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4452 Lakeshore TerINS] CIfiY OF EAGAM ? 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: r , II312F,r; PERMIT SUBTYPE: TYPE OF WORK: 11i" E;.C Rt i' T 1014 W F 1J t i r,F 2 Uw I r>> INSPECTION „ • .A , ?, i ?•s?. ,??a? t i;?. I .?ARx4; ???O tcIr J 1141 ON RECORD PERMIT TYPE: Permit Number: Date Issued: 0r: v^?p.a 141 0 , v f APPLICANT: Permit No. Permit Holder Date Telephone k ELECTRIC 3y(p ? . ?(? 9 s? ? QO PLUMBING ? ?G (r t7l a'??'? HVAC inspectfon nap. Comments FOOTINQS FOUND FRAMING ROOFING ROUGH PLUMBING 1-317 PLBG AIR TEST ROUGH HEA7ING -? - A? ?/ GAS SVC TEST ?o INSUL GYPBOARD Y Jr?,' FIREPLACE w ?6 lJ FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL ?? ? R .. : _ CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 E ADDRESS• ry ' ?,v w r f L' ' ' k() l": I LLit f L?1Kf:>if(1F?E> I PERMIT SUBTYPE: N RECORD PERMIT TYPE: Permit Number: Date Issued: , A ., .R., APPLICANT: _. .,? - • . ' ( h 1.? ? 894 - 98w INSPECTION .. . DA ' t ? I ti;;l f l f:i. ,: i?r• f I ii AftkS: lERU (.l'IT t.i.N! s & wPt "k E,r r_ w! r ? r i i3 ili TYPE OF WORK: t,. , . I : . 1 10 rr r ta ? ? Permit No. Permlt Holder Date Telephone # ELECTRIC PLUMBING ?a? 94 5 - HVAC Inspection Insp. Comments FOOTINGS FOUND 1( - :? - ? c v?=? ?G FRAMING i ROOFiNG ROUGH PLUMBING "? ? PLBG AIR TEST .. ? ? ROUGH HEATING J GAS SVC TEST INSUL ? GYP BOARD Jw4f FIREPLACE , _G r 7 FIREPIACE AIR TEST FINAL PLBG -l3 97 FINAL HTG /S, OR5AT TEST BLDG FINAL ?1?/a r1 i BSMT R.I. BSMT FINAL DECK FTG DECK FINAL Certif[CQfe df CCC1tpQ1iC? Wit4 o f Wagan Mepomt ext of laxi[bing anoection This Certificate issued pursuant to the requirements of the Uniform Building Code certifying rhat at the time of issuarrre this strucrrere was in corr+pliance with the various ordinances of rhe Ciry regulating buildiag eonstruction or use. For the followrng: ux classirwAtion: SF DC sia8. Pemit No. 2q 102 0-„p,,,cy Type 83/U 1 Zoamg Duawt PD rypc c.t. VN o,,,,,,, or s;,d;,,s I30F1MM HQCS IlW. - Aamza 2214 E 11 T1i ST. B'Ii11L Building Address?? ?? 110= l.ocaliry L2 1+ +»P ?? I-W SHOM ; n,e: POST IN A CONSPtCWUS PLACE WCr#IftCQ.te 0f ' CCIIlpQIiC? Wio of Cfagan ZOarta?eut of Bailbing 3n3pectiott This Certifcau issued pursuant to the requiremen[s of r6e Uniform Building Code certifying that at the time of issuance this structure was in compliance with tiee various ordinances of the City regulating burlding cor+struction or use. For the followrng: uY ciawrcatiom , SFM Bldg- Permil No. 2c) I03 00-p-r TYve R3/CI 1 Z..ig o6aMPD rra cortsi. VN ow,K,or B.iia???W "MS IN' Aa&?.2214 E 1 17IH ST, B'ViT7 F auiwing naa?4452 IAESHOFT "iE?'??,?'?,r,_ t?oi?ry?. B3Ff:r.rFF i.AKr' 4?l1RFS o? "- Dw: ?m-w ? ? P0.ST IN A CONSPICUOUS PLACE 1 L/ /?2 q 4 F q aFFlCE USE ONLY This reqoesl void 18 monfhs Bom vaLdohon dote prinfed in his 6ox ? k 7G9 ? ?°= $dsid ? ?K 04 0 5 3 9 6 3* PLEASE PRINT OR TYPE Requesr Date l -` Rough in inspecoon reqwred2 Yes ? No ?Va musi coll ll?e inspecbr when reo y? Inspecfion Olher TMn RoughJn ? Ready Now Will Coll Dare Reod T .tz I, Ilicensed <onhacror ? owner hereby request inspection oF the pbove IT41 wor ? Job Add.ss ?Sheer, Bw?, ooie No ) Ciy E / ? a ` Seclian No. Township Name or No Range No Rra N. rut(K Occupont " Phone No- ? ' ? UO 1 Power u Address Elxrcical onkocbr tCompany Name) Connacror Lcrose N Maskr Lit N. (Plam Elect Only) Moiling Address JCommcbr or er Performing Insiallaoon? A ized Signomre ?Conh°?or or Owner Performing Insiallm?on) ?! llx.d?1 '/i rVb?6?,l_t_?___ Phone N. ? EB0000IA-11 9/96 ererc wneonAZov - ec= mcmucrnuc nru aecr nF vci.i.bw Cbov 405-?6 81 REQUEST FOR ELECTRICAL INSPECTIOM'? "A ? Minneso[a State Board of Electriciry 1821 Unrversity Ave., Rm. 5-128, St. Paul, MN 55104 Phone (612) 642-0800 Home Duplex Api. Bldg. Other: ew Addn mmercia) Indusfrial Fnrm Remod Re air Air Cond Htg. Eqwp. Water Hir. Lood Mgmt Ofher Dryer Range Elec Heat iem . Service "X" obove tbe work covered by this requesf. Enter remarks in f6ts space and an the back of the white copy only. Z? Calculote Inspection Fee - This Inspection Request will not 6e accepfed wrt6out the mrrecl fee. Other Fee k $ervice Entrance Size Fee # Circuits/Feeders Fee Mabile Home Park Stall 0 l0 200 Amps 700 Amps Sfreef Lig./Traffic Sig. Above 200-Am s Above 100_Amps Tmnsformer/Generator INSPECTOR'S USE ONLY TOTA Sign/Oulline Lfg. Xfmr. Alarm/Remote Conirol i Swimming Poal I hereb cerri ihar ' le n desa.6ed herein on the doles si d Irrigafion Boom RougMn ?J D. ecial Ins ection $ ? p p Invesfigative Fee Final Da? 7HIS INSTALLATION MAY BE ORDERED DISC NNECTED IF NOT PLETED WITHIN 1 M NTHS. 9?f OFFlCE VSE ONLY This requast void 78 momhs fran validanan dote pnnred in this box. ? . ( P7G % I I II I I I l I I I I I I I I I I I I I I I I I I I I I I I I I??% ? 3- ?-? ?? ??-?-? ? / - ? * 0 4 0 5 3 9 0 6* pLEpSE PRINT OR TVPE ?/7 Reqvest Dala 0 RougMn mspecnan req?ned2 e, ? No Inspection OMer Than NwgMn. ? Ready Now 11 Call - 1 ffoo usicolllheinspecrorwh rea Dale Reody I, ' ensed contractor 0 owner hereby request inspecfion oF ihe abo elecirical work af: Job dress ?Sheei, Bon, v Roure No.) A Gy e t y?-1 ??.?n F- Secfian N. iownship Name o, N. Range N. fire No Couny A' I Occupam ? Phone N. Powe p6er Address , Eleckicol onhaclor (Company Name? Nwsbt lic Na. (%ant EIecL Only) Conh licenze No ? ? V Mat6 g Addre:: (conkacror or er Parfo.mvg In:mllanonl ? Au 'zed Signamre Conhaeor r Owner PeAorming Insmllalian 3 5 i a Phorre No ?t EBOOOOIP-11 A/96 ??.z a??on.-.?w? _?cc??umu.-r?nue iw onrr nc vn ? nw enov ?/???7 . 405°390 00 El REQUEST FOR ELECTRICAL INSPECTION & 6 Minnesoha State Board of Electricity 1821 Universiry Ave., Rm. 5-128, St. Paul. MN 55104 Phor:e (612) 642-0800 Home Duplex t. Bidg. Orher. ew Addn ommercial Indusfrial Farm Remod Re air Air Cond. Hlg. Equip. Water Htr. Load Mgmt. Other. D er Range Elec. Heal Temp. Service "X° obove the work covered by this requesl. Enler remorks in fhis spoce and on the back oF the whife copy only. Calculate Inspecfion Fee - This InspecFon Request will nol be accepted wifhout the correcf fee. O[her Fee # Service Enhanre Size Fee # CircuiWFeeders Fee Mobile Home Park Stall 0 fo 200 Amps 0 to 100 Amps Sfreef Lfg./Troffic Sig. Above 200 Am s 0_Amps Transformer/Genemtor INSPECTOP'S USE ONLY \ TOT Sign/Oudine Ltg. X(mr. ??- Alarm/Remote Conhol Swimming Pool I hare reni ihot I, e crci ns on d s herein on the dales i Irrigafion Boom RoogMn oor? .i/ $pecial Inspeclion ? Invesfigafive Fee THIS INSTAI.1 ATIOIJ M AV BF ( F??ol 1Rf1FRFl1 MC _ Il 1 _ fl WI D THIN A fl THS 2006 RESIDENTIAL BUILDING PERNIIT APPLICATTON City Of Eagan 3830 Piloi Kno6 Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Canswc6on Rwwrenents ] registereG srte surveys showing sq. R ot l04 sq. R of housa; arid 11 roofed areas (20 % maumum lot caverage aVowed) 2 copes of plen shvmng 6eam 8 wmdow s¢es; pwred fwnd desgn, atc 7 set of Energy Calculabons 3 capias of Trea Preservabon Plan if lot plaCed afVt 711A3 Rim Jrnst Oelal Optlons salection sheet (OUilCmgs wiU 3 or 1e5 unib) Minuegasco mechanioal venularioa form Date /(/ / o[ / Site Address W5y ? RemadaVReomrReawremens 2 capies of plen showmg foohngs, 6eems, lasts 1 set N Enegy CalaYahons for hwted aGGifians 1 sto survay for additiaro & tledcs AEd'diai -indicate d oo-ute SePtrC sysfem Construcrion Cost IZ 55, Description of Work 'tTOC// 1 ( Y ! _ N Muiti-Family Bldg -?/ Fireplace(s) _ 0 _ 1 _ 2 1n PropertyOwner liI'?[u?IL,(1?('elephane#(9I -F'?? i ?-?7t' Contractor Address Stace ylls'/i?/!J City n ?ip SS? Z'eleanone j(C?rL az,? .;??jn a ?? °T GaMPLETE TI-I1S AREA ONLY 3F CONSTRL3CT]NG A NE'1U Bi31L331NG - Minnesota Rules 7670 Cateeorv 1 Minnesoh Ruies 7672 Energy Code Category . Residen6al VerNlation Category 1 Worksneet . New Energy Code Worksheet (-1 submission type) Su6milted Su6mitted • Eneigy F_rrvalope CaIwlaUona Submittetl In ihe last 12 months, has the City of Eagan issued a permit for a similar plan based on a masTer plan? _ Y _ N If yes, daTe and address of master plan: Licensed Plumber Mechanical Confractor Sewer/Water Contractor Telephone # ( Telephone #( ) Telephone #( I hereby apply for a Residenrial Building 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 perrnit; that the work will be in accordance with the approved pian in th case of work which requires a review and approvai of plans. V ohJ 'k r Applican 's Printed Name Applicant' Signature Office Use OnN Cat of Survey ReW Y N Tree Pres Pfan ReW Y N Ttee Pres Reqtured Y N On-site SeOc System _ Y_ N LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMITAPPLICATION ??/? PROPERTY LEGAL: ?f .J-7- "'J )Z?-- DATE OF SURVEY: ' LATEST REVISION: DOCUMENTSTANDARDS oo' 0 a • Registered Land Surveyor signature and company 4'.0,0 ? • Building Permit ApplicaM ? • Legal description 11 • Address ? ? / ? • North arrow and scale O V ? • House type (rambler, walkout, splft w/a, spiit entry, lookout, etc.) V 0 ? • Direcdonal drainage arrows with slope/gradient % av**?O ? • Proposed/ebsting sewer and water services & invert elevatlon ? ? • Street name 0 • Driveway ELEVATIONS Exdstina 0 ? • Sewerservice(orProposed) ?? ? • Properly comers ?0 13 • Top of curb at the driveway 0 GK?0 • Elevations of any ebsting adjacent homes Proposed ?? ? • Garage floor P-'o ? • First floor 2"'?o ? • Lowest exposed elevation (walkouUwindow) 2?' ? ? • PropeRy comers B?'13 ? • Front and rear of home at the foundation PONDING AREA fif aoolicable) 0 e" ? • Easement line ? ap-? ? • NWL ? L9-? ? • HWL cl ff-'o • Pond # designatian ? ?o • Emergency Overfiow Elevation ??y !p/ • Lot IinesBearings 8 dimensions ? f31 ' B' • Right-of-way and street width (to back of curb) ?? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', / porches, etc. (.e. all structures requiring permanent footings) r ? • Show all easements of reco?d and any Cily utilfies wiMin those easemeMs ? • Setbacks af proposed struclure and sideyard sethack of adjacent ebsfing structures C3 ? • Retaining wall require a Reviewed: Name Date January 1996 CRAIGi BB8IBLOGPRAR.FM , C.[TY 017 EAGAN t;A4ild:f.E:l,:s 5 TEI:M.T.NAI_ NQc 1.3 LYA7k=: 10/28/96 'T'TMEa 13:40:43 SDg '' NANiE;: I40FFMAN F10Ml:S iNr_ ,r ? %i!ii`f'.i£r 9001 445i? I._f.i;l-Ili TF_RR Q492,.38 ?256 9001 4454 l..!(SHli 1'Ef?li 4743c',.38 TnL;:a7 fiE>pC?:Lpi; PoIriOu71'1;;1 1i,43.34.76 0o6%ri. l.tsER TD, NhParv :1?:YY?(?F?*?`Sk?k??*:rri?'J,!?XSXh''.\'CPFS49X:ti?k"r',?.W,.YF><?'<FFBt>X%§:Y,: !."?,.9F>kTY 4, , PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: a u xLnIN G Permit Number: 029103 Date Issued: 10 / 2 8/ 9 6 SITE ADDRESS: 4452 LAKESHORE TER LO7: 22 BLOCK: 3 CLIFF LAKE SHORES P.I.N.: 10-17785-220-03 DESCRIPTION: (1 OF 2 ?,!5% UNITS) ?,. ? ?€-YEs?a ? ng?Permit Type SF DWG ?UZ?i3irtJ ?drk 7ype NEW ??UE3C L?Geu?iari='yN? R-3 U-1 t-`Cv,n.s-tr'uc,Gza`Yr, qT?e V-N ? P D n t? W$- ?t?3 L F3 fA g'?tt: =c .' 38 . . . .: ? ° 8utkked?ri g 47,idtk? E? ?`''? a , 66 ? .. p a[ 102 1 - FAM. ATTACH a 4a- '9g? ?. 4 fi6 $R ? y?'s ? a 0 REMARKS: ZERO lOT LINE FEE SUMMARY: Base Fee Plan Review Surch7arge SflC SRC % SAC Units Subtotal } VALUATION $136,000 $1,067.25 MISCELLANEOUS $533.63 Total Fes $68.60 $900<00 100 1 p P29C '^?6p GapV ?y V $1,923.50 $4,492.38 CONTRACTOR: - Applicant -" ST. LIC OWNER: HbFFMAN HOMES INC 18349807 0009284 HQFFh1AN HOMES TNC 2214 E 117TH ST 2214 E 117TH ST BURNSVILLE MN 55337 BURNSVILLE MN 55337 (612) 894-9807 (612)894-9807 ? . hereby a?ek,n `i nfarmatkon Statw;tes a d ?n w? e?ac? 9k p???-oa?dn sCetie--tira??sCl?e ? cur;??c? `?:wxd wve c?ar[pl?+?,w??'?? -ile ? State'°af Mfl, , Ctag?an' ?"k•d1- y.. ? . ? ] , . CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ?414G1.3 ? O 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) ! /f ? 681-4675 ???/`? New Conslruction Reauiremenls RemodeVRenair Reauirements ? 5 regislered aite aurveys ? 2 copies of plan ? 2 copies af plans (include beam 8 window sizes; poured }nd. design, etc ) ? 2 site surveys (exterior additions & decks) ? t energy ralculations ? t energy calculations far heated adddions ? 3 capies of Iree preservation plan if iot platted afler 711193 required: _ Yas 'A_ No DATE: 4??oI94 COh1STRUCTION COST: r DESCRIPTION OF WORK: STREET ADDRESS: `Ei 5 7- L.&t?,-stAorLL- -c-. aaacC LOT Lz BLOCK 3 SUBD./P.I.D. #: to - t"{-}$ 5- 7-7-0 -0 3 ' t-f 6T z/ cL.%FF L.Y?Vrw 5*+wras PROPERTY Name: f-1oFRrtA.i,3 N?r-?es ?*?• Phone #: owNeR ..,, .,..Street Address: Zz,-{ E. i s-T a.tE? . CItY: 13 State: *At-3 Zip: 5533't - CONTRACTOR Company SANG 5treet Address: Phone #: License #: q Zg i State: Zip:. ARCHITECT! Company: M: urtCirw4YJt ENGINEER Name: LyLC Phone #- `13`t ' Iy`,P Registration Street Address: 90 U'- 2$ .". 210?-r 5"L rE p Clty: C HaJ NA?,E.J Sewer & water licensed piumber: `J E"' 2A- `' IA&uA change are requested once permit is issued. State: M.-I Zip:553t'i- Penalty applies when address change and lot I hereby acknowledge that I have read this application and state that the informaf is(cqrrect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ? Signature of Applicant: ? OFFICE USE ONLY " Certificates ot Survey Received V Yes No :01G, I 71996 Tree Preservation pian Received _ Yes _ No Aiii. OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ?02 SF Dwelling ? 07 4-piex 03 ? SF Addition ? OS 8-plex 0 04 SF Porch o -plex ` 0 05 SF Mis ? 10 _-plex .; •.: W,ORK TY p'-"1l 1' New ? 0 32 Addition o 34 Repair GENERAL INFORMATION Const. (Actual) ?-? (Allowable) jr, u UBC Occupancy X3 u-j Zoning P-k # of Stories ? length 3b Depth Gz' APPROVALS Pianning ? 11 Apt./Lodging o ? 12 Multi Repair/Rem. ? n l7 .G^r.,..vlArr.P.SAON ? ? 14 Fireplace ? 15 Deck ? &( ? 37 Demolition ?% ? 16 Basement Finish 17 5wim Pool 20 Public Facility Basement sq. ft. MClWS System ? Main level sq. ft. 1, ?yZ City Water sq. ft. Fire Sprinklered sq. {?. PRV sq. ft. Booster Pump sq. ft. Census Code. /OL Footprint sq . ft. SAC Code Census Bidg Census Unit Building Engineering Variance Oz. Permit Fee Valuation: $ 60c> Surcharge Plan Review License MCNVS 5AC p ` pc"lG - City SAC Water,Conn. I Water Meter / Acct. Deposit S/W Pertnit, S/W 5urcharge Treatment PI. Road Unit ? Park Ded. Trails Ded. Other Copies Total: % SAC ° SAC Units Alk - ' CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERIVIIT PERMITTYPE: BuzLoznG Permit Number. 029102 Date Issued: 10 / 2 8/ 9 6 SITE ADDRESS: P.I.N.: 10-17785-210-03 DESCRIPTION: ae."• zi- ?.' CS 17r5et 4454 4.AKESHORE TER LpT: 21 BLOCK: 3 CLIFF IAKE SHORES (1 OF 2 UNITS) ermit Type 5F [7WG ?grk Type NEW 'n'c?y, !Ia R-3 U-1 , k r?.ri,?;To e V-N PD 38 66 1 102 1 - PAM. ATTACH r R '?,''"" Pfr ? ;? d#;?c ?,????*?? ???- `r,? ;? 9"6? ?6„? mr '*? -? d ?2 ,? 4"i ,=xi ?':, rWa+'?' e;?.k4-' mb ?t§,i? ? ? ? 't;f ? '#1 :`-? _ Wr REMARKS: zERO Lor LxNe FEE SUMMARY: Base Fee $1,067.25 MISCELLANEOUS Plan Review $539.63 Total Fee Surcharge $68.00 SAC $960.00 SAC % 100 5AC Units 1 Subtotal $2,568.88 VALUATION $136,000 $1,923.50 $4,492.38 GONTRACTOR: - Applicant - 5T. LIC OWNER: H4FFMAN HOMES INC 18949807 0009284 HOFFMAN HOMES ZNC 2214 E 117TH ST 2214 E 117TH 57 ' BURNSVILLE MN 55337 BURNSVILLE MN 55337 (612) 894-9807 (612)894-9807 _ - I hereby aoknpw A?dg_e th6?rw? hdt?? ??ad -Ith?s in.f.o?ririatIn/i? , orx'ect aSg`t1 ag?^?? a?}tM-arJ k??PFAis'??b3e,8??'t?, <r? Mhx= u S?B?Wr E'5 a.t 1J `fkk'F Edt,?s,4:Ci .?? j{ o?f +i:5":',,,Xk?M' %riin+:t'•X'#??ch;?'<?:'X•:'+?:??o?9F?'t7F?Y•??:X'i:?:'F";FN,#:{r:v: ?:1r?F irrv OP E.i4it:lFlta (.'(a`ili:l.liiR: `.i TL:.II1.i'NAl. W(7,' t.:t ItnTc F 1DNE31':)Ea TIi4!=.': 1214008 r NFN'iLir. ;'I(IFI'?4f-1hd Fi(.1MG'^ [P!C . e25r;. ? Ir>, '. TI=..d. ?C;.: ^r,??l`?'L.:??i C. 44_'?c (.I::I-. 225.0 9t10. 4454 '_!:==Nf; 'rETiR 4,¢9i?•:38 I y0411 Rr:ar•'r.r! CL t'Itiqi.:iia, : s"c.i w,, 7(a ..'-?FF: N„ 7d.^-tNCY .... (9?:..y1?(?:;:'9F:: P? ?', 76PQY'i; ;t ": tF'-F>Y'?y.,:.';'.1nii:ti l?Snl A4' J•i(•ni +i`)?)F f W? • CITY OF EAGA.N 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMI6 1-4675ATION (REStDENTIAL) fol c0?p .P? New Constrvclion Reouiroments Remodeln?eoalr Reavirements i i . ? 3 registered a%e aurveys ? 2 coples of plan ? 2 copies of plans (include beam B window sizes; Doured Ind, design; elc.) ? 2 site surveys (exterior additions & decks) ? 1 energy calculaliane ? t energy calculalions for healed addilions ? 3 copies ot tree preservalion plan R lot plaHed aRer 7l7/93 required: _ Yes if No DATE: a I?° I ae CONSTRUCTION COST: 134, p oo (M)4CL, ?2c,q 4 J,_iewk) -F ; DESCRIPTION OF WORK: STREET ADDRESS: `? 4!?-q LAv-6 sN? -L-&aa-4cE LOT Z? BLOCK -3 SUBD./P.I.D. #: kO ' t *?$ 5 '2 -10- °j 1 DaPLSK N CeT Z7- C,LIFf• LI"lCsa ?jHnaltS .' PROPERTY Name: +1oFPr-c+?Q kor-kg- ,?-?• Phone #: $9`k-`?$°-i OWNER us nnn Street Address: 6' CItY: State: mkJ Zip: S533't CONTRACTOR Company: SANG _ Phone #: Street Address: License #: 4Zg? City: State: Zip: ARCHt7ecT! Company: M;,,,?-r?oar.n L?es?6? Phone #: `13`t' ENGINEER Name: Lyt-L- Tc? ? Registration #: Street Address: 5..i rE --ll2t o Clty: C .{pJ NAS6E.J State: M-i Z(p; 553t"4- Penalty applies when address change and lot Sewer & waler iicensed plumber: UJE''' 2.A" change are requested once permit is issued. I hereby acknowledge that I have read this appiication and state that the inf aCon i c rrect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ? Signature of Applicant: OFFICE U5E ONLY Certificates of Survey Received Tree Preservation Plan Received _ Yes No _ Yes _ No OCI 171996 BUILDING PERMIT TYPE OFFICE USE ONLY 0 01 Foundation ? 06 Duplex 0 p'?102 SF Dwelling ? 07 4-plex o e 0 03 SF Addition o 08 8-plex 0 0 04 SF Porch ? 09 12-plex ? 0 05 SF Misc. 0 10 _ fe?t'J o WORK TYPE ? ??L? - • +?? ,;w Li n ? ?F 11 Apt./Lodging ? 16 Basement Finish 12 Multi Repair/Rem. ? 17 Swim Pool 13 Garage/Accessory o 20 Public Facility 14 Fireplace ? 21 Miscellaneous 15 Deck C'OT ,,o?31 New ? 33 Alterations nnove ,, 0 32 Addition ? 34 Repair ? 37 Demo i ion GENERAL INFORMATION ConsL (Actuaq ? Basement sq. ft. 4 MC/WS System ? (Allowabie) ,L-?? Main level sq, ft. ? City Water UBC Occupancy 2 3?i sq. ft. Fire Sprinklered Zoning P-b sq. s ft. ft PRV Booster Pump # of Stories length ?S q. sq. . ft. Census Code. laa Depth ? Footprint sq . R. SAC Code or ? Census Bldg Census Unit APPROVALS nwF?v??K?«n+•r?el: .. . .. .t . Planning : Building Permit Fee " Surcharge Pian Review ;., { ?lLicense MCNVS 5AC ' City SAC Water Conn. Water Meter Acct. Deposit S/W Permit, SMf Surcharge Treatment PI. Raad Unit Park Ded. Trails Ded. Other Copies Totai: _ Engineering Variance Valuation: $ ??? , or ? ? ? /?ZG57 % SAC SAC Units 10:13 6129344305 PqIIJNETONI<A UESIGId r EXTERIOR?E?IYELOPF AVERqGE °U" COMI'llTATION PAGE 07 FWNER • ----•-. ---W nn rr 51TE ADDRESS: 1I PHONE: CON7RACTOR: Yto±rn1?(? -u0V?1FS PIAN # C1?.a3k ??E_??pn" Determine wor•king square footage of each 1. Total exposed wall area...,, }FS`j?, ? sq. ft. x .lI 2A?07- 2. Tota1 roof/ceiling area .... sq. ft. x .026 = 42.,7? Tota1 exposed wall area above fioor=?? ?,2. a." b ' 7otat wall rrindow area ......... . Total ..... door area.. """" "••••••••••.•.. . 1? 3 d Tot T Sliding glass door, area.......... , ..... ............. . a ..... P ? ea .. .................• L. f TOtdl wdll framing area aver:a e 10% ........ 9 ) .................. ... . 7ota1 . " " " rim Joist area " ' •?•••••-•••-•..., 9• h net .. wa11 area above floor ................ • ...... ............ . , •••-.... ? . I _,.. ....... _Wall area a6ove floor ............ ... .................- .. ?vall area a6ove floor ' ' """"' • • • • • .• • J- frame .. wdll drea at foundation .............. ................ .... Total exposed foundation area= k- Totat foundaCion window area.,.,,,. 1• Total net foundation area ahove grade ............ ..? - - ??-'_-5----._ Determine "u" value (e•9• window, door, a. 173 , 3 x b. '2X „U x „u„ ., " X „u„ e • x f. 1?O`I? IS x s- IZ3?S,?1 x n. i, ? •. k, of each wall segment each separate wall section) C??_3j _ •?5.--_.?..._._.= V (?,,.?-._ „U„ I L = CP ?Us X -------- -lul, ? g U I - ' X "U" 1. cS2.,-7lrs, x??u" , ?j ( Q s` 1 ?T_ 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . To t a 1 = =V75 If item 03 is the sa;! aS• or less than itei, ?ntentuofaSBCm6006h(l ? 995 10:13 6129344305 a. toTAL exvosco RaWcaiLIHa uceuu?rrais: MINNETONKa DESIGN PAGE 08 ToC+) axp034d rool/ca111nrt area........ (p2 !q ft ' j) Total fkyllyht araa...... ' sq ft x "0" " k) Totat roof/ca111nq Pr+ning arna (Avera s '• ft •"tl„ ?JZ?- • M ` .?.? qe q x 1). Total net Insutated • ? • ro0f/cOl l Tnq area...... sq . fC x "U" h 4. • TOTAL }) tb ru 1) 33. ? tP 1f toeal of s!I is the same as, er less than if2, you havn met the intent of 24CAR 1.16008 JA emd 0. ' " ' . ,, ' . ACTEFPATE BUILDING fiNVELOPE OESlCk . Yo utTllxn th* total envalope sys tem mthod.•the values esta6]•Ished 6y thq sum of ltonis E3 and 14 shal) nat ba grnater than thn suoo'of ttess 11 and !2. . . ?1. ' t 2_ . ? • , . ' 3• . + b. ? . - . , . , . ` , 995 10:13 6129344305 . h1INNETONKA DESIGN * LINEAL FEET EXPpSEO WAGL BLOCK:,(p-rjls, KNEE: WALKOUT: 3? FULL 1: 1{,p7,}S E'U[.L 2: FIREpLACE: AIM: BLOCK ; KNEE: WALKOUTt E'ULL 1; FULL 2: FIREPLACE; RTH: {(611c? 2Ca4tv ?+it II ,9 ,S? 2?aCp CpikZ pATIO DOORS: J?z ZI ?J2 3Q50 I `? g? BASEHEVT UI3ITS: zc?4o li 4?,?3 ?,Gs SKYLIGHTS: ! 27.3 SQUAbtE FEET FjCpOSED WALL ABEp X .5 .II 82,15 x 5 ? x 8 a 30? x 8 = I33"7, 2- x 8 - x = x 1 =ILo? I{s SQUARE FEET ERPOSED C£Ii,ING I(9Z(,p? ,° ?,t 1 WINDOWS: DOORS: PAGE p9 ?N? HOFFMAN HOMES, INC. 2214 Enst 117tk Stmet Telephone I3ttrnsville, MN 55337 (02) 894-9807 Fa CONTRACTOR ?' 9284 x (612) 894-9878 q (tD l4y Mr. Joe Voels City of Eagan 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) ? Block 3 , Cliit' Lake Shores, as were used on Lot(s) , ) ?, Block v, Cliff Lake Shores. None of the structural building compone/nts, HVAC, plumbing or electrical will change from engineered drawings dated IG/lZ(?'[i6- . Sincerely, ?---- Patrick C. Hoffman President PCH/jem pcWeagftr r I . " L 2 P- BL CITY USE ONLY SUBD. ? na,c- RECEIPT #: ? ? Y?el DATE: 11115 k 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612)681-4675 Please compiete for: ? singie family dwellings ? townhomes and condos when permits are required for each unit New construction Add-on fumace Y Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: //? /L/" cJ( FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge .50 v TOTAL ,? SITE ADDRESS: '/`7' J6 4,610L' r_Jk/Df'GL ?L?IC/'l"/7C`L OWNER NAME;1'4DPf7Wi"I N PHONE #: 9 `?gVI INSTALLER STREET ADDRESS: : ' ; ' CITY: (fiki STATE: ZIP: ? D PHONE #: ( Y ? g CITY USE ONIY L ? BL ? RECEIPT #: 66 LV SUBD. DATE: VL/ 1996 MECHANICAL PERMIT (RE5IDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 6814676 Please complete for: ? single family dwellings / ? townhomes and condos when permits are required for each unit ? New construction Add-on furnace _ Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: b - 14' V FEES ? Minimum Fee: Add-on/Remodel (existing residence only) ? HVAC: 0-100 M BTU Additional 50 M BTU ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge TOTAL SITE ADDRESS: -/?-s7 ? XIIALT OWNER $ 20.00 24.00? 6.00 1 !Vl- .50 ?7 ? PHONE #: b IO?a] INSTALLER STREET ADDRESS: `'te 4 CITY: PHONE #: STATE:& ZIP: ?7 Y ? CITY USE ONLY , L ? BL 3- Y SUBD. dL- tIv 7996 PI.UMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3630 PILOT KNOB RD EAGAN, MN 55122 (672) 681-4675 RECEIPT #: & D el ? 5 DATE: 19 / , Pfease compiete for: ? single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES F,AC_F1 t14.. I4IA4 Shower 3.00 x 1 = 3;00 Water Closet 3.00 x Bath Tub 3.00 x 2 = 6.ae Lavatory 3.00 x 4 = 12.bb Kitchen Sink 3.00 :c / o = 3,0 Laundry Tray 3.00 ;c / _ .b6 Hot Tub/5pa 3.00 :c = Water Heater 3.00 :< Floor Drein 3.00 :< 1 = 3.oa Gas Piping Outlet " minimum -1 3.00 x 9.vb Rough Openings 1.50 ;< i. sb Water Softener 5.00 x = Private Disposal " Dakota Cty. license 65.00 = (new and refurbished systems) U.G. Sprinkler " home under const. 3.00 = ANerations * to existing 20.00 = Water Tum Around 20.00 STATE SURCHARGE .50 TaTAL 53. C-0 SITE ADDRESS: 4452 LoK???cvec- -7Z&"c? OWNER INSTALLER NAME: 1V#_:CJ-J,4'v1Gq C-- STREET ADDRESS:?I 959 JNAGJN4-?? KO CITY: E,4&AAJ STATE: ?A-1) ZIP: 55122- PHONE #: (4/2 ) 457,- 15'67 d"? ? cirr use oNLr ? ? g? ? RECEIPT #: (/ /? ?Cv?9CP SUBD. ? A Ag- v DATE: 1996 PLUMBING PERMIT (RESIDENTIAL) CITY aF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings • townhomes and condos when permNs are re quired for each unit FIXTURES EACti tLQ. TOTAL Shower 3.00 x -3 = 9.60 Water Closet 3.00 x 73 = Bath Tub 3.00 x 3: ? Lavatory 3.00 x / ,oa Kitchen Sink 3.00 ;c 3.ati Laundry Trey 3.00 ;c Hot Tub/Spa 3.00 :c = Water Heater 3.00 :< ! _ ,Qo Floor Drain 3.00 ;c ! = S.oa Gas Piping Outlet' minimum -1 3.00 ;c Rough Openings 1.50 ;< _ Water Softener 5.00 x _L = S? Private Disposal ' Dakota Cty. license 65.00 = (new and refurbished systems) U.G. Sprinkler " home under const. 3.00 = Alterations • to exisung 20.00 = Water Tum Around 20.00 STATE SURCHARGE .50 TOTAL to Z. SO SITEADDRESS: 4,4$4- 7a/24Gc OWNER IlJ INSTALLER NAME: w? Z??-- MEGU'a AJIG4<?, STREET ADDRESS: ?g59 51'14wNEDr- /`O cmr: E4e',4,0i STATE: "!&.) ZIP: 5S/ZZ PHONE #: ( G17, ) 4$2- /5'G ?? i I SUBD__(? /f?d U?.v7' L.? B ? -?'_?-r- 13EW RBCEIPT # RECEIPT DATE 9 n1?9 7 DATE [ Z ql ? To sos owrrER e.?-?-- PLEASE BE ADVISED THAT THERE I3 A FEE SHORTAGE ON THS AB(7ilE ELECTRICAL IN3TALLATION IN THE AMOUNT OF $ 35 ' ?-u!:_??' 0 - 30 AMP CIRCUITS = / 100 AM P CIRCUITS = 7 0 - 100 AMP SERVICE _ 101 - 200 ANP SERVICE _ yG? TOTAL FEE nuE = i 3 Z - LESS E'EE RECEIVED TOTAZ, E'EE SHORTAGE DUE = > ? PERMIT # y0-)-- 3 3?995' ORIG RECEIPT # RECEIPT DATE PLEASE RETURN A COPY OF THIS FORM WIT& YOUR REMITTANCE. THANR XOU !- °C1 ° S b SUBD NEW RECEIPT II RECEIPT DATE DATE ? TO .ros OWNER PLEASE BE ADVISED THAT THEBE IS A FEE SHORTAGE ON THE ABOVE ELECTkICAL INSTALLATION IN THE AMOUNT OF $ ?? SHORTAGE MUST BE PAID WITHIN 14 DAYS. ?tEMARKS ? 0- 30 AMP CIBCUITS = snO 31 - 100 AMP CIRCUITS = 0 - 100 AbIP SEBVICE _ 101 - 200 AMP SEBVICE _ PE_RMIT # ORIG RECElPT ll RECEIPT DATE ` tp PLEASE RETURN A COPY OF THIS FOBM WITH YOUR REMITTANCE. ? t?,?.? ? I/YLJL7. ^ I /A7 THANK YOU ! ?'?'` 7 City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ?----------------- Q?Cey'zUie I I FoQ j Permit #: I ? Permd Fee: v O' I I ? Date Received: I ? I ? I Staff: ? I ------------------' 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Oate: ' w D SiteAddress: "L-1.'59' g/ Tenant: Suite RESIDENT I OWNER Name:CLl4 Uj,{(,(J SYLCY'QS ? vU.kA('10W.Q.S Phone: g4 ? WzCC '?CA 'vi , Address / Ciry / Zip:1 l r Applicant is: _ Owner _?L Contractor TYPE OF WORK Desc(ption of work: l V' 4)(V Y'QN ? w l YtGl.d? ? ?`1 ?'' ,?,,v? C? Construction Cost: ?tP?'i'w? • MuIG-Family Building: (Yes?,__ / No __j CONTRACTOR Name:? P??n Ilowcipai. TW z License Address:oq(Po 3(.L0L(UCLk 1?-N • f`? (OD State: Zip: 9?)33 Cit na l/lt CQ ' - y: I x YO Phone:qe) 0-1 cn ' v u'l ContactPersorr. n1ctA4' &JA<<Ar COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 EnOrgy COde . Residential Ventilation Calegory 1 Worlcsheet • New Energy Code Worksheet CatEgOry Submitted Su6mitted (4 SubmissiOn type) • Energy Envelope Calculalions Su6mitted 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: `psldered to;b'e;pu(iltc'?forma#iqn ,iPortions of ,->. NOTE: P/snsand suppoafing,documepfs ftiat?you sutir"nit"a.re+c'o" , fbe inforination may be;classrhed as non.publre,?flyou,piovrde specrfJc r'?e"`asonA that woultl permrtrffYe I hereby acknowledge that this intortnation is complete and accurete; ihat ihe work will be in coniormance with the ordinances and codes of the Ciry of Eagan; that I understand this is not a permit, but only an appiication tor a permit, and work is not ro start without a percnit; that the work will be in accordance wRh the approvetl plan in ihe case ot work which requires a review and approval of plans. xU(.W1(A SC.{/Q( 2 t"'Q t- x dC71A,, c.?C?-i-S(•-- ApplicanYs Printed Name ApplicanYs Signature Page 1 of 3 CER TIFICA TE OF SURVEY LEGAL DESCRIPAON: Lots 21 and 22, Block 3, CLIFF L.4KE SHORES, according to the plat thereof, \ \Q?? ? ? \ / Dakota County, Minnesota Too of /rons @ Offsets rop of Block = Uaries (see, qraphic) i , Lowest Floor = Varies (see graphic) 10.00' Offset 904.65 Garage Floor = Varies (see graphic) 70.00' Offset 91345 GRAPHIC SCALE izo o io zo w 10.00' Offset 906.23 i 10.00' Offset 905.0 ? mmmmi (siz.zs Tcl ( W FEET 912.09 TC ??((''?? ?' ?i?? 1 inch = 20 ft. (913.70) 901.7 ??/ TF?Q \\\„/ ? I Lb ? Ll?' i 972.2 (913.57 Dfi /y 930.0 Denotes Sonitory Sewer Service Invert ? \ TC) ? i / ? \ tC ?G/ ? B y ??,,? ? / AzooSS °j ? 913.42TC j ?.! ' ? E???u EIi1ItiG I?EP'i: 865.0 denotes exisfing elev. (865.0) denofes proposed elev. denotes surface droinage °A sroo ti q? ? ? i ? • Denotes rron monument found + 0 lo' % 1tiryl n '?s ? S Denotes )ron monument set o a? O ? ? "'I / 0 ? m o o? ir Beorings bosed on assumed dotum. 914.2 60%,h p / p? .,o? ?,?p6^p. p \ ? a? o I hereby certify thot this survey was prepared O by me or under my direck supervision and Yhat i 1lb ? (915 70) CNI' l am o duly Registere : i , Land? Surve}ror under the & lows of the State o,?finneso,td. 9?`? 0 t'ooo 905A ?oQ ?e`'oAe c0??q? ^°o (90360) rh? ? ? Mortin J. Weber, R.L.S. Date i °F?? •9 V .? ?p p< ? ati? r 1 / \ ? Registratron No. 12043 9040 oa< 913.3 DO ? 0O? v ?0`pA¢ REQUESTED BY.r? ? ./ ? ?. %•? ? s ?8? HOFFMAN HOMES /NC. N? O L \-j i q ? ,ytK ? ? . Weatwood Professiona/ Services, lnc 74180 West Trur,k Hwy. 5 ccer, Prairie, MP/ 55344 (612) 937-5750 906.3 ? Lots 21 & 22, Block 3 63L20-21.0W3 Use BLUE or BLACK Ink . r-____----'-------� I For Office Use � � 4`--'-� I I � Permit#:_� j ��y 0� '"�� 1 Permit Fee: o�}� I 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 i Staff: i 2015 RESIDENTIAL BUILDING P RMIT APPLICATION Date: ��' ��5� SiteAddress: �� '�� '�""` Unit#: �,.�. _ ; Name:�.�.��fl�Y� � LQ.��L,...u .,,��.oi1�__�,�,.a�,,��,.,,�,.._.�..�.. Phone:�,,�,.��..�.�.�,...,��,A..�.�.a..�..�� G � F�esid��#1 ; j i Q��;r � Address/City/Zip: �'� �� Applicant is. Owner Contractor Description of work: W r✓�� KK �� ; Typ+@ Qf 11�IQ�k � � ' � Construction Cost: Multi-Family Building: (Yes /No� � � � � Company: �t,-Vlt�� Vtf.�� [��.G�o 1' �hc, Contact: ��s ��'( r��. ��---..�....,��.,�,.�� , �/� �U Sul�z ��'- ��'�'�' � � � Address: �� G1� �7w�� s� City: C an�ractor � r �' £ State:�Zip: �Sy�� Phone: 7�3�SS� �an'�� Email: �� arn�.I��iuy��0".I•� �� License#: �c �0� 7�.3 Lead Certificate#: ,�..��.��.��.�.� �,.a.�r..�. _��.��...,.M�..�.�.�_...�x��,��.,,.�,.�.�..�.�.�.�„�_,,,,.�,w...�.,�.,. �.��.�„�„�.��.��.,...,��„��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? � Yes No If yes, date and address of master plan: � Licensed Plumber: Phone: � � Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: � Fire Suppression Contractor: Phone: N�T�':P��S a�d 5u��o�t��g dvr.u�er�#s t�t�}�o�r��ar�e ccrr�c�re�l�be�J�c%��►r�#i��. l�cr�or�s o�' � t�€rn��r�a.��r b��lass��ed as�ron p�rb��i��o�pro�ide s�ec��reas�r�s tl�at�►►c��d p�r�#�he Ci�ta � con��d��le t��t tl�e are t�a�►e�c�f�. �� CALL BEFORE YOU DIG. Call Gopher State One Cafl 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.clopherstateonecall.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 Minnesota S t Building Code must be completed within 180 days of permit issuance. "�---•�---_-- X �u�� rr�(��'°i'�s-� x Applicant's Printed Name Appli s Sign ture Page 1 of 3 Use BLUE or BLACK Ink r-----------------+ i For Office Use � ; � �j � City of �� , Permit#: � � � �:�; � Permit Fee:�� 3830 Pilot Knob Road � �— � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I � Fax: (651)675-5694 I Staff: I � I 2015 RESIDENTIAL F�UILDING PERMIT APPLICATION .�.� S'.f�z Z Date: � �� S �� Site Addre��Z� �� -��c.1�� '��`� �"� ��"�� Unit#: ,�u� �.�.,��r.�..�....�,,.��.�,,�.��.�.�.,�.��,�,��. �� ,��.��,..w � Name: ��'�� °� Phone: 'F�S�'rld@11#/ �/ �> /� �?Wt�E�I' Address/City/Zip: y7 S�- �'1 �� l�J"t.I�dwvL �-t i-d� cc. C� � � .�S/Z� Applicant is: Owner Contractor ' Description of work: J l��r �,Ty�3e 0��1�(?rk� � /, � Construction Cost: /�� ` �� Multi-Family Building: (Yes /No� � �� Company: ��x c� ��v� �"""��"'�o l ,�c. Contact: ��fis �Ya�`'�-d„�-, � � Address: �� j��-�`5S�'�A � �� /`� '�� 3� City: fa��/Z%�7.c1'ti C��'�1 aC'��D1' State:�Zip: �-Sy�% Phone:iG3-'S.S6-o�t,f� Email: 1��1��.1L.��,F,�C.�'t../�a�� ' License#: ��v 6 G�7 �!� Lead Certificate#: 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? � Yes No If yes, date and address of master plan: � Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: 1VOT�:Pl�l�S c'ii?#��1�3/10l'tl#��dOCtliil�l�itS t�?c�`j+OtJ Sklbtlki�'e�!'8 COI?S!`C��'@d t0',b@�Ttlibl�'C 1'!?ft?f►�?r��'1Q►1. P0�0►?S.:O� ' t�e tia�'arinat�on�ay be cla�si�etl as non-perbli�.��i y�a�r prrrr��d�e�peci�ic r�;�sr�rr�f�a#wai�{�1 per��t��ie G'��y t� 'co�rcl�de i�i�at tJ�� a�e�ra�e.,se�►e�t�.: 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 Minnesota St e uilding Code must be completed within 180 days of permit issuance. x ��5 ��GC.�.�� X -�'`--- Applicant's Printed Name App c s Si ature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA139342 Date Issued:10/19/2016 Permit Category:ePermit Site Address: 4452 Lakeshore Ter Lot:22 Block: 03 Addition: Cliff Lake Shores PID:10-17785-03-220 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Jane E Nordin 4452 Lakeshore Ter Eagan MN 55122 (651) 503-9511 Prior Lake Heating & A/c 16584 Pebble Brook Ct Prior Lake MN 55372 (952) 447-8110 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA165731 Date Issued:11/18/2020 Permit Category:ePermit Site Address: 4452 Lakeshore Ter Lot:22 Block: 03 Addition: Cliff Lake Shores PID:10-17785-03-220 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Jane E Nordin 4452 Lakeshore Ter Eagan MN 55122--247 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature