4559 Horizon CirCITY OF EAGAN Remarks L'q
Addition iCEMS MAR EAST 4th ADDITIOA Lot 3 Rlk 2
Owner (jP4di? kh??•,?ij ;?-_71 Street 559 Horizon CiI'CZC
N(o9D /? f r DlS K>!
10-17153-030-02 State
Improvement Date Amount Annual Years Payment Receip# Date
STREETSURF. 1983 1191.76 238.35 cJ 1191
STREET RESTOR.
GRADING 15/ 1983 729.95 145.99 5 729.95 C008006 9-17-82
SAN SEW TRUNK 2 Z( 1 106. 0 5.35 20 3. o aoio866 1-14-82
* SEVYER LATERAL 1983 1851.59 370.32 5 1851.59 C008006 9-17-87
* WATERMAIN 1983 5
WATER LATERAL
WATER AREA 1983 370.00 74.00 $ 370.00 008006 2-17-82
*Services 1983 5 - .
STORM SEW TRK 7 1983 379.56 75.91 5 379.56 C008006 9-17-82
STORM SEW LAT
CURB 8i GUTTER
SIDEWALK
STREET LiGHT
I
Road Unit 185,00 26803 9-15-81
WATER CONN. 335.00 26303 9-15-81
BUILDING PER. 6877
sac 525.00 26803 9-15-81
PARK
cITY OF EAGAN Remarks
Addition ' CHEs MAR FmT 4th ADDITI0N Lot 4 Bik 2 Parcel 10-17153-040-02
bwner tLEr ?-! 5: 1.0 . t!..:-,, , Fi cck street 4561 Hori zon Circle state
yrr?n __J'li?e(h !??
Improvement Date Amount Annual Years Payment Receipt Date '
STREETSURF. $ 1191.76 238.35 5 '
STREET RESTOR.
GRADING 1 1983 729.95 145.99 S ;
SAN SEW TRUNK -7, 1973 1106.90 5.35 20 3. 0 A01o86 1-14-$2 I
*SEWERLATERAL 1983 1851.59 370.32 5
* WATERMAIN 19$3 5
WATER LATERAL
WATER AREA 1983 370.00 74.00 $
*Services 1983 5
STORM SEW TRK p 1983 379.56 75.91 5
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit 185.00 26803
WATER CONN. 335.00 26803
BUII.OING PER. 6878
sAC 525.00 26803 9-15-81
PARK
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
nr.caIvac
FROM
AMOUNT $ I
? CASH
& OOLLARS
too
? CHECK
FOR
FUND I CODE I 4tA0UNT
Thank You
c?t? 61- BY
White-Payers Copy
Yeilow-Posting Copy
Pink-File Copy
? cirY oF EA"N
j 3795 Pikf Knob Road Eapon, MN 55122
PHONE: 454-a100
BUILDINCa PERMIT Receipt #
Stte Nddrcss : '" I Q ." Lot Biack l Sec/Sub.
Porcel ?t
oc Nome ' ?lller
W
? Address ''c'd8r AVe.
.. 1. 1.' I I ry r' -1
°C Name ? •,I,
o .
?? /lddrtss
? ri.., o?....._
Name _
Address
I hereby ocknowledge that I hove reod this application ond state that
the inlormotion is corred ond agree To comply with oll opplicable
State of Minnesota Statutes and City of Eaycn Ordinances.
Sipncfure of Permittee
A Building Permif Is iuued to: oll work shall be done in xcordarxe with oll opplicable Stote of Mir
Buildinp Officiol
Np 6878
(_7(r
Erect '13 Occupancy .
Alter ? Zonirq ?
Repoir ? Firo Zor?e
Enlorps ? Type of Const. -
Move ? # Storias
Demotiah ? Length
Grode p Depth ' '- Sq. Ft.
Approvob Fees
Assessment
Water 8 Sew.
Pol ice
FI?e
Enp.
Plcnner
Council
Bldy. Off.
APC
Permit - ) '
Surcharqe 7r"
Plon check SAC ,.
Woter Conn. .
Woter Meter '
Rood Unit ? - -
Totoi
on the express condition thni
Statutes ond City of Eognn OrAinances.
Permit No. Parmit Holdsr Misc. Permit No. Holder
Plumbiny o-2s(D ? M/lA??L? ct `lS`fS?
H.V.A.C.
w.u
Watsr
Disp.
Sowsr
electric Tlo7 57 , -6: -rlw ?o -7-??
Inspection Date Insp. Othe?
Footinys
Foundation
Framiny
RouYh Plbp.
Rough HVA
Insulation
Final Plbp. •
Final HVAC -4/1- X2
Final -4/,-
Wa"r Deseribo Location:
YVetl
Sewsr `
?
Pr. Dbp.
?
BUILDING PERMIT
Site Addrcss
Lot
Paroel # -
z?
°u?
?
cirY oF EA"N
3795 'ikf Knob Roati Eeyen, MN 55113
PHOHE: 454-8100
N? 687'7
Receipt #
?
M_... 1 Fr _ , o
----•
Alter ?..?
? --- ?-••-? .?
Zonirq
Repoir ? Fire Zone
Enlarye D TYpe of Const.
Move ? # Stories
Demolish ? Length
6rode ? Depth Sq. Ft.
Approrab Faes
5ec/5ub. `ies t%r F.v.3t l+th
1 hereby acknowledge that I have read this opplicotion and stote that
the inlormotion is correct and o9ree to comply wlth oll opplicable
State of Minnesoto Stotutes and City of Eogon Ordinonces.
Siflnature of Pertnittes
A Buildin9 Pcrmit is issued M:
oll work sholl be done in accordonce
Buildinp Officiol
Assessment Permit
Water & Sew. SurcFwrpe -
Police Plan check
Fire SAC "
Eny. Woter Conn. "
Plonner Woter Meter
Countl) Rood Unit
Bidy
Off
.
.
/1PC
Totol
on tfie expreas conditlon thai
opplionbJe Stote of./Ninnesota Srotutes and City of Eopan Ordinonces.
oc I Name
W
; Addrcu
Parmit No. Parmit Holder Mise. Permit No. Holder
Plumbing -?'j ?pp
? M
H.V.A.C. ??-l
l
?? E?
l?ZQ?H?I
Woll
wm?
Disp.
S?wer
Ekctrie (?"t S 3? ?fj? Tko? 10 -'I ?+
Irapection Date Insp. Othar
Foot?ngs
Foundstion
FnminQ
Rouph Plb¢ v !„ % C
Rouph HVA
Inalation
Final Plbg.
Final HVAC
Final
Water Dascribe Locatfon:
YYrli
Sov.vr '
Pr. Dhp.
Receipt MECHANICAL PERMIT Permit No. ?
CITY OF EAGAN •
Fee •
Fi1/ in numbered spaces S/C • ?'?`
Type or Print /egibly Tot. • ?' ?
1. Date ?2. Installation Cost ?^?
A I
3. Job Address` L'ot Blk. Tract
4. Owner - . '
5. Contractor
Phone
6. Address > 7 G'i iir
7. City State "-' Zip
8. Building Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New 0
I 10. Describe -' • _ . '
1 11.
Add ? Alter O Repair O
:Fuel Type
No.
? Eauioment STU - M. Ea.
Forced Air No. Eauiament CFM
Air Handlin
:
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
° Gas, Piping Outlets
12. I hereby certify that the above information is true and carrect, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved _ CITY QF EAGAN 454-8100
Receipt
MECHANICAL PERMIT
CITY OF EAGAN
FiN in numbered spacea
Type or Print legib/y
Permit No.
Fee
S/C
ToL ,
1, Date - - 1 2. Installation Cost 1:'OC. 0 `
3. Job Address Lot Blk. Tract -?
4. Owner
5. Contractor 7 „ Phone
6. Address
7. City State ? Zip ?
8. Building Type: Residential 0
9. Work Description: New Q
Commercial ? Institutional 11
Add ? Alter ? Repair ?
10. Describe-` '-I_ force •j r'?,e Fuel Type AL-,t
11.
No.
? Equioment BTU - M. Ea.
Forced Air No. EQUipment CFM
Air Handlin
:
Mfg. g
Bailers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
I_ Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Finel
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
: :t
C-f co 'VA
.Receipt PLUMBING PERMIT Permit No.
I
CITY OF EAGAN ' '/ ,
Fee ;.
Fill rn numbered spaces S/C
Type or Prinr legib/y
Tot.
Date c { 2. Installation Cost . ?
3. Job
4. Owr
5. Contractor Z//?_ Phone
6. Address
7. City
8. Building Type: Residential ?
9. Work Description: New M
10. Describe
State Zip ?
Commercial ? Institutional O
Add ? Alter ? Repair O
11,
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
= Lavatory Softner
Shower Well
? Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains ?
I
`
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454,6100
.Receipt- PLUMBING PERMIT Permit No.
CITY OF EAGAN !;' ; •
Fee
Fill in numbered spaces S/C
Type or Print /egibly Tot '
1. Date 2. Installation Cost
3. Job Address y, /Lot ? Bik. Tract
4. Owner ; // - : , ,. (-
5. Contractor Phone
•/?
6. Address
7. City State Zip,?
8. Building Type: Residential 0 Commercial O Institutional ?
9. Work Description: New M Add ? Alter ? Repair ?
I 10. Describe
I 11.
No. Fixtures
Water Closet No. Fixtures
Ce
l/D
fi
ld
i
Bath tubs ra
e
sspoo
n
Se
ti
T
k
Lavatory p
c
an
Softner
Shower Well
Kitchen Sink
Urinal/Bidet Othe
Laundry Tray r
; .
?
' Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : 'for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
cIn OF uGAN SEWER SERVICE PERMIT
27fb INk! Knob Roed PERMIT NO.:
6egsn, MN 95122
D/1TE: ,
-
Zontnfl: No. of Units:
OW11Of:
Addff'SS:
Si.e Addreu: •- ' iin rizv-i ?;1 .cle 1.•=
Plumber. v-dC 71
1 eDroe to aomplr wkh the Cky of Eagan Connectton Chorpe:
OrdimoeeN. Account Deposft:
Permit Fee:
Surchcrge:
By
Dote of I nsp.:
Misc. Charges:
Total:
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Kno6 Reod PERMIT NO.:
Eayan, MN 65122 D/1TE:
Zoning: No. of Units:
Owner: - T
Address:
E-ite Address:
Plumber. _
Meter No.:
Size:
Reader No.:
1 vOros M canPly wil6 the Cifp of Eagan
adiwanam
a.,
Dote of I nsp.:
Connedion Chorge:
Account Deposit:
Permit Fee: nrL
Surcharge:
Misc. Chorpes:
Total:
Date Paid:
CIn OF E,,,"N SEWER SERVICE PERMIT
379s Pllot Knob Read PERMIT NO.:
EAgan, MN 55122 DATE:
Zonln9: No. of Units:
Owner. ,
Address:
Site Address: - zon i;i rcle T,'?• -
Plumber: K, f c i l
I egra* h oompy wkh The Cily of Eagan Connection Chcroe:
Ordinane". Account Deposit:
Permit Fee:
$urcharge:
BY Misc. Chorpes:
Date of Insp.: Total:
Insp.: Dote Poid:
'
No..
M oomply wifh the Cihr of Eayan
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units: - - -
Connection Chorge:
Aooount Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Total:
Dote Poid:
aI
?
. , CITY OF EAGAN N? - 6878
3795 PIlef Knob Read Eoean, MN 53I22 -
?
. ? PHONE: 454•8100
BUILDING PERMIT ReceiPt #
To be wed Mr 1/2 DUPLEX Est. Value $55,000 oote-RP. FtPmbnr 15 , 19ill_
sire Adereu 4561 Horizon Cirele Erect ;pG o«ucancr R-3
Lot k Blotk z Sec/Sub. Che3 Mar E83t 4t'h Alter ? Zoning PD R'-2
Parcef # 10 17153 040 02 Repair ? Fire Zone
eniorga ? Type of Const. VII
W N.M. Joseph M. Miller Construction Move p # sm.ie:
; Address 13015 Cedar Ave. Demolish ? Length-26
b ci Apple Valley P,ane 454-4753 Gmae ? Depth__-44-Sq. Ft.-
? Name Owner APprovaH Faes
0
o
Assessmenf
Permit ?8•M
" Address
?I Water 8 Sew. Surchorge 77-50
Cit Phone
police
Plon check 149.00
?w Name Fire SAC 525.00.
Addresa Erq. Water Conn. 335-00
<1° Ci Phone Plonner Water Meter bo_no
co„„c;i Road Unit 185_00
I hereby acknowledge that I hove read this npplicofion and ztate thaf Bldg. OFf.
the information is correct and agree lo comply witM oll applicable APC Total $1629.50
State of Minnesota Stotutez and City of Eogon Ordirwnces.
Sipnofure of PermiMee
A Building Pertnit ls issued to: JQ
all work sholl be done in accordonce with
Buildiog Officiol !y
_ on the express condition thai
ond City of EaOan Ordinantes.
, .
BUILDING PERMIT
Te 6s uaea fer 1/2
N? 6877
Receipf #
Site Address 4559 Horizon Circle Erect ]a o«uaemv R-3
Lot-3 Block2_ Sec/Sub.rhEB IJja1' E88E 4th Alter ? Zoning PD R-2
10 17153 030 02 Repalr Q Fire Zone
Parcel # Enior9a ? Type of Const. vn
rc Name JoseAh M Miller Construction Move ? # Sro.ies
; Addrcss 13015 Cedar Ave. Demoliah p Length 26
b
gpple Valley
454-4753 Grode ? Depth_4-4_Sq. Ft.-
Phom
ci
eT Avvrorols Fees
o' Name
a
Z?
Assessmenf 9 ??
Permit
oU Address
ul
Water 8 Sew. ']'].$Q
Surcharge
Cif Phone Police Plan check 149.00
Uw Nome Fire SAC 525.0Q
iZ Address Erp. Water Conn ?J- ?
u
W
Planner
WaterMeter
CI Phone
< Counc;l ttooe unir 1185_00
plication and state that
d this o
th
t I h
k
l
d Off
Bld
p
ave rea
e
ge
o
I hereby ac
now .
g.
the informofion is correct and c9ree to comply with all applitable APC Total ????-5n
State of Minnesota Stotutes and City of Eagon Ordirwnces.
Sipnature of Permittee
A Building Permit Is issued fo: '
OIl wark Sholl be done in occordonce
Buflding Officiol
' CITY OF EAGAN
3793 Pilet Knob Reod Eagon. MN 55122
PHONBs 454-8I00
on tha express cordition Ihni
and Ciry of Eayan Ordinances.
1 ; •
CITY OF EAGAN Include 2 sets of plans,
1 site plan w/elevations &
UILDING P?T APPLICATION 1 set of energy calculations.
To Be Used For Valuation SS, co C-1) C) Date 9/14/81
Site Pddress: " 4559 & 4561 Horizon Cie OFFI(E USE ONLY
I.01(2?4_ Block Z Sec./Sub. _C?
hes Mar Erect ? Occupancy _
Pdreel #: /O (7?sS 03o East 4th AdditonAlt2Z' ZOninq y
Repair Fire Zone
Qunpx;JOSeph M. Miller Construction, Inc, EI1ldzge _ Tyj]E? Of COILSt. A/
Address: 13015 Cedar Ave. Move?' # stories
Denplish Front ft.
City/Zip Code: _i?pgle Valley 55124 Grade Depth ft.
Phone #: 454-4753 ?FPROVALS
FEES
Contractor: SAME
Pddress:
City/2ip Cade:
Phone #:
Arch./F1ng.
Address:
City/2ip Cade;
Phone #:
Assessments Pezmi.t Z
Water/Sewer Surcharge
Police Plan Check,
Fire SAC
Fhg. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off. -
APC
'PDTAL
CITY OF EAGAN Include 2 sets of plans,
• 1 site plan w/elevations 6
BUIIDINC; PERNqT APP? LICATION 1- set of ertiexgy calculations.
" z N _
'!b Be Used For ttoValuation pate 9/14/81
Site ss: 4559 'Q41PHorizon Cie OFFI(E USE OfII,Y
La?lock Z Sec./Sub. ChP< F1ar Erect k Occupancy _
Parcel #: /(' (-Z ?Ko o Z Gast 4[h nddito?lter Zoning - - y
Repair Fire Zone
Oaner:Joseph M. Mi11er Construction, Inc. En1dr4e _ 4Yp2 of Const. A/
Nbve,' # Stories
Addre55: 13015 Cedar Ave. Demplish Front 17 ft.
le Valley 55124 Grade Depth ,% 2?ft.
City/Zip Code:
Phone #:
APP%n7PSS F'EES
454-4753
COl'ltrdCtOT: SAME
Address:
City/Zip Code: _
Phorue #:
Arch./k7ig.
Pddress:
City/Zip Code:
Phone #:
lnw?
Assessments Permit 1 p 0 .
W3ter/Sewer Surcharge
S
?
Police Plan Check / y_q,
QC)
Fire SAC - ,71 ?.. C"O
Eng. Water Conn. _?.7.f. 00
Planner Water Meter O
?
Council Road Unit 1?
Bldg. Off. -
APC
TOrpa, 4' / (p 2 4 I ??C7
REQUEST FOR ELE,CTRICAL INSPECTION „;, EB-00001-03
, See instructions for compleliny lhis torm on back of yellow copy. ?? ??
T 6 t5:3'4 ..
?
"H?" Below Work Covered by 7iiis Request
New Atl Reu Type oi Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Liyhting Fixtures
Apt. Buitding Dryer Electric Hea[in
Commercial 61dg. g Furnace .50 Silo Unluader
Industtial Bldg. g Air Conditioner 1.50 8ulk Millc Tank
? Farm ner nf- o,ner (spedey)
iho? lSOOCifY? Oihc Othxr
Compute lnsper.tion Fee Bel w
k Fee Service Enha # Fee Feetlers/Sobfeeders N Fne Circvits
0 co 100 a o co sn Am,s o co so am,s
101 iti (10 ? 31 to 100 Amps 31 to 100 Am s
mps Above 100_Amps Above 100-/amPy
; J?a??sumers RernoteControlCirc. =0 Partial -'OtherFee
igns Special hispection
$
T
Aemmk,
45
50 OTAL F E({r?
R
le
C '
on
ap
a
Rouyh-In ? ? ? Dste 1.tha Elecvical
?? Inspectoq hereby
Final
i ?
t
Q''
"i. j
F?(77
certily tha[ lhe nbove
pection hes been
) m2Ae.
Thls reuuesi ?oid
18 months trom
Thi, request wld ?C -7
18 mon[hs rrnm
T 67534
L 3I V Ll -
a-7( -7
ftetluest.Unte
? Pire No. RouHh-i?? ?nsner,tion
fleqairedl
E]Reedy NomodLklll NaAify, InspeC-
10-2-1981 7gv", 0 No tor When Ready
filicensed ElecVical CunVactor I herehy repuest insoection uf ehove
? Ownery elecvical work installotl at
Strvet AAdress, doz or Routv No. CItY
4559 Horizon Circle Eagan
ecti m o. Townshio Name or No. Hanyc No. CounlY
Dakota
OccuuAn> IPRINTI Phone Nc.
Joe Miller
aown, suuore, . ada«s,
Dakota Ct . Farm i ton
F.lecuir,al Convacto, ICOmpany Namel Comrar.lor's i.icensv. No.
O.B. Thom son Electric Co. 0602
MIiJ?qg??d?¢?y_ .Gcyiy,? qi.; r pyy? er Ma???sjallatinni
LCV lldyiza 81 4 1tl1L ?
Authorized5i0naWie
IConvactodOwn?rMakj
rg;ln stall?tio j Phon?Numte? -
?
?
MINNESOTA STATE BOAND OEELECTqICITY .V THIS INSPECTION PEQUEST WILI NOT'
Grig9s•Midwey BIAg. - Room N.191 ' BE ACCEPTED BV TME STqTE BOARD
1821 University Ave., St. Paul, MN 55104 UNLE55 PHOPEfl INSPECTION FEE IS
ph- lqi?l ?q77111 ENCLOSED.
Thisrequestvoid lcl -7 1 ?T?
718 m6'T535 -?-7 t -7
(
Request??Jate
' FireNO. FouHh-in?InsPCCtinn
Fe??ulrcA E] . 15Pe(
ROady Nov.?W,ll Notifv. 1
-2-1 81 11Yes ?NO to, 'Nhen qesdy
:aLicensed ElneVical Cnnlractoi 1hereby request inspection ol above
? Owner elecvical work installed al:
Street AdJress, Box or Rou[e No. . City
4561 Horizone Circle
ecuon o. Township Namo or Nn. Rnny?, No. Cowity
Dakota
Occupani (PFINT) Phone Nn.
Joe H4iller
Powcr Sup0lier Addross
Dakota Cty. Farmington
Elec[rical Cnntrnr.tor ICOmoany Narnel Conliactor's License No.
O.B. Thom son Electrio Co. A40602
Mailinp Address ICoMrar.[or or Owner Ma kinp Installatiunl
i 2201 Mtka, Biva., Mtka 55343
Authorized SlgnatureflConvactor/Ownnr Makiny Installitionl Phona Number
J
R
MINNESOTA STATE BOARD-0F.ELECTHICITY THIS INSPEGTION REQUEST WILL NOT
Griggs-Midwey Bldg. - Room N-791 ' BE ACCEPTEO BY THE STATE BOAHD-
1821 University Ave., Sf. Paul. MN 55104 UNLESS PflOPEH INSPECTION FEE IS
an....o 19121 997.7111 . ENCLOSED.
/? ?! ?`?REQUEST FAR. EL?TRICAL INSPECTION ,-.p EB-00001-03
T Y47 ?' See instroctions lor completing ihis tnrm on back ol vellow copv. ?? ??
V ! I
""X'" Be/ow Work Covered by This Request ?
New P,dd aV? Type of HuilAiny poaliancas WireA Eqvipment Wired
Home Range Temporary Service
Duplex Water Heater Lightiny FixWres
Apt. Buildinq Dryer Electric Heatin
Cnmmercial Bldg. Fumtice 2.50 Silo Unloader
Industrial Bldg. Air Conditinner 2.50 Bulk Milk Tanl<
Faim otner Iv
5,00 Utnei Isuor.ityl
t erl5pocity pther Othqr
Canpute lnsnectron Fee Below
A Fee Service EntranceSize k F
ee FAeders?5u?teaAers 4 Fee Circalls
OUG ?O OOo 100 Am s 0 to 30 Am?s 5• to 30 Amos
101 to 2U0 qmps 31 to 100 qrnps 31 to 100 Am s
°°6 200 <1 Ps Ahove 100_Amps • ? tlbove 100_Am?s
'ris+ rn r ? Remote CoMml Circ. Partial-'Other Fee
iyn Speciallnspection p
S 45
?
T
Aemar
ks
9..« n_..l .... ?J OTAL F E
Rough-in ( Date
r
?
?. me eie«.icei
D70' Inspector, hereby
tif
th
h
Final
D;?I1x/,? ? cer
y
ut t
e above
pection has heen
? ? Y/ made.
T'his requesl voitl
18 i... nths hom
(Etx#ifirtt#P nf Orrupttnry
Citp uf Cagan
Depwrfmrni nf BuilDittg Ittsprdimt
Tbir Crrtifitale itruul purtuant to the reguirtmentt of Section 306 of the Uni fornt Building
Codt a+tifring that at the time of ittuantt thit ttrutturt wuf im compliantt witb the vrtriout
ordinannl of rix City rrgalating building rontt+nttion or ute. Fa rhe following:
OoChNiuum V2 njIPi'FX BId, PemrilNa. EP.77
0-wwr7Ym R3 rrvca..,o,? Vn F. Z. Tm z?rowma (Pn) R-2
1-?-Ih -t-I ?°yi 4t
eawwoffiow A,- o.v: Jariuary 6, 1982
.o.. ,. . ??,?. ...?.
(grxtifirttte af 09rruvttnry
Citp uf eaqan
Drpttrimenf nf lguilding 3nspertiun
TSia CMi frtatt irrued purauant to the nqairrmrntt of Settion 306 of the Uni form Building
Code tMi(ying that at the tinu of irtuarut tbit thuaure was in tompliann wirh the varioHJ
adinancrt of the City regulaling 6ruldirsg ronn+uttian or ure. For tbc (o!lowing:
UA?hm 7?2 DUP= 6878
,
0--V? Tya R3 ?.C?tl. ? F.??, rA ?t rn R-z
a.a.orma.,_Joseoh M. Pdiller ,,. 14115 Guthrie Ave., Apple
By. -? u+
a,.: Januarv 6, 1982
.o., ?. . ?....,?,. ...?.
5q Sq"j RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telep6one # 651-675-5675 FAX # 651-675-5694
kOO-?.?
New Construction Reauiremenfs RemodeVFteoair Reauiremants Offce Use OnN
3 registered sfle surveys sharirg sq. ft of lot, sq. ft. of house; and all roofed areas 2 copizs of plan CeA of Survey Reoi
(20% mauimum lot coverage allowed) 1 set of Energy Calalafions for heated additbns Tree Pres Plan ReW
2 copies of plan showing beam 8 window s¢es; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd
7setofEnergyCalalalions Addifion-indicateffon-sifesepticsystem _On-siteSepticSystem
3 copies of Tree Preservation Plan 'rf lot platted after 7/1193
RimJoistDefailOp6onsselectionsheet (hldgswith3orlessunAs
Date ?-L70`S
Site Address ? 5 s g ? ?el7G Construcflon Cost ??? , 00
j / 11ae1,_-_D!V UniUS[e #
Description of Work 9&*1OViF_ 621P11j/6 -??ff?(?? Ga//Y7? //?/1./?L
Multi-Family Bldg ?C Y_ N FSreplace(s) _ 0 _ 1 _ 2
Property Owner ??GAtq/e__ 10,q- Telephone # ( )
Contractor .gEeeGL(JA)jj 9/--
Address 1{6 0PG1E4S.4N7- ?¢11Q_5A/(JV City
State ?r?/??????So"7?`I Zip SS 3 3/ Telephone #(6 %-) ) 75 /.
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculatlons Su6milted?
?????Y?
Licensed Plumber t?. ?? ? ,.., 1Telephone #( % ILu.
Mechanical Contractor ?UN O Telephone #(
Sewer/Water Contractor Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand Utis is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name ApplicanYs 1117•e
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 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 or_ N? 25 Miscellane0us
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (FoundaUon) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors
? 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 Bidgs 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 _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone ,
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
CITY USE ONLY
PERMIT #: ?1 I '?;f
2002 RE5IDFNTIPcL MECHANICAL i'EftMIT APPLICA110N
CITY OF HAfiRR
3$30 PILOT KNOB RD
E?s" MN 55122
s5i-6Rti-4675
RECEIPT DATE:
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
/?6 A''
Date: e
SITE ADDRESS:
?
?
OWNER NAME: ?Y L L ?`' ?ZiTELEPHONE #: C?SI L/? ? ?
INSTALLER NAME . . . . TELEPHONE #:
STREET ADDRESS: M Washingt?nAvenue
rame, MN 55344
941-1044
CITY:
STATE:
ZIP:
Place a check mark next to the permit work type
?
1 Add-on, modification or alteration to existina dwelling unit
C^ X.00
? • urnace replacement
air exchanger
• air conditioner
• ather ?
Natu of work:
State Surchar e $ 50
Total $3?
?TUOF GNMITTEE
iroz
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
2002 COMMEftCIAL 14I£CkaAN[CAL P£ftMIT APPIriCATION
C1TY OF ERfiiakN
S$SO PILOT KNOB ftD
EASA1u,1Kht 55122
651-6$1-4675
Please complete for: all commerciaVindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
llATE:
SITE ADDRESS:
OWNERNAME: PHONE#: -
TENANTNAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
MSTALLER:
STREET ADDRESS:
CITY: STATE: Z]
TELEPHONE
WORK TYPE: New construction Install U.G. Tank
_ Interior Improvement , Remove U.G. Tank
_ Processed Piping
SpecifyNature of Work:
When installing/removang underground tank, call 651-681-4675 for inspection by Fire Marsha[ and
P[umbing inspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaVinstallation = minimum fee
Contractprice: $ x I%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNA"I'URE OF PERMITTEE
Updated 1102
CITY USE ONLY
PERMIT #: RECEIPT DATE:
2002 R£SIDEN'fIAL MECHABIICAL. i'E{MTl' APPI ICATIOP
crrY oF eAsAN
S$SO PILOT KPOS RD
C,tfiAN MP 55128
651-681-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: A _
SITE ADDRESS:
?
"
OWNER NAME: x,J I L S ?l-Gdz4f- TELEPHONE #: z9v II -L 17
INSTALLER NAME:
STREET ADDRESS:
cirv:
78109, MN 56344
941-1044
STATE:
Place a check mark next to the permh work type
-.-"
?- -
ZIP:
1 Add-on, modifcation or alteration to existino dwelling unit 00
Qfurnace replacement
• air exchanger
• air conditioner
• other
Nature of work: '
State Surcha e $ 50
TOt81 ISV2
N II O PERMITTEE
vo2
7402
TELEPHONE #: ?? ?_?
CITY USE ONLY
PERMIT #: RECEIPT DATE:
APPROVED BY: , INSPECTOR
2001 COMME$CIAL MECHANICAL PEiZMTT APPLICATION
C1TY OF EtRfiAN
S$SO PILOT KNO$ ftD
E+kHABT. M1V 55122
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME:
TENANTNAME (IMPROVEMENTS ONLY):
PHONE #: -
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
STREET ADDRESS:
CI1'Y:
TELEPHONE #:
WORK TYPE:
Specify Nature of Work
New wnstruction
Interior Improvement
Processed Piping
ZIP:
Install U.G. Tank
Remove U.G. Tank
When insta[ling/removing underground tank, call 651-681-4675 jor inspection by Fire Marshal and
Plumbing inspector.
Fees: I% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee
Contractprice: $ x 1%= $ (Base Fee)
State surcharge calculate at $50 for each $1,000 Bas _Fee
TOTAL
$
STATE:
Updated 1/02
. ,
, YC;cqc? rerlr
P!•
C
P
:
?
.
UO
P1iR10R PNV
r::
- ' pW W e Joseph M P`itier ConGtruetiQa•??ns_
iITE A1wftBSS: 4559-4561 Horizon Circle___ PIIONti:
aaNnu+cTvR: L,??, u4=?GZ
DeYecminc aorkinq squai.: loot.ayc of each
.
. 17 471
?
1.
S(]
?bCAl CXpOYd W811 IITBa......
? _.?.
. ft. X _.
--
C
>7 05
ft. x
2. ---
lbal roof/cviling area ......
- ._
1bta1 expasec' wall area aLove f lu
....... Z Z
•. Total wall window azea ....................... ...
......
Y7
L?
?. ^s t.,i 7. :1e:,r area ... ............ . .......... _
....
.
......
C. Total slilin;l 9.1acs dunx area ............... ....
d. Total fireplace wali area ................... ..........
•. Total wall frming aree (averaye 10.)........ t,........
f. Total zin joirt azea ........................ ..........
Q? ? vall 1?rea atbove floor ................ .......... Sp
h. wa)1 aree above floor ................ ..........
i. wall asea alwve f.loor ................ .... .....
j. aall area above floor ................. .......... "
' 'Motul azposm3 fouiid.,tioii arca _ __PPD6?
:
i
k. i?btal taas.dation windoa area ................. ..........
?1. Total net foundation ares ebove grade ....... .......... 77 •
Detcrmine "L"' valuc nf
(e.g. windcw, door, e.u'.L c,;ax at.:. wal! Sn_.'.ion) ' .
Z x "U"
?Q
a. _
c
b.
C.
x
a.
??O,O r, „0"
e
.
300
f
z ° U'
G ?
- -
.
?
--- . . .__- --
f:.
x ..U.• _` _.. . _ ...??......._
X "'J" ;,c t;t.in ii.em ;t1, vot
?'? I..??•,. ?„,t Ihr iol.?nP ot
k.
? ._.._.__.. __
?
?? i
_.... _
-_. ?_._. .
:. • _._
?? • -? ?
MNcior Inwlope 1Werage "U" Computat:ion
?
',.? . ?? . ..
w
1bta1 exposed roof/ceiling area
a. 'lbtal skyliyht area . ......................_.. i
n. 1blal soot/osilirq fraMing area (avaraqe kUa)...
o. Total nst iruylated roof/ceiling area........... 11 • v
Determine "U" value for each roof/ccilinq seqment
r.yyw c ui Y
¦. `- X •U• r'
n. I -Y?6 X "U" -5. L 2
O. J t -XP • 3 X -U-
4 ........................... 7bta1 = .?Q• '?"l?'
..
Ii total of /4 is tM saoa ar, or less than Y2, you have met the intent of
mC 6006 (c) 1.
AlW+tata wllilding Envelope Design
1r atilise t1M bfal uwolqp'systeo aathod, the valuea establishad by the sum of
Lrt #3 ana 41 iall mk be 9rwter than tha eun of iteu il and N2.
i. 473, fo + s. /S-,44 ° 5
z. + 4. ?.--
???-?'?
2??qz_w-titl=??v
?? ?? _? ? = l0 4
--?-------..
37 O 1
? I io DRS, II
51-(e,°=7`l.Z
M4 U u t +5 C?
ZIMti ?F! 1S? Ot OpaqVQ MYta o..-.. -..-
'?"?' - l'ra?s eonstrueti"
oooooooooo?
?
Cu _nstrticrion
1.
1.
7. '
1. '
5.
Exterlor ASF Illm ToCel
? . . ?_ .o.? . .
1.
z.
,.
4.
5.
6.
U•.o4
?.
z.
3.
4.
S.
6.
'O is
? .
: %?
?? • ? ??) 1
, ? • y ?' ?
i. • .
? A:.
. .• ? r
: c.r.. 03
. 7?98-
0.69
Int74, i?r til filn?
2• 3. im 0 17 F.x., ?. (.?
_--r-?- - . Total ?
j v .4
ST.T.D uN Gt_titi,E . ?-----
?-?"
r ,. • . ??L ' , e
• •
(?(?:P? 1 ? 1{ k . ? . • ? •" '? . ? ..
J •
/( ( ' d • ;:-
?? ? • ? . . ? . ? 'r ? ? ,,
1fI • ?. ' _ /(!,
? t
= '• ?
Fsr;. 04 Irt b '• ,° 'rlI ?.
x
x =
W =
InJicate ty!lc, °4.. value, QePth and. _
placanent ui insulation. ' .
'STYRc
CITV OF ERGAN
CASHIEF: JS TEkMINAL N0: 6$D
DATEe 12/06/33 TIME: 15:11:21
ID:
NAMEz L.EE FlLLEN RERGLUNL1
3210 ?OQi 4553 HOFIZON CI 125.25
2155 3001. ¢553 HORIZON CI 3.00
Tn9;a7. Receipt Amaunt? 126.25
Cfi:1.2030i
UuEF ILi: iAN
1999 BUILDINC pERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGl1N
C? 3830 PILOT KNOB RD • 55122
651•681-4675 ? a-. ?• ?.- 5
NewComtruetlon ReauiremeMs
D 9 repistered ska surveys shwving sq.IL of IoL aq. R of lauae
and all roo(ed araas 120% menimum bt ewenae ellowed)
D 2 copbs o( plans (show beam 6 window ahes; poured fid. deaign; ete.)
D 1 set of aneryry ealeuleUons
D 3 copiec of tree presemtion ppn H bt plaroed atter 7H193
DATE: 11?tA / "J?
DESCRIPTION OF WORK: 7 A E,'OF? /E
STREET ADDRESS: y S S/- yS ?? ?
LOT: ? BI.OCK: ? SUBD.IP.I.D. #: CC
RemodeURaoefr Reauiremams
la-Cd-99
2 wpin of pWn
7 oat of energy ukuiatbns tor hea'ed eddilbne
1 site suney for exterioraddltions 3 deeks
CCYS7RUCTION COST:A rv??l Cc
q_ `
i
Name: ? Phone #:
PROPERTY Lag First
OWNER I
Street Address:
City I State: Zip:
Company: phone#: 6l1?- -t"5/-5??
CONTRACTOR ?
Y/
Y86 D ?area eode)
??s
5/
0
Street Address: /
/?JN ?
0
License # d922,??1
Enp. -3
City State:Zip: ?553a SL
ARCHRECTI
ENGINEER Company: Name:
Telephone #: ( ) I
Sf; eet Address: I
I 4eg!stration #:
CI1y State: Zip:
SewisP3 vwter licensed plumber (new eonsWctlon onlv): Telephone #:
Penalty applies when addreas change and IM change is requested once permR is baued.
I hereby acimowledge tliat I have read this appllcafion, stata fhet fhe Infortnatlon Is wrted, and apree W compy wHh all applkable,.BJ?Ee^oFMiqnesota Sta[utes and Cit
M Eagen Ordinances.
SignalureofAppila .
, /
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace O 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plez ? 12 12-plex ? 17 Garage ? 22 Poroh/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck . ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging O 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permi:
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
5AC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee
Surcharge
Plan Review
i irerisA
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
r
SAC Units
% SAC
? Certificate for:
,Soa Miller Construction p?K 5Z154
. 13015 Cedar Ave. So.
Apple Valley, Mn. 55124
DELMAR H. SCHWANZ
LAND SU(iVEVOR
Reqisteretl UnGSr L+ws of The SUU of Minnesota
2978 - 1457H STREET W. - BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 812 423-1769
SURVEYOR'SCERTIFICATE
N1???h=30?e?,?
, ? S?ale
? ? 942.2Z DF.?oT?s T'cKt srIuc. VA-Ej AT?oa
I \ S. ? [?@.rJOTES ?R.JA?s20 F ? N?,5 N
'"fc0 +1'TtD?
IU?
O \ Sg. I] DE00"r'ES SET WOOD t406
o . ;
p? Iq30 'rop No? ? ?3J,
0
0) N? ;:? To ??FJ ToPloorJ
Z
Z I ?, 3c) . Fx.tJ. _ 93b.r01 e,,,'J. = 33.i
? 9 4 i ?i ?4 8/4 \ 11
3 bV 30
?,o tiro9?Z.?
? ? PI?POSE15 / ? ?
N"i
1VDIS
? . .i ??V • y `/
Tup Ilva ?/`' O ?.
?? f?eo.94o.a5 _. ? ? ? •
Thp gmg
/o v it
N 8Oo 23' =~ 10 ?GLJ Q? ?
w E 54, 84 4` ? 3,3 ? v
_ °?3?•5
ToP ?QOa
?cU.t1,-?132•`?°1 3D
I hereby certify that thie is a true and correct repreeentation of
Lots 3 and 4, Block 2, CHES MAR SAST FOURTH ADDITION, according to
the recorded plat thereof, Dakota County, Minneeota.
Also showing the location o3' a propoaed bul3ding°as-ataiced-thereon.
Dated: July 21, 1981
MINNESOTA REGISTRATION N0.8625
?
Use BLUE or BLACK Ink
I
_F or O ffice Use I
l
j Permit
non
City of Ea I Permit Fee:
3830 Pilot Knob Road RECEIVED {
Eagan MN 55122 MA~ Z 3 ?~~2 i Date Received:
Phone: (651) 675-5675 t staff
Fax: (65.1) 675-5694 1
- - - - - - - - - - - - - - - - -
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant: Suite M
RESIDENT ! OWNER Name: Phone: FZ~Z
Address / City / Zip:
Z21- LW a 10
Applicant is: t _ Owner Contractor
~ C± G r
TYPE OF WORK Description of work: f l l ,i c_ i
Construction Cost: o_; ~G'LP r Multi-Family Building: (Yes
CONTRACTOR Name: il1CVL~T~~f Ji~S License#: 6L~DU& S(~
Address: 7 6 ~a , ~s . City: All
State: 9- Zip: Phone: ~ i - _7
Contact' Email: tom, r
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.2cp_herstatecnecalLoi
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 the approved plan in the case of work which requires a review and approv of plans.
X
~Awh
Applicant's Printed Name Applicant' gnature
Page 1 of 2
Kampsula & Schepers 1013340 & 1013214 288.25 Use BLUE or BLACK-Ink
For Office Use
Permit
1 of Wall j~ ~s ;
Permit Fee: 24 0
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I ;
Fax: (651) 675-5694 1 Staff: -Z~g
i
~_._____________J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11-15-1 Site Address`. Unit
Name: Tammy Kampsula & Peter Scheper/Joined TownhomePhone:
Resident/
Owner Address/ City! Zip: 4561 &4559 Horizon Circle - Eagan, MN 55123
Applicant is: Owner X Contractor
Type of Work Description of work: Reroof 33sq & Reside Back 8sq
Construction cost: 6,700 Multi-Family Building: (Yes X ! No )
Company: PCS Residential Contact: Patty Hanna
Contractor Address: 2nns Pin nak l)riva City: Fagan
State: MN Zip: 55122 Phone: 651-255-0609
License BC593158 Lead Certificate
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 fora 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 supp?orting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.oopherstateonecall.org
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 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 Patty Hanna/PCS Residential x
A/Ocn
pplicant's Printed Name Applicant's gnature
Page 1 of 3