY USE ONLY
3830 PILOT KNOB ROAD
EAGAN MN 55122 PERMIT #
PHONE: (612) 454 8100 RECEIPT
DATE: g R
Wkl.&NSGAL..
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
---------?----------- -- ------ - -------------------- -----
wuxx UP.SGKIYIIVN
NEW CONST _
ADD ON
REPAIR
OWNER NAME:
SITE ADDRESS:Tf.L J /t
LOT: v BLOCK I SUBD.
e ?
INSTALLER: ?.?i?iy?.?
ADDRESS
w
CITY:VA..?? ZIP:
PHONE #:_43 / - 7 ? ) I
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL: $30 '
STATE SURCHARGE: .50
r? TOTAL: $ 3O ?
/'? vv? - r
`b"•°`- SIGNATURE OF PERMITTEE
??HMER?TAY.JINT3pSTRI.AX.:< PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
_...... . ..... ,._
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEYARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: Zip;
PHONE
FOR:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING m $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
$
CITY OF EAGAN
+ 1991 ? ?NGI(PAPPLIION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MTLTIPLE DWELLING5
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY AYPLIES iJEiEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be llsed F Valuat ion: Date: j4Z?
Site Address?2? ?1,/,j? OFFICE IISE ONLY
Lot ? Block ? FEES
Occupancy Bldg. Permit
Zoning Surcharge
Parcel/Sub Actual Const Plan Review
Allowable SAC, City
Owne ' j # of stories J$ y?/6? SAC, MWCC
Length 1AX 15y2 Water Conn.
Address Depth /2X TI Water Meter
S.F. Total Acct. Deposit
City/Zip Code Footprint S.F. S/w Permit
S/W Surcharge
Phone l/?7- -/( On site sewage Treatment Pl.
' ?- J _
On site well Road Unit
Contractarnn?r MWCC System _ Park Ded.
?/ City water Trail Ded.
Address• t?/?2 PRV Copies
_
6ooster Pump
City/Zip Code 76r,Aqi,) ?=17 _
SIIBTOTAL
APPROVAIS Penalty
Phone Planner _ Lot Change
Council TOTAL
Arch./Engr. Bldg. Off. /(?-Z-9i?S
Variance
Address
City/2ip Code
I-1-_
Phone # I ?OrS
?? ???tt0.`c?Q?l
Sewer/Water Licensed Contr.
agrees that all wotk shall be done in accordance with
-,(Sig o on rac or)
all ap icable State of Minnesota Statutes and City of Eagan Ordinances.
* pion
d-
L11N0lV RV [YOIN • CI VIL ENGINEER9
l6NOPLANNEft4• 111NDSCAPE 6HCHIiECiS
Certificate of Survey for._
?
h?
/
/
?
?. ?
°p ?
? I
8 ?
p)
?
?oAS• I
T?
ioz9.i
.1
51 ?
Y i ?s ?y M1•???
! S ?? ?a
,
6 ? ? J '•o?
•Os-?
Ao.
b?
6?a?e
<?e
e
r. ati.
ti , ?; rG
.?
s :
Jd p??
\'•? '
?. ,
`?? ?•x?« v?
i
NORTH
?
?
? DEPT
,v ` EN
PUMR¢?3¢?`S"w ?
. REQUIRED x 900.o Dertofes fxislin? Elevalion Pr?ovosEn HoUSE El.E? rioN
? oao benoles Propo ed f/eva/ion Lowes loor Elrvo ion io24. S
- --- DcnotesUroma er'Ufili?ly £asemenf Topo?'BlockElevalion toaz.c
--i---- Denolts Dr?a'??e? Flow7'Orreclion Gardot Slab Elevafion
o l7enodrs Monumenl BPartings shown are assumenl tl Dprxges q e l-hb
LOT;5
-,BLOCk l, FAlRWAY 91LC5 3RD 41)DIT1an1
UAjKoTA ?Nryr M/NivESOrA
1 hereby oertily th t this survey, vIen or report preperad by ??- ?qr ?-u?-ny)y]__r mV dirett super lon anQ 1 I nm duly Regis red u vlye?
under the lav.a ol fhe Sute of Mlnnefole, Dated thleny ol - A.O, 19 . r-..' ?
?, v 41$ 2ale:Pnl,40?rel n RFfT TM4 .SIKUI i_..Rec.N .tae9t
?-- -- -- - _
2422 Enterprise Drive
Mendota Heights, MN 55120
f612? 681-1914
dZMUN -PEDERSon/
1991 BIIILDING PERMIT.APPLI ION
CITY OF EAGAN
SINGLE FAMILY DWELLZNGS
2 SETS OF PIANS
3 REGISTERED SITE SIIRVEYS
1 SET OF ENERGY CALCULATIONS
MIILTIPLE DWELLINGS
2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PIANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
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For Office U(se/ ;
City of Eaaau Permit C/
Permit Fee. ~
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 1 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7(P O Site Address: 47 J r4 ?_>'<L 1 ti J l
Tenant: Suite
RESIDENT / OWNER Name: u ~IZ Kip Phone: 6-t
4 4`7`c5
Address/City /Zip: 7~, , ~ ` -L I\ E_ Z EA '/J M l4, v5)23
Applicant is: Owner Contractor
TYPE OF WORK Description of work: .5 / P /A)&
Construction Cost: * 7, out) Multi-Family Building: (Yes / No
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(~l submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No if yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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, a work is not to start without a rm' ; that the work will be in
accordance with the approved plan in the case of work which requires a review and appr of
plans.
Applicants Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA147411
Date Issued:01/05/2018
Permit Category:ePermit
Site Address: 4723 Hazeltine Lane
Lot:5 Block: 1 Addition: Fairway Hills 3rd
PID:10-25602-01-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Robert W Martin
4723 Hazeltine Lane
Eagan MN 55123
(651) 456-9929
Bonfe's Plumbing & Heating
455 Hardman Ave
South St. Paul MN 55075
(651) 228-7140
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA157397
Date Issued:08/19/2019
Permit Category:ePermit
Site Address: 4723 Hazeltine Lane
Lot:5 Block: 1 Addition: Fairway Hills 3rd
PID:10-25602-01-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Robert W Martin
4723 Hazeltine Lane
Eagan MN 55123
(651) 456-9929
Kat Construction Llc
8833 79th St
Annandale MN 55302
(320) 266-3455
Applicant/Permitee: Signature Issued By: Signature