4448 Lakeshore TerINSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number.
? Eagan, Minnesota 55122-1897 Date Issued: '
(612) 6$1-4675
SITE ADDRESS: APPLICANT:
% rii`7.'..I1!+i?i 11 It i:i?l ? T'i,?;r ;;i?l•!i '. 1?3!
?{ifi{2F a
PERMIT SUBTYPE:
TYPE OF WORK:
tvre?
(1 f `-; r tt i' {' T t t? N
INSPECTION ., .
?? . .•
I iA kk"•:: ?f & W wLHk? - bJrMZfl. Mf:(14
Permit No. Permit Holder Date Telephone #
ELECTRIC I/A?"? .$ 107 00
PLUMBING G !,119-7 q-V-1545
Hvac J?7 97 9,q6- 4, b101
Inspection Insp. Comments
FOOTINGS
FOUND
FRAMING -7 q
!
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING / ? ?
GAS SVC
TEST /2'7 /1
INSUL C-'71 7 ?
GYP BOARD :- '?j
/
FIREPLACE
FIREPLACE
AIRTEST
-?-g
019
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
?
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
? 'A INSPECTION RECORD
CITY UF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
I Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS: APPUCANT:
_9130 7
PERMIT SUBTYPE:
TYPE OF WORK:
ttEI'llyrK1r1:T" N
Nt"W
j1 rit : IiMtYS)
INSPECTION D• . .A
; t ri ? -,?,i ? r!•
t t!',i1E ii i i iil,
???'?•?i ! r? . . . ,??it?. i il ;i I •
? i, a;': ( I' I 4 i ?, 4 I r.i i?, ?
RFMnRKs: S & W Pi.fift - Wrrr.f. I MF.4.:1i
, . .. ?
Pertnlt No. Permit Holder Date Tetephone N
ELECTRIC
PLUMBING 97 _
NVAC
Inspeetlon a e Insp. Comments
FOOTINGS
FOUND
FRAMING
/? .
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GA5 5VC
TES7 ?
INSUL
I
GYP BOAFID
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG ?? ?-7
l rJ
1V
FINAL HTG
l
ORSAT
TEST
BLDG FINAL Z?
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FlNAL
sk s. =-??
. _ ? -'-- -?-------" . 4
OtrtiitCRt¢ df CCCIipQIiCV
Witv o f Cfagatt
?e?rartmeut of ZuiLbing Znapection
This Certi,ficate issued pursuant to the requFrements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with rhe various
ordinances of the Ciry regulaiing buelding construction or use. For the following:
Ux Classificatiore SF DWC Bldg. Pertnft No. 2()202
Occuparicy Type R3! u, 7sming Uistrict PD Type Const. VN
o,?r.fBuiiei.g HOFTYM fOWS IlVC naam 2214 E 1171H ST, BJ'Oi1M
Building Address ?? U6102M Md= l.ocaliry L23s B3f MIFF IAM RIDEW
.(. . . ,?-
Uate: -
-- 8uildiogOfficial .
POST IN A C0IVSPICUQUS PLACE
WtrdfiCQ.t¢ 0f CCC1ipQIiCv
%itij of Wagan
ztoartmeut of Zxi[bncg 3x4pectiua
This Certificate issued pursuant to the rrquirements of the Uniform Building Code
certifying that at the time of rssuance thrs structure was ire compliance with the various
oridinances of tlu City ngrilating burldeng construction or use. For the followrng:
Use Classifiption: SF DW Bidg. Permit No. ?? 1
0-uPancy TyPe R3/U ' Zoniuy DistriR Type Canst. VN
o? ar s„ikling FWFMAN HQWS Ilr' Addl,? 2214 E t 17'IH ST, B' Vn 7 R
eii,d;,,g Ad&lm$4448 I.AKESHORE TEFJ= Lmcal;ryi.24, B3, MFF UM MOW-.S
` . n?:
Building Official .
POST IN A CONSPICWUS PLACE
/ /. ?? ?•9 C? /(f1? OFFICE USE ONLV This reque9 wid 18 monllis Imm vaLdohon daNpnnted in Ihis boz
V . l"+
4? 7
3
?? ?
? III I?I III I
I II II I II I I I II I(I
?
e
?7
^'a
I
0 4 0 5 3 8 4 9 ?? .
PLEASE OR
TYPE
kiequesr Dare Rough.n mspechon reqmredz ? N. Inspectian Other TMn Rough-In ? Ready N. dl Coll
?You mas? coli the inspeclor wh n readyl Date R O fl
I, 11,1icensed canfractor ? owner hereby requesl inspection of Ihe above electrical w
Job ddress ?Street, Bw,
-Y??, e No ?
aul ?Vt• Ciy Code ,?
p- •
Sxhon No Township ame or No Range No. Fre Na Coun
Ocapenl Phone N.
PowerS?pp Addrexs
Eledrim Convacior (Company Name) o Imcbr L< se N Nwsrer Lc No (Plam Elecr Only)
Maainy aa;e„ lconnecro, w e, vedo,min9
? qo '
Avllior ed Signmure (Conrcocror or Owner Parbrming InsMllofianj Phone No.
__r?k _ -6 S1 aq -?- ?
EB00001Ali l 6/96
116,197
405-384
• • REQUEST FOR ELECTRICAL INSPECTION '?-o XZ
? Minnesota State BoarU of Electriciry
1821 Universiry Ave., Rm. 5-128, St. Paul, MN 55704
Phoue (612) 642-0800
Home Duplex Apt. Bldg. Other: Naw Addn
Commercial Industrial Farm Remod Re air
Air Cond. Ht . Eqmp. Woter Hfr. Load Mgmt. Ofher:
Dryer Ran e Elec. Heat Temp. Service
°X" obove fhe work covered by this request Enler remarks in Ihis space and on rhe back of the white copy only.
?
Cakulate lnspection Fee - This Inspedion Request wilf rtot be accepted without ihe mrrecf fee.
Other Fee # Service Enirance Sizc Fee q Circuits/Feeders Fee
Mobile Home Park Stall 0 ro 200 Amps 0 io 100 Amps
Sheet Ltg./TraHic Sig. Abave 200_ Am s Above 100_ Amps
Transformer/Generotor INSPECTOR'S USE ONIY TOTAI
Sign/Outline Ltg. Xfmr.
Alarm/Remote Conhol ?
Swimming Pool
I hereb cem tha, I ms ad the el xallarion de hami on the ddes siared
Irrigation Boom go„91,1„ ooM
nql
S
eciallns
echon
p
p
Invesiigahve Fee _
Finol D
i
TNIS INSTALLATION MAY BE ORDERED SCO CT NOT COMPLETED WITHIN 78 MONTHS.
e p_rmtOn this boz.
O yJ/7/?s e OFFlCE USE ONLV This request void 18 momhs Fom wli31
n dOl4
Y / O ?? ?? II?I?
III??III I II II IIIIIIIIIIIIIIIIII?uy/'?3/ J?
???
0 4 0 5 3 8 5 6 *
LEASE PRINT
Reqoest Dom koughm mspection reqwradE as ? No
?Yw musl mIl IM inspacror when ready?
Ilrail
Ins eon Olher Than RwgMn. ? Ready N.
1,?.4censed coNmcror 0 ownar hereby request inspection of the above elec al w
n
i56 Addrass ISheep Box, Rw&
'V Ciy
Secnon N. iownsh, ame ar No. Ronge N. fire No. Cou
Ott?po?? PhonaNO_ ? Vo
Pawer Su Address
Electri I Conrcacror (Compony Nomel A I R
? Conl c Licenu No.
nO U Masbr Lc Na (%anl EIM Only)
Mai6 ddress romm< Owner.
Pehorming I siolloli
A=ocbr ) or ParForming Inslollmion) f
? ? I Phone No
Co
EBOOOOIiY-i l 8/96 er..c o..dd;l r-v _ ?« ??e.aur.?nue nu .rv ne vm i nw rn.
//& / 97
405-385
\ i
REQPEST FOR ELECTRICAL INSPECTION
61 Minnesota Siats-Board of Electnciry ?
1821 University Ave., Rm. 5-128, St. Paul, MN 55104
2hone (C:2) 642-0800
Home Du lex A 1. Bldg. Other: ew Addn
Commerciol Indushial Form Remod Re air
Air Cond. Htg. E uip. Woter Hlr. Load Mgmt. Ofher:
Dryer Ran e Elec. Heaf Temp. Service
°X" obore rhe work covered by this request. Enier remorks in this space an on the bock of fhe wh' copy only.
??t p?& o.,f<?.. '?Y,Sn
Colculo(e Inspection Fee - ihis Inspedion Request will not be accepted without fhe correct fee.
Other Fee q Service EnUance Size Fee ft Circuits/Feeders Fee
Mobile Home Park Stall 0 b 200 Amps )_S0 0 to 700 Amps M'k
Shee1 Ltg./TmHic Sig. Above 20Am s Above 100_Amps
Transformer/Generator INSPECTOH'S USE ONIY TOTAIL
Sign/Oudine Llg. Xfmr. ?
/
Alarm/Remote Control
Swimming Pool I here cerri thm I ms echic on d nbad harein on the doiea smt d
Irrigotion Boom poi? n
Speciallns
ecfion azz ?
p
Invesfigafive Fee Hooi oei`?' 9
/
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT COMPLETEU WITFI?N 19 ONTHS.
HOUSE HEATING TEST RECORD
ADDRESS,q/?-G'I?P f-C APT._FLOOR
O(:CUPANT d W1Oj?" OWNER
HEAT LOSS DATE HTG. INST
SOLD BY INSTALLED
Elsctrical Work By ? _Gos Line By
TYPE OFHEAT GA _ FA _HW _STEAM _SPACE MTR.-
8Y
?
CITY?qg, e0'ISUBURB
UNIT HTR. -OTHER
GAS DESIGN CONVERSION
MAKE - V t'_A"' -MAKE OF BURNER
Model f'V 1) ICY)c 9 M,d,i RAY N. WELTER •
$enal Mac. BTU Rorinq 4637 Chicago Ave. So.
?
_
INPUT.??3fcYG:t' -MAKE OF FURNACE i f7PapQIjR MN 55407-3592
Model RR67
THERMOSTAT
Valve
Limit
limif SsMiny _
Fan SeHin9 -
Pilot Trpa -
Pilot Make -
Piloe Model -
Pilof Timing
L.W. Cut Off
??? ?f d
Pros:ure?u_k5I -PoresnTCO2
Input CFH . C? ff... Parcont 02 e
Sfoek Tamp. Pareent CO
Fam 235
CONTRDLS
Vant Size -
KIND OF LINER
SIZE NONE
Draft Hoad Rsgularor
Filten Si:e Numbar
Chimner LoeaNen I ids Outfide
Chimney Conaemetion (??
$moke Bomb
Drah .
Door Prossurs
Wiriny'
Tasf Toq
Liqhtinq inst.
Date Tastad ?- ? /r
Company Tsating
Nams oF Tsstsr
2006 RESIDENTIAL BUIIIDING PERIVIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Constructian ReouiremanLs
] regiscered srte surveys showing sq. R of lot sq. R of hase: and all roofed areas
(20%mitumum lotcroverage allawed)
2 mpies of plan shoMng beam'& wmdrnv sizes; pared found design, etc
1 set ot Energy Caluila0ons
7 mpies of Tree Preeervatlon Plan it lot Dlatled after 711A3
Rim Jdst Oefaii Optlons stlecppn sheet (yuJtlings wAh 1 ar less wits)
Mimegasco mechanical ventilation foxm
Date /v / 01 / 00
SiteAddress A16Q'f yCA
Description of Work
Mutti-Famiiy Bldg
Property Owuer
Contractor
Address
Sta[e `
YJ_ N
0.emadeVReoeirReauuenen6
2 cWaes of qen shawmg fuotlngs, beams. lasts
1 set of Ensqy Calahdons for heated atltlitlau
1 srbg wrvey tar adOitians 8 tlecks
AddiSOn - indicate d ?srte sepffc sysfem
Canstrucrion Cost ;5
Fireplace(s) _ 0 _ 1 _ 2
.41 Ce r5a?
3,??-,2,?
dlfice Use Onlv
Cet of SutveJ Reod Y N
Trgg Prgg Plen ReW _ Y_ N
Trea Pres Required _ Y_ N
On-site Sepac System _ Y_ ry
J'1G7?../ City v/
-ip 653 n Teleohone =(q//l
/?
CaMPiETE T3-IIS AREA OldLY ]F LaNSTRl3CT7iHG A NE'N B331LDING
Energy Code Category r Minnesota Ruies 7670 Cateeorv I _ Minnesota Rules 7672
(?I suhm?xsion rype) • Resitlerrtal Verrtilabon Category 1 Worksheet . New Energy Code Worlsheet
Submitted SuCmitted
• Errefgy Errvelope Calalatlons Submitted
In the last 12 months, has the City of Eagan issued a permii for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/water ConTracTor
Telephone # (
Telephone #(
Telephone #( ?
I hereby apply for a Residenrial Buiiding Permit and aclmowledge 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 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 th case of work which requires a review and
approvai ofpians. , Ok
aI
?- I/OhS I Applican 's Printed Name AQplicant' Signpture
V ~ CITY USE ONLY '/
L BL ?- RECEIPT#: 210 `?a
SUBD. ? py RECEIPTDATE: 311 '797
9997 MECHANICAL PERMIT (RESIDENTIAL)
CIT1f OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN $5122
(612) 681-4675
Please complete for. . single family dwellings
? Wwnhomes and condos when pertnits are required for each unit
New construction Add-on fumace
Aad-on air conciffioning Aaa-on air excPanger, i.e. vanea sysixr n, ete.
Date: 3 '1Li '.7 7
0
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M 8TU 24.00 ?
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @ $3.00 each) 1 ?
? State Surcharge .50
12.60
TOTAL
SITE ADDRESS: &14f ? ? ? ?? ? 1WL
OWNER NAME: I P N4 k1 I4mL PHONE#: 02/?' 910
INSTALLER NAME: ?? PHONE #: 3ri 5?-IOL?
STREET ADDRESS: ?? ? / ? • ?CKR/I . &
CITY: ?j/JCL STATE: ZIP: ?U J
r
?
SIGNATURE OF PERMITTEE
R74
?.
L aJ gL CITY USE ONLY
? RECEIPT #: vD VD
SUBD. L2?1?1iwe-? RECEIPTDATE: 3// 719 7
1997 MECHANICAL PERMIT (RESIDENTIAL)
Y
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 66122
(612)681r4675
Please complete for. • single family dwellings
? townhomes and condos when pertnits are required for each unit
w"e New construction Add-on fumace
Add-on air conditioning f?dd-on air excnanger; i.e. vanee'systzm, eic.
Date: 1 /y?v
? Minimum Fee: Add-on/Remodei (existlng residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00 ?
Additional 50 M BTU 6.00
y
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL 27
SITE ADDRESS: '
OWNER NAME: _
INSTALLER NAME:_
STREET ADDRESS:
PHONE#: 8'1
PHONE #: ''h0
CITY: ' / IIIL ? STATErniU,, ZIP: -7
4O zo?/-
SIGNATURE OF PERMITTEE
q 7J
?
?
L cP41 BL 43- CITY' USE ONLY
SUBD.
STATE SURCHARGE .50
TOTAL
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please compiete for. ? single family dwellings
? townhomes and condos when permits are required for each unit
. backflow preventer for underground sprinkleh system
FIXTURE3 EACH N,Q, TOTAL
Shower 3.00 x
WaterCloset 3.00 x.
Bath Tub 3.00 x = 3,?
Lavatory 3.00 x = :/2.CN6 -
Kitchen Sink 3.00 x = 3,00
Laundry Tray 3:00 x
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x _3•a6
Floor Drain 3.00 x
Gas Piping Outiet • minimum -1 • 3.00 x
Rough Openings 1.50 x
Water Softener "far dwellings under construction 5.00 x I = S.Oo
V1laYer Softenee ' for existing dwelling 20.00 x =
U.G. Sprinkler ' for dwelling under eonst. 3.00 =
U.G.Sprinkl0r "forexistingdwelling 20.00 =
Altef3tions ' to existing residence 20.00 =
Water Tum Around 20.00 =
Private Disposai System " oak cry iic. 75.00 =
(new and refur6ished systems)
Private Disposal Systems ` nbandonmem 20.00 =
SITE ADDRESS: QT4 p C
I hereby acknowledge that I have read fhis applicaNon, state that the inTortnation ia mrtect, and agree tocomply wfth all applicable City
af Eagan ordinances. tt is the applicanPS responsibllity to nMify the-property owner that the City of Eagan assumes no Iiability for any
damages causad by ihe City during ils nortnal aperafional end maUrtenance ectivitias to the faalities eonshucted.under this pemik within
City property/rightof-wayleasement.
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS I 7 Z??7 ?
CITY: ??ZA-)
RECEIPT#: 7'7` 9 ?7 1
RECEI,PT DATE:
TELEPHONE #: . 452-IS6 S
STATE: MAJ ZIP: 5s?2
L!?-? - - -
SIGNATURE OF PERMITTEE
L/ J Y CITY USE ONLY cy
L ? BL ? RECEIPT#: 735 ? /
SUBD. ao RECEIPTDATE:
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681 -4675
Please complete for: . single family dwellings
• townhomes and condos when pertnits are required for each unit
• backflow preventer for underground sprinkler system
FIXTURES EACH I TOTAL
Shower 3.00 x 2 = 6.00
Water Closet 3.00 x ?.Cz,
Bath Tub 3.00 x 9 = 3.00
Lavatory 3.00 x g.w
Kitchen Sink 3.00 x 3xo
Laundry Tray 3.00 x 3.00
Hot TutUSpa 3.00 x 3•Oo
Water Heater 3.00 x o0
Floor Drain 3.00 x _/_ = 3•00
Gas Piping Outlet "minimum-1 3.00 x
Rough Openings 1.50 x =
Water Softener "kr dwellings under consWCtion 5.00 X ?j,06
Water Softener ' for exfsNng dwelling 20.40 X =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Spflnklef ' for existing dwelling 20.00 = -
Alterations ` to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ` nek cty uc. 75.00 =
(new and refurbished systems)
Private Disposal Systems ' Abandonment 20.00 =
STATE SURCHARGE .50
SD
t
2
TOTAL ?
;
I hereby adcnowladga Ciat I have read this appllcation, state tltatthe infortnetian is oorted, and agree to comply with ell applicable City
of Eagan ordinences. It is the applicanPs respunsibility to notify the property owner that the City of Eagan assumes no liability tor any
damages pused by the City Guring its nortnal operational and maintenance aGNiGes ro the facilitlas constructed under this perrnit wkhin
City praperty/rigM-oF-wey/eesemeirt.
SITE ADDRESS: 4?9'SD L?.RKE$FIOQ.c ?rLQc?
OWNER NAME: !'Y ` OFFMA?t1 /7`O/N?S _
INSTALLER NAME: WA!ZNZEC.. ME?y?j+lJ/cALTELEPHONE #: gSZ-?SGS
STREETADDRESS: A75-9 5y'Q"Wti49C,?
CITY: EACof}N STATE: MAl 21P:
SIGNATURE OF PERMI.TTEE
L--a/ B ?
NEW RECEIPT #
RECEIPT DATE 9/9S -7
DATE ?// rY ??
TO
soB
OWNER J? 1?N:ytR'.? l?c>rsz e 5'
PLEASE BE ADVISED THAT THERE IS A FEE SHORTAGE ON T8E A80VE
ELECTRICAL INSTALLATION IN THE AMOUNT OF $ ?S
REtYII+,RKS
Z? 0- 30 AMP CIRCUITS = % G 3
1 31 - 100 AMP CIRCUITS = 7
0 - 100 AMP SERVICE _
/ 101 - 200 AMP SERVICE _
zo
xarAt, FEE avE = j 3 Z -
LESS FEE RECEIVED
TOTAL FEE SHORTAGE DUE
PERMIT # W 0,'-- - 3 8?y
ORIG RBCEIPT #
R$CEIPT DATE
PLEASE RETURN A COPY OF TSIS FORM WITH YOOR
THANR YOU
. ?
_ , .. ., ..:.. ......... ... ' _. _..,,-__....._.. _.,?.,?
PHONE N0. Au9. 18 : 1996 67:54RM P3
L?3 B 3
517BD
Ne'a Receip O 05
Reveipt Aate 9/c;25/9 7
Order For Payment
Date 8,112139 Request for 7nspection Number on this job 3103-3 ?`
Date Filed 1-2I 9ro
Electrical Installer Ke?&tc,K flcc-F?; ? License No. C?cso9?8
7ob Address 4,HSo -A'Js City Xw-J Eftmch
Additional Rough-in inspecdon was required.
_?RA shortage o£fees an the above job.
Reinspection Fee. .
?,?,',- •
A Copy of this order must be rehuned with payment to the; '
Eagan Municipal Center :
3830 Pilot Knob Road
Egan, MN. 55122
Phone: 681-4606
TiPA
Please return this with a check in the amouint
The above arder rnust be complied with by (c
payabla to tne City of Egan.
Elecuical Inspector Chris Brinkhaus, 1026 Oak Rd., Shakopee, Mn 55379 (612)4969615
lOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
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PROPERTY LEGAL:
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DATE OF SURVEY:
LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• Buiiding PertnR Applicant
• Legal description
• Address
• North arrow and scale
• House type (rambler, walkout, split w/o, split entry, lookout, etc.)
• Directional dreinage arraws with slope/gradient %
• Proposed/existing sewer and water services & invert elevation
• SVeet name
• Driveway
9--'0 13
• Eastina
Sewer service (or Proposed)
2--?o ?
2/?'o • Property comers
? • Top of curb at Uie driveway
? ?? • Elevations ot any exdsting adjacent homes
Proposed
2r"' 0 ? • Garage floor
? 0 13 • Frst floor
EK' ? O • Lowest exposed elevation (walkouUwindow)
r7'? ? • Property comers
?0 ? • Front and rear of home at tha foundatian
PONDING AREA frtaoolicablel
o w, o • Easement line
? [a,-,? • NWL
O Sd^ ? • HWL
o • Pond # designation
? ? • Emergency Overflow Elevation
IJIMENSIONS
E, o ? a Lot IinesBearings & dimensions
0' ? ? • Right-of-way and street vvidtli (to back of curb)
ET- ? ? • Proposed home dimensions incfuding any proposed decks, ovefiangs greater than 2',
porches, etc. (.e. all structures requiring permanent footings)
?o ?
?? • Show all easements of record and any City utllities wiThin those easemenLs
• Setbacks of proposed structure and sideyprd seffiack of adjacent existing structures
? 0 • Retaining wali requirements,ij-ony ?
Reviewed:
January 1996
CAA10100d8lDGPRMf.FM
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-- - - - --- - --- -
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K:k't<?k?K:kXc?%? ?::?CM?k!F?:dcX??k?K1??„X'?Y??a??k?k>K*Wx?:?W?%<?
r:l:l `t CF F..AG(tN
C,ATH:CI':R: ::i TG!{MTNr`1S_ N:..`. 539
DAfFi:;, !i/ii_'/`3; T:I:f:E:u 007:0;2
:I! :
tdAM:.a fiO("FMAtd I-IOMI'::S ENC
2256 700i 4448 I...Y.!'s4-'Rf::: TEh 4,49208
22.56 9001 t.y..°iQ 4};;:iiiRI= 7ii::ft 4,492.38
t
?
,-
ToW Rer_njpi, ltmourtit: 0,924.76
SRO60706
i!5'":rt 10 tJANC:V
?CIYY OF EAGAN
3$30 Pilot Knob Road
, Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: BuzLqxNG
Permit Number: 029201
Date issued: 11 J 12 / 9 6
SITE ADDRESS:
444$ LAKE5Hp12E TER
Lp7: 24 BLOCKe 3
CLIFF LAKE SHORES
P.I.N.: 10-17785-240-03
DESCRIPTION:
?
?
(1 OF 2 UNITS)
ermit Type SF OWG
Ork Type NEW
R-3 U=1
e V-N
% ?
PD
38
66
102 1 - FAM. ATTflCW
?
IF?a
??.?n . ? ?. ? 4, --??,
REMARKS:
S& W PIBR - WENZEL MECH
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC &
5AC Units
Subtotal
VALUATION
$1,067.25
$533.63
$68.@0
$900.00
10@
1
$2,568.88
$136,000
MISCELLANEOUS $1e923.50
Tota1 Fee $4,492.38
CONTRACTOR: - Applicent - 5T. l.IC OWNER:
HOFFMAN HOMES INC 18949807 0969284 HOFFMAN HOMES INC
2214 E 117TH 5T 2214 E 117TH ST
BURNSVILLE MN 55937 BURNSVILLE MN 55337
(612) 894-9807 (612)894-.9807
I Z hsr,0by ack'r?o+?l? ge _?
- xn?Formratiotr a" c??=
?. Stattrt?s ?ttd ? ?
.,,..?r?.;!?..? _t?.???:?M `
statg Ctralt=;the
m?a?y.w?.th,
K'?3,ik?PRGE* -''
ISSl1ED .SIGNA E
??10 1
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-06T5
New Constmdlon Reauirements
? 3 regiskred aile nurveys
? 2 copies of plans (include beam 8 window sizes; paured fnd. design; etc )
? t energy calculations
? 3 copiea of kee preservelion plan d lot platted afier 711l93
raqvired: _ Yes ?C No
RemodeURepaii Reauiremenls
13 1e.ooo lic,-yBCi %?-/?f
L.
1 2 copies of plan
? 2 sile surveys (exterior additions & decks)
? 1 energy calculations for heated additions
DATE: (I I`? I qY CONSTRUCTION C05T:
DESCRIPTION OF WORK: 'RESi DF-?IT% AL. T,>..J,j tkovA6 1:
STREET AbDRESS: q`t`? g L.Av?6sxidue
LOT BLOCK 3 SUBD./P.I.D. #: tO 't-k-?$ 5-2Jp-° 3
' buPG£X e-"l e07 -g?g- .2.5 CLkFF L.1NK6 S?S'
PROPERTY Name: -HoPPrcA.?3 ?r-«s .?*'?• Phone #:
OWNER `^°T
Street Address:
City: State: w? Zip: 5533'1-
coN7rtACTOR Company: SAMr- ' Phone #:
Street Address: License #: qZgj
City:
5tate:
ARCHITECT! Company: M???-C??Kh ?6sttp?l
ENGINEER
$4 ,0z.s?
Zip:
Phone #: `t3`t - 1y`kp
Name: Llt.L- Tjr.,xL^,3 Registration #,
Street Address• 90 t^'- IgI`Y Slure-T S'" rE °
City:
C HA?J NA---6E.J
Sewer & water licensed piumber: `^;'E" Zf-
change are requested once permit is issued.
State: H?j ZiP; 553ki-
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that th ' m ion i correct and agree to comply with all
applicable Staie of Minnesota Statutes and City uf Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of 5urvey Received
Tree Preservation Plan Received
4- Yes _ No
_ Yes ?Q No
NOV 0i 1996
OFFICE USE ONLY
?
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
,d--02 SF Dwelling ? 07 4-plex o 12 Multi RepairlRem. ? 17 Swim Pool
? 03 SF Addition o OS S-plex o 13 Garage/Accessory ? 20 Public Facility
? 04 5F Porch o 09 12-plex o f4-Fire ? 21 Miscellaneous
0 05 SF Misc. 0 1?-_--ple ? 15 Dec
WORK TYP ? 7-
? 1 N o 33 Altera '
2 Addition o 34 Repair ? 37 Demolition
0 3
GENERAL INFORMATION
ConsG (Actual) ;Irw_
(Ailowable) AZ-N
UBC Occupancy
Zoning O- ?
# of Stories
Length
Depth
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. R.
sq. ft.
Footprint sq. ft.
APPROVALS. ,
Planning Building
_ Permit Fee.:
: Surcharge
' , Plan Review
?- . License
MCNVS SAC
' "City SAC
Water Conn.
• ° Water' Meter
Acct. Deposit
S!W Pertnit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
r 6( MCNVS System vL
/, 747 City Water ?
Fire Sprinklered
PRV
Booster Pump
Census Code. oL
SAC Code 1.1?_
Census Bldg
Census Unit
Engineering Variance
r
Valuation: $ /3 6,D ° -
V ?
? /
0
U'
.?
G?
G?.
C p'?
% SAC
SAC Units 1
:kt*:a,??ykt?ciX?t>uv??CXcM:k?CY?.?i%:#h ?k?N??lckc%c??'a?t?+?krK?Yl-k?kX??e
cI:rr cif- :r:ncAN
CASNl:E'R: S TLRK.T,NA_. Nf1z 539
PA'C'k : I. i./.I.G/S)C, "f 714r.: 00709
rYy -,
N6;ME:e f-IP_4`FMAN NOMI='3 TtdC
r'.^c5-L `JDCIi 4448 I...It;ihl('if= IE(i 4v43t?.::38
2256 9001 400 I_F.S!-!F?E T:_F. 4,492.38
a
7o+,a:. IiC:rotr$ Rirt:>urti'tg E32984,'i'6
r.ko;.:670i-.
1.51:R .T.D: N4Nt'V
Y,:k`;:?'n ?X ??t "?FY,: i?? KYF;?7,`'?,".'K;; ?>k?;ew:tiC9ri9(51:>k)!;XCYn9F7n>'f.;l. 'MY')k 1:1k h'
?. ,.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERIVIIT
PERMITTYPE: euTLozNG
Permit Number: 0 2 9 2 0 2
Date lssued: 11 / 12 / 9 6
SITE ADDRESS:
p.I.N.c 10-17785-230-03
4450 LAKESHORE 7ER
LOTe 23 BLOCK: 9
CLIFF LAKE SHO,RES
DESCRIPTION:
?. (i oF z uNxrs)
Permit Type
&tiiltlY"`?;2?, SF DWG
g
rk Type
? NEW
. R-3 U-1
ma C#?SCi"u???Qlr e V-N
? P o
&kti?i3ing
?-f`tkg?h < f? 38
_
? .? ?us,ldin? h 66
x?? n•' e ???:?di ? ??tories.' ?; ,?`
imz 1 - i
FaM. aTrAcH
r;,
?,..y'
?'sa, ? g „?, +aii• -^,a^';.?;, t.. Y?'.. ?ro"
N?
'?P?it `??u' MF
REMARKS:
5& W PLBR - WENZEt MECH
FEE SUMMARY:
Base Fee
Plen Review
Surcharge
SAC
5AC t
5AC Units
Subtotal
VALUA7ION $136,900
$1,067.25 MZSCELLANEOUS
$533.63 Total Fee
$68.00
$900.60
100
1
$2,668.88
$1,923.59
$4,492.38
CONTRACTOR: - Applicant - sT. LIC OWNER:
HOFFMAN HOMES INC 18999807 0009284 HOFFMAN HOMES ZNC
2214 E 1177H 5T 2214 E 117TH ST
9URNSVILLE MN 55337 BURNSVILLE P1N 55337
(612) 894-9807 (612)894-9807
1 he,heby:. a?ls:noMrY?tfge th4t4 V h6 c4?re??t
inf•nr?mat?on?-`isT?"-t actd. ?gr'?,? 0:a?n?r?F?d?gW?S.th
? statu?tes ?nd': Y. f ?aga?i ?rdEn?nOe5.:
_-
?
CITY OF EAGAN ?( t? q
3830 PILOT KNOB RD - 55122 ?y',?'t?.-J?
jq,10 I1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
Naw CnnstruNion Reqyirements RemodeVReoair Reuuirements
? 3 registered site surveys ? 2 copies o1 plan
? 2 coples ot plans (include beam 8 window sizes; paured Ind. design; elc.) ? 2 site surveys (e:terior additions 8 decks)
? 7 energy calculalions ? 1 energy calculations for healed additions
? 3 mpiee of tree preservalion plan H lot plaHed after 7l1/93
required: _ Yes -21 No
DATE: « 15 19 tt CONSTRUCTION COST: I
??F ?
DESCRIPTION OF WORK:
STREET ADORESS: LA" '4?
LOT 4?-Z BLOCK SUBD./P.I.D. #: 1O 't --rt$ 525° -0 3
'?ar?cx' w/?r L?i' G??FF e.fK? 5«a•?t6s ..
PROPERTY
owNeR
CONTRACTOR
ARCIiiTECT!
ENGINEER
Name: -i;4oFFrc4a N??es ???• Phone #:
1A511A6i
Street Address• Zi``j E. k1ictH S-c?tE'
CItY. ?'-tl'YSJ...(a
Company: SAnc
Street Address:
City:
Company:
N.'l7e5ir...!
State:
Name: Ly-r--
Phone #:
Registration
Street Address• -I$L St"?-T S,L, ' e -lk2? °
City:
State: ?? Zip: 5533}
Phone #:
License #: RZg
C «,,a.) NA,Z66J
State: Khi Zip: 553«"
Sewer & waler licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that t ation is c rrect and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. `J \/'g I ,\
Signature of Applicant: ' I " -" v, -
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes No
_ Yes _ No
BUtLDING PERMIT TYPE
OFFICE USE ONLY
0 01 Foundation ? 06 Duplex 0 11
02 SF Oweiting ? 07 4-plex o 12
? 03 SF Addition o OS 8-plex ? 13
0 04 SF Porch ? 09 12-plex o 14
? 05 SF Misc. ? 10 = plex --- " ? 15
WORK TYPE
` .?.
.
Apt./Lodging ? 16 Basement Finish
Multi Repair/Rem. ? 17 Swim Pool
Garage/Accessory ? 20 Public Facility
Firepla 21 Miscellaneous
Deck ?--
_
?1 New ? 33 Alterations ? 36 Move
o 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) ZILd[..,
(Allowable) :97-lv
UBC Occupancy L3zu-/
Zoning p- /?.
# of Stories _j
Length _3'&
Depth
APPROVALS
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft,
sq. ft.
Footprint sq. ft.
Planning Building
116
-1,2YZ
Engineering
Variance
?
?QZ
?1L
/
/
Permit Fee Surcharge
Plan Review ,
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SMI Permit
SIW 5urchargeTreatment Pi.
,? ., , Road Unit _
Park Ded. "
Trails Ded.
Other
_.,,. _., .. `Copies ..
Total:
valuation: . $
I ?? . .
V
U?
?
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
5AC Code
Census Bldg
Census Unit
2
U?v
?('J0
GS
% SAC
5AC Units /
;a5 10:13 6129344305 MINhJETONKA DESIGN
' EXTERiflR EFIyEIOPE_AVrRAGC "t1COMFIlTAT10N
nnrr
own?a • _____... ----
PAGE 07
PHONE:
5T7E ADDRE55:
N 0
CON7 RACTOR 11o-- t11 ? o'h??S
: tt PIA
Determine working square foota9e of each
?Wj l , 1
5q. ft. x 70?
.ii _
1 Total exposed wa11 area.-..•
. ?() 2(p sq, ft. x
= g'2?71
.026
2. Tota1 roof/ceiling area.....
Total exposed wall area above floor=` ?,Z-
IZ1,3
. ...
a." Total wall window area ...................... ......•
....
.. ,.
.......... ??,?
b: Total door area .... ..................... . ..... .....
•••
c, Tota1 sliding glass door area .............. ..... •-••••• •.
" " " ..... ?
d. Total
Total fireplace wall area••,•••••••-••••-••
whll framing area (average 10%) ...... • " " " " "
........... ........... ?.. .?
e. ... ..•
f. Total rim j0ist ar2d ....................... ........ .....
.
g. net wall area above floor ........ ....... . :::::;::: .
::
h, wa11 area a6ove floor....--•••.••••• ?•
i. T wa11 area a6ove floor........ . ..-•• .••-••••••• •
j. frame wall dt'ea dt foundation ............. ........... ....
Total exposed foundation area= 62\ ____ .
k. 7ota1 foundation window area---•.•••-•.•..•••••••-•
1. Total net foundation area ahove grade..............
Oetermine "u" value of each wal1 segment (e.g. window, door, each separate wall section)
a. 127,3 x "U'i
X „u,? ,4S = lc??iq
. b. ??1 ?
c x ,lu1%
.
d. g 11 u I, _
e. X gluit 12-,3z?
f. l?O`1,45 ? x „U„
X I, W„lio_
h. X ?lull
X uul- =
. j x Mull
k,
1, ctSZ-.`?c? XU„
3 . .................................rotal
If item #3 is the sa
as, or less than ite
#1, you have met the
intent oP SBC 6006 (
,i3l1995 10:13 6129344305 MINNETONKA DESIGIJ PAGE 08
/
/
?
' 4, TOTAL IXP05E0 IIdOK/CEiLINO CALGUI.A710NSI •
Tota) expostd
roo!/eai11n.q area......,. (p2 iq ft
J) Total fkyllyhe aras...... ' sq ft x
•,,_,?,? "U" "
k) Totat roof/ca111nq fr+ping ?` ? ' •
aras (Avara
?
ft
ldy
? ?„
' U ?C??? • M 3?'1
q
......
pa
x
,
0, Total net insulated • ,
"
"
`??
2??
• roof/Gellinq area.....,. aq ft x U - ?
•,
4. • TOTAI. J) thru 1) 33,??p
If total oF sh Ts the sama as, er )nss than fl2, you hava inet the intant of
• Z:tCAR 1.16008 St end 0.
. , .
• ? AL'TERNA7'E 8UIU1lNG ENVELOPE EIESFGI! . '
Yo utTl (xn cht cota) envalope system pethod. -lt+n values esta6 ]•Ished by thq sum
' of ltems f3 and 14 sha11 nat bn greater than tfie aum'of Ite.s 11 and !2. . . ..
I . ?. ?, • . •
. 3. . ' ._ ? ? ,
. i .
, ' - • : .
. `
.
. . . . , . 3
?
j/1995 10:13 6129344305 MINNETONKA DESIGN PAGE 09 i .
BLOCK:
K-%EE:
WALKOUT: 3?
FULL 1: 1cQ'7,?5
FULf, 2;
FIREpLACE:
RIM: 1(,D71
BLOCK; IS
KI3EE:
WALKOUTt
FULL 1;
FULL 2:
EIREPLpCE:
RTM: {(o,lc?
e
* LINEAL FEET EXPpSED S1A4L
SQUARE FEET EXppSED WALL ABEI?
x . S .a $2,`)S
x 5 ? •
x8
x 8
X 8 =
x a
SQUARE FEET ERPOSED CEILING IC9Z(
p?
WINDOWS: 12-7,3k _
?--
O-tr«f' W-11' I/ a9 ?
21P3(,q 1 ' ??42
zo sl:z? l I I I 2? p2
3050
las?b?,Ll?,? ?- ,s
J
3
? ? I (n? , I 5
DOORS : 3-7,-1jkL
PATIa DOORS:
BASEME:iT UNITS:
SKYLIGHTS:
, . ..
?N?
HOFFMAN HOMPS, INC.
2214 Enst 117th Street
Telephone 8trrnsaille, MN 55337
(612) 894-9807
Fax CONTRACTOR 1/ 9289
(612) 894-9878
I ?(st(:Vy
Mr. Joe Voels
City of Eagarr
Plan Review Department
Dear Mr. Voels,
- This letter is to inform you that Hoffman Homes, Inc. will be using the exact same plans
for the layout for Lot(s) 23 Z Block 3 , Cliff Lake Shores, as were used on
Lot(s),', Block -? , Cliff Lake Shores. None of the structural building
components, U-VAC, plumbing or electrical will change from engineered drawings dated
10 /4z.(? ?
Sincerely,
?
Patrick C. Hoffman
President
PCH/jem
pcwuglv
7??'3 2005 RESIDENTIAL BUII.DING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reauirements RemadeVReoalr Reaulremenis Office Use OnN
3 registe2d sAe surveys showing sq, ft of lot, sq. tl of house; aM all mofed areas 2 wples ot plan
(20% maximum lot wverage allowed) 7 set of Eneigy Calculatans for heated additians Cert of Survey Recd
Tree Pres Pgn RecE - Y_ N
=Y ,_ N,
2 copies of plan showmg beam 8 window sizes; poured found desgn, etc. t sRe survey for add@mre & decks Tree Pres Required'`, Y,'_ N
lsetofEnergyCalculations Addition - indicateifon-stlesepdcsystem OnsAeSepticSystem _Y,=N
3 copies ot Tree Preservation Plan if lot platted after 717193
Rim Joist Detail Options selection sheet (6uildings w(ith 3 or less units)
Date -\])-, / A_/ ?
Site Address Construction Cost $4,v`-'b
Unit/Ste #
Description of Work 1`e. (L o? 6J?? ?lU ??
Multi-Family Bldg ? Y_ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner Q v5? L Telephone#(RSa.) K\\- 6, b3
Contractor ??,
Address o?\
State VA.) ,A
e ? W QZ S.
Zip 5SIag_ `
City Sv??nSU.\e
Telephone #(QS4.) 707- fo4lS??,
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 9670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residentiel Ventilalion Calegory 1 Worksheet • New Energy Code Worksheel
(Jsubmissiontype) Submitted Submiped
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Telephone #(
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
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 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 wark which requires a review and
approval of plans. n I ?? l ?l`? l.'JJ'n.,r\ """"6' \
Applic 's Printed Name Applican's Signature
------------------
?
j Permit #:
i Permit Fee: 4
? Date Received: j
I ?
I Staff: ?
I----------------'
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: '1S'() Site Address: 4"1o ? L4L? (?o """?r' %m mn/4cc
Tenant:
Suite #:
RESIDENT/OWNER
YUJt?5 1uLi7dlh0'NU.S Phone:
NameGlt'rk U4,IL('. S
Address/City/Zip?[?? CLIF-Y IA?L Cc?019,gy? 551 a)- -gxt-I 5
Appiicant is: _ Owner _?y Contractor
TYPE OF WORK Description af work: l 2wV' LXY Y-MUt" ? w l OAD4r
Construction Cost: ? 4 -?, V]w 00 - Multi-Family Building: (Yes No ?
CONTRACTOR Name: ??aoAbcitn.f VPC, License #: gol (04y8
Address:01g(P0 3cA.c3LlC'tCLk M • ? lOD
Ciry: bwonslA State: Zip: 9D-33
Phone:"l'5 a -1 DI '? ContactPerson: o1aao' ?Cf/LL(fAr
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
EnePCJy Code . Resitlential Ventilanon Category 1 Worksheet • New Energy Code Worksheet
CategOry Submitted Submitted
submission type) • Energy Envelope Calculations Su6mitted
In the last 12 months, has the City of Eagan issuetl 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: F?Cans an'i! sr?pportfn?docufffie"Ats i ;}??ru'st'r6lrif?are co'rrs?F0e04"W?G60?"rrtt``?s ?i?„?o{rs
"
t
'
b3t Wd3?Ctl?perdi .Ee
Ly,??o,:_
the infnsmaNori,rtiay be ¢lasstfred as kian?fpb?a?i? ou proa?e
?pecet? sptrs
I hereby acknowledge Ihat Nis information is complete and accurate; that the work wili be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permiL but oNy an application for a permit, and work is not to start without a perrnit; that the work will he in
accordance with the approved plan in the case of work which requires a review and approval ot ptans.
x ucw(l JW MefQ 4- X X?-
ApplicanYs Printed Name ApplicanYs Signature
Page 1 of 3
\ CER TIFICA TE OF SUR VEY LEGAL DESCRIP710N:
Lofs 23, & 24, Block 3, CLIFF LAKE
SHORES, accordrng fo the plot
?SyO thereof, Dokota County, Minriesofa
7op of Block = 978.88
?LPg ? Lowest Floor = 910J3
t A U A I"- Gorage Floor = 918.50
<916.18 rc> R E V t
? ? 916.05 TC GRAPHIC SCALE
(916.80) zo o io xo <a
sis_ss
/ o• ? ? (sn.aa rc) p (
sizas Tc IN FEET )
o(9 8 BO /h TF?,Rq \ 1 inch = 20 ft
C
'o
(97,9 ?S0? Denotes Sanitary Sewer Service /nvert
St
?'? o? ?,? pp sos.s ?? g65.0 ? d dentotesPxisf?Ainosed elev.
/914.2) 10
(
918.6 ?
(91980) denotes surfoce droinoge
23
919.24
• Denotes iron monument found
Al O Denotes iron monumenf sef
Beorings bosed on ossumed dotum.
o?° o? 2 4
?
FS
i 970'9 yO Q Rs?ry ?2 1 O / ! hereby certify thot this survey was prepored
? oc 16) by me or under my direct supervision ond thot
(908.20) 9?? ?? ! om o du/ R istered Lond veyor under the
909.20 law f e tate of Mi s
IDa? ortin J. Weber, R. .. Dofe
I? `S?o C,C? P. ? ? ? o? ? ?i / ?G'AllT EIVGgVk;?RING DE? ?'d: Regrstration No. 2043
A
`h °
o ?
o
? REOUESTED 8Y:
To A
P of Irons Offsets
HOFFMAN HOMES /NC.
AO 10_00' Offset 909.34 ?OObO
? oo J
B? 70.00' Offset 998.09 (912.00) Westwood Professional Services, Inc
.
O 10.00' OffSEf 972.83 911-60 14180 West Trunk Hwy. 5
? Eden Proirie, MN 55344
OD 10.00" Cffset 909.90 \ (612) 337-5150
\
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JOb No: 95198
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Use BLUE or BLACK Ink
�____�_�__�__�_�-�
I For Office Use �
' � Permit#: ` ��� � I
C��� O� ��6�� I Permit Fee: [ L�����I
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: i
I I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
,- �( /��j� �,( �'s�2y-
Date: �� 1�/�S Site Address: ��� " L'�+,��"'� ��`�- ����' / '°� Unit#:
��. ��Name: ,.. Vtl f'Y°�aM... ,���L .Y.,..,.._,j�.oi/�.��,.,�.�,,,�...��.e.��...�,,...�.m...�,�Phone: �,._,,�..,�...�,�,.�...,.�..�,,.�,�
� RBSS�d��#1 � (.�' �
� Q���r Address/City/Zip:
�
Applicant is: Owner Contractor
�,� ,�.,.�,�..�..,,.,.�,�,�,..,�,a,�,...�..�.�._»,:.�,�„�.�.�,.,�,..�,.wp. �....��.�._�.�.,�.....�,._,�,,�,.�.�.�..w..�...,�� �.�._.�.
� �.�
� ,� Description of work: W�Yz� l��
� T�f@ Of 1�1�1'1� �
� ' ? Construction Cost: Multi-Family Building; (Yes /No� �
�..�.���. � �
� � � Company: �U/�t S �hfi�� L��t�.G�o 1� �hc. Contact: �^�f ��'� u�� ��--- �.,.., �
� Js�b �/� �U Suife �/°v- �`J'/�t� 11 �
Contractor � Address: �G�_��� �S� City: � i �
� /
� State:�Zip: �Sy�+� Phone: "7�3-S.S�.Gn�� Emai�: �/�1 � �a�.f9�u,.w(�`"°c�vl.
�
� License# /.�G v D� '7�1.3 Lead Certificate#:
�..��.��,�,. �M..,,.n���,..�.�.���_�...��. .�,��,.,�.,�.��.�..=��a��,,..��,.�..�,�,,��,�.���.ti,�,�...a,��,,�,��,�.�a.,,�,��,.��,.�.�.�,.,.�._�,...,�..��,.�.a..���_�.
� � � �.� � a
If the project is exempt from lead certification, please explain why: �
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? �
�
i
Yes No tf yes, date and address of master plan: �
,
Licensed Plumber: Phone: � i
�
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
IV�'3TE:f��ns ar�d�u�port��g el��ur�e�r��t�at yoW��a�ca��ered fo�p��c��rr���, Pa����o�'
' t��inforrr�a�n�r�ay be c�as���etl as n�n p�bf���y��r pro�I�s�ec�ic r�a��t��at�vact��per���e Ci�r t�
c��cl�cf�ti�at t� ��e tr��e�c�e�. '�
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.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with 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 Min�esota S t Building Gode must be completed within 180
days of permit issuance.
�ul� l�r�c��..��--� --�
X X
�---
Applicant's Printed Name Appli s Sign ture
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA156420
Date Issued:06/28/2019
Permit Category:ePermit
Site Address: 4448 Lakeshore Ter
Lot:24 Block: 03 Addition: Cliff Lake Shores
PID:10-17785-03-240
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Sandra J Speck Tste
4448 Lakeshore Ter
Eagan MN 55122
(651) 454-6637
Boys Mechanical Inc
490 Villaume Ave, Suite 300
South St. Paul MN 55075
(651) 340-5956
Applicant/Permitee: Signature Issued By: Signature